Roseola

• Alternative Names

  Exanthem subitum; Sixth disease

• Causes, incidence, and risk factors

  The disease is common in children ages 3 months to 4 years, and most common in those ages 6 months to 1 year. It is caused by a virus called human herpesvirus 6 (HHV-6), although similar syndromes are possible with other viruses.

  Roseola occurs throughout the year. The time between becoming infected and the beginning of symptoms (incubation period) is 5 to 15 days.

• Symptoms

  The child may have a runny nose, sore throat, and eye redness.

  A fever usually occurs before the rash appears. It lasts for 3 (sometimes up to 7) days. The fever may be as high as 105° Fahrenheit, and it generally responds well to acetaminophen (Tylenol).

  Between the second and fourth day of the illness, the fever drops and a rash appears (often as the fever falls).

  • The rash starts on the trunk and spreads to the limbs, neck, and face. The rash is pink or rose-colored, and has fairly small sores that are slightly raised.
  • The rash lasts from a few hours to 2-3 days. It usually does not itch.

  Other symptoms include:

  • Irritability
  • High fever that comes on quickly
• Signs and tests
  • Physical exam of rash
  • Swollen lymph nodes on the neck (cervical nodes) or back of the scalp (occipital nodes)
• Treatment

  There is no specific treatment. The disease usually gets better without complications.

  Take steps to control a fever with acetaminophen (Tylenol) and cool sponge baths. If convulsions occur, call your health care provider, or go to the closest emergency room.

• Expectations (prognosis)

  Most children with roseola fully recover.

• Complications
  • Aseptic meningitis (rare)
  • Encephalitis (rare)
  • Febrile seizure
• Calling your health care provider

  Call your health care provider if your child:

  • Has a fever that does not go down with acetaminophen (Tylenol) or ibuprofen (Advil) and a warm bath
  • Continues to appear very sick
  • Acts irritable or lethargic

  Go to the emergency room or call the local emergency number (such as 911) if your child has convulsions.

• Prevention

  The viruses that cause roseola are spread either through fecal-oral contact or via airborne droplets. Careful handwashing can help prevent the spread of these viruses.

• References

  Leach CT. Roseola (Human Herpesviruses 6 and 7). In: Kliegman RM, Behrman RE, Jenson HB, Stanton BF, eds. Nelson Textbook of Pediatrics. 18th ed. Philadelphia, Pa: Saunders Elsevier;2007: chap 253.

Review Date: 11/2/2009

Reviewed By: Neil K. Kaneshiro, MD, MHA, Clinical Assistant Professor of Pediatrics, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.