Roseola

About roseola

Roseola is a mild infection that usually lasts for three to five days. It's most common in babies aged between six months and three years. Most children will have had the virus that causes roseola at some point during their childhood. It doesn't usually have any long-term effects.

Roseola is also called roseola infantum, or the medical term exanthem subitum is sometimes used. It's also occasionally referred to as sixth disease or three-day fever.

Symptoms of roseola

It can take between five and 15 days after getting the virus before your child has symptoms. He or she may have:

  • a high temperature (about 40 °C), which comes on suddenly
  • a non-itchy rash that consists of flat, red spots (about 2 to 3mm across) with some raised areas, which usually starts on your child’s body and may spread to his or her face, legs and arms
  • a sore throat
  • diarrhoea
  • a runny nose
  • a cough

Children with roseola generally appear well during the fever, with a normal appetite and behaviour, although they can sometimes be a little more irritable than usual.

These symptoms may be caused by problems other than roseola. If your child has any of these symptoms, see his or her GP for advice.

Complications of roseola

A roseola infection can cause your child to have a febrile convulsion (seizure). You may need to call for emergency help if the seizure lasts for more than five minutes or if your child injures him- or herself. If the seizure lasts less than five minutes you should contact your GP or seek medical advice after the seizure has ended.

Rarely, an infection can occur in your child’s brain (encephalitis), or his or her liver may become inflamed (hepatitis). However, roseola is rarely life-threatening if your child has a healthy immune system.

Causes of roseola

Roseola is mainly caused by the human herpes virus 6 (HHV-6), or sometimes the human herpes virus 7 (HHV-7). The viruses can be passed on through infected saliva, for example by kissing or putting something in your mouth that has the virus on it.

Diagnosis of roseola

Your GP will ask about your child’s symptoms and examine him or her. Your child may need to have a blood test, but this is unlikely.

Treatment of roseola

There is no specific treatment for roseola, but you could try the following self-help measures to ease your child’s symptoms.

Self-help

If your child has a fever, you can treat it with over-the-counter painkillers such as paracetamol or ibuprofen. The National Institute for Health and Clinical Excellence (NICE) advises not to give your child a dose of both paracetamol and ibuprofen at the same time, or in alternating doses. Young children may need to take a liquid form, depending on their age.

Always read the patient information that comes with your medicine and if you have any questions, ask your pharmacist for advice.

Special considerations

If your child has a weakened immune system

Roseola is a more serious condition if your child has a weakened immune system, for example if he or she has HIV/AIDS, is taking medicines that suppress their immune system, or has had an organ transplant. The roseola virus can remain in your child’s body, come back and be life-threatening, but this is rare. If your child has a weakened immune system, your GP may prescribe him or her antiviral medicines.

Prevention of roseola

The roseola virus is found in the saliva of an infected person. It can be passed on through kissing or sharing objects that you eat or drink from, such as a cup. It can also be spread through droplets in the air, such as when an infected child coughs or spits.

You can't completely prevent the roseola infection spreading as you may only realise your child has it when he or she develops the rash, by which point they may have already passed the virus on to others. However, encouraging your child to wash his or her hands regularly can help.
 

How can I tell if my baby has roseola and not measles?

Answer

It may be difficult to tell the difference between roseola and measles, as they both cause fever and a rash. You should watch how the rash develops and if your child becomes unwell, contact her or his GP.

Explanation

If your child has roseola, the rash usually starts on his or her body and then spreads to their legs, arms and face. The rash is made up of red-coloured spots and lasts for a few days. It doesn’t usually itch and goes white if you put pressure on it.

Measles is a similar condition, which causes a high temperature and rash. The measles rash is red and usually starts on your child’s face and neck before spreading across his or her body and lasts about a week. Your child may also have small white spots (Koplik's spots) on the inner side of the cheeks in their mouth, red, watery eyes and a cough.

If your child has a rash and is unwell, you should contact his or her GP for advice.

My son has roseola - what should I do if he has a febrile convulsion?

Answer

You need to take care of your child while he is having a febrile convulsion (seizure). If your son hasn’t had one before, it lasts longer than five minutes, or if he injures himself, you should call for urgent medical attention.

Explanation

If your child has a febrile convulsion you should try, if possible, to move anything around him so there is less chance of him hurting himself. Don't try to restrict your child’s movements by holding him down as this may cause injury and don't move him unless he is in danger. Stay calm and reassure your child as much as you can.

Don't put anything in your child’s mouth or give him food or drink until he has fully recovered. If you are able, put your child into the recovery position after the seizure is over.

Call for emergency help if your child hasn’t had a febrile convulsion before, if the seizure continues for more than five minutes, or if he injures himself. If your child has had a febrile convulsion for less than five minutes, you should seek advice from your GP, or the accident and emergency department of your local hospital.

How long should my child stay away from others to prevent the roseola infection spreading?

Answer

It isn’t usually necessary to stay away from others while your child has roseola. As it can take up to 15 days after your child gets the virus before he or she has symptoms, they may have spread the infection before you even know that he or she has it.

Explanation

You may not know your child has roseola until he or she gets the rash, by which point the virus may have already passed to someone else. The Health Protection Agency doesn't advise school children to stay away from others while they have the virus. However, encouraging your child to wash his or her hands regularly may help reduce the risk of them passing it on to others.

If you need more information, speak to your GP.