Roseola

Roseola is a mild illness caused by a virus infection. Roseola has a sudden onset and short duration, and it most commonly affects young children. Roseola is most common in children 6 to 24 months of age. The average age at onset is around 9 months. Less frequently, older children, teens, and (rarely) adults may be infected.

What virus causes roseola?

Roseola is primarily caused by a virus called human herpesvirus 6 (HHV-6) and less commonly by human herpesvirus 7 (HHV-7).

How is roseola spread?

Roseola is spread from person to person, most likely by transfer of oral secretions. Roseola is not very contagious. The incubation period between exposure to the virus and onset of symptoms is nine to 10 days. Humans are the only natural hosts for HHV-6 and HHV-7. Unlike other viral infections, roseola occurs throughout the year without seasonal variation.

What are roseola symptoms and signs?

The signs and symptoms of HHV-6 (or HHV-7) infection vary depending upon the age of the patient. Infants and toddlers routinely will develop sudden symptoms with a sudden onset of a high fever that lasts for three to five days, irritability, bulging "soft spot" on the head (fontanel), swollen glands in the front or back of the neck, runny nose, puffy eyelids (due to swelling with fluid), and mild diarrhea. Within 12-24 hours of the fever breaking, a rash rapidly appears. Older children who develop HHV-6 (or HHV-7) infection are more likely to have an illness characterized by several days of high fever and possibly a runny nose and/or diarrhea. Older children less commonly develop a rash as the fever abates.

How high can the fever go with roseola?

The fever can be quite high. The fever averages 103.5 F (39.7 C), but it can go up as high as 106 F (41.2 C).

What is the treatment for the fever of roseola?

If the fever is not causing the child to be uncomfortable, the fever need not be treated. It is not necessary to awaken the child to treat a fever unless instructed to do so by a health-care practitioner.

If you wish to treat the fever, acetaminophen (Tylenol and others) can be used to lower a fever. Aspirin should never be used for fever in children or adolescents.

A child with a fever should be kept comfortable and not be overdressed. Overdressing can cause the temperature to go higher. Bathing with tepid water (85 F or 29.5 C) may help bring down a fever. If a child develops shivering during the bath, the temperature of the bath water should be raised. Never sponge a child (or an adult) with alcohol; the alcohol fumes may be inhaled, causing many problems.