Diseases & Conditions

Roseola

Roseola is a generally mild infection that usually affects children by age 2. It occasionally affects adults. Roseola is extremely common — so common that most children have been infected with roseola by the time they enter kindergarten.

Two common strains of the herpes virus cause roseola. The condition typically causes several days of fever, followed by a rash.

Some children develop only a very mild case of roseola and never show any clear indication of illness, while others experience the full range of symptoms.

Roseola typically isn't serious. Rarely, complications from a very high fever can result. Treatment of roseola includes bed rest, fluids and medications to reduce fever.

The most common cause of roseola is the human herpes virus 6 (HHV6), but the cause also can be another herpes virus — human herpes virus 7 (HHV7). These herpes viruses are related to, but different from, those that cause cold sores and genital herpes.

Like other viral illnesses, such as a common cold, roseola spreads from person to person through contact with an infected person's respiratory secretions or saliva. For example, a healthy child who shares a cup with a child who has roseola could contract the virus.

Roseola is contagious even if no rash is present. That means the condition can spread while an infected child has only a fever, even before it's clear that the child has roseola. Watch for signs of roseola if your child has interacted with another child who has the illness.

Unlike chickenpox and other childhood viral illnesses that spread rapidly, roseola rarely results in a communitywide outbreak. The infection can occur at any time of the year.

Roseola can cause a high fever — 103 F (39.4 C) or higher. Call your child's doctor anytime your child has a fever greater than 103 F (39.4 C). The doctor may want to examine your child to rule out more serious causes of fever.

Your child could have a convulsion (febrile seizure) if his or her fever becomes too high or spikes too quickly. However, usually by the time you notice your child's high temperature, the threat of a possible seizure has already passed. If your child does have an unexplained seizure, seek medical care immediately.

If your child has roseola and the fever lasts more than seven days, or if the rash doesn't improve after three days, call your child's doctor.

If your immune system is compromised and you come in contact with someone who had roseola, contact your doctor. You may need monitoring for a possible infection that, for you, could be more severe than it is for a child.

Roseola can be difficult to diagnose because initial signs and symptoms are similar to those of other common childhood illnesses, such as the common cold or an ear infection. If it's clear that no cold, ear infection, strep throat or other common condition is present, your doctor may wait to see if the characteristic rash of roseola appears. Your doctor may tell you to look for the rash while you treat your child's fever at home.

Doctors confirm a diagnosis of roseola by the telltale rash or, in some cases, by a blood test to check for antibodies to roseola.

Seizures in children
Occasionally a child with roseola experiences a seizure brought on by a rapid rise in body temperature. If this happens, your child might briefly lose consciousness and jerk his or her arms, legs or head for several seconds to minutes. He or she may also lose bladder or bowel control temporarily.

If your child has a seizure, seek emergency care. Although frightening, fever-related seizures in otherwise healthy young children are generally short-lived and are rarely harmful.

Complications from roseola are rare. The vast majority of otherwise healthy children and adults with roseola recover quickly and completely.

Concerns for people with weak immune systems
Roseola is of greater concern in people whose immune system is compromised, such as those who have recently received a bone marrow or organ transplant. They may contract a new case of roseola — or a previous infection may come back while their immune system is weakened. Because they have less resistance to viruses in general, immune-compromised people tend to develop more severe cases of infection and have a harder time fighting off illness.

People with weak immune systems who contract roseola may experience potentially serious complications from the infection, such as pneumonia or encephalitis — a potentially life-threatening inflammation of the brain.

Most children recover fully from roseola within a week of the onset of the fever. With your doctor's advice, you can give your child over-the-counter medications to reduce fever, such as acetaminophen (Tylenol, others) or ibuprofen (Advil, Motrin, others). However, don't give aspirin to a child who has a viral illness because aspirin has been associated with the development of Reye's syndrome, which can be serious.

There's no specific treatment for roseola, although some doctors may prescribe the antiviral medication ganciclovir (Cytovene) to treat the infection in people with weakened immunity. Antibiotics aren't effective in treating viral illnesses, such as roseola.

Like most viruses, roseola just needs to run its course. Once the fever subsides, your child should feel better soon. However, a fever can make your child uncomfortable. To treat your child's fever at home, your doctor may recommend:

• Plenty of rest. Let your child rest in bed until the fever disappears.
• Plenty of fluids. Encourage your child to drink clear fluids, such as water, ginger ale, lemon-lime soda, clear broth or an electrolyte solution (such as Pedialyte or sports drinks such as Gatorade and Powerade) to prevent dehydration. Remove the gas bubbles from carbonated fluids. You can do this by letting the carbonated beverage stand or by shaking, pouring or stirring the beverage. Removing the carbonation will mean having your child avoid the added discomfort of excess burping or intestinal gas that carbonated beverages may cause.
• Sponge baths. A lukewarm sponge bath or a cool washcloth applied to your child's head can soothe the discomfort of a fever. However, avoid using ice, cold water, fans or cold baths. These may give the child unwanted chills.

There's no specific treatment for the rash of roseola, which fades on its own in a short time.