Roseola: Signs, Symptoms and Treatment

Roseola is a common and generally mild viral illness that can affect babies and toddlers. It’s sometimes called sixth disease or roseola infantum, and it’s usually not something you need to worry too much about.

Roseola typically causes a few days of fever that’s sometimes followed by a roseola rash, but in mild cases, your child may not have any symptoms at all.

Read on to find out more about what roseola is, learn about the symptoms and get some tips that will help you assess whether it’s time to visit the doctor.

What Is Roseola?

Roseola is a viral infection caused by two common strains of the human herpes virus. Babies and toddlers are at the greatest risk of contracting roseola because they have not yet built up antibodies that help fight the viruses that can cause it.

Older children and adults can also get roseola, but this is rare because most people have it as children before starting nursery school, and it’s very unusual to catch it twice.

The rash and other roseola symptoms might alarm you at first, but don’t worry – if your child comes down with roseola, they will usually be back to normal within a week or so.

The Symptoms of Roseola

If your child has roseola, it can take one or two weeks for visible signs to appear. Although it's possible you’ll see no symptoms at all, some of the first symptoms to appear could include:

• Fever. A sudden fever, which is often higher than 39 degrees Celsius. Fever associated with roseola usually lasts around 3 to 5 days.

• Swollen eyelids

• Swollen glands in the neck

• A runny nose

• A sore throat and/or cough.

• Mild diarrhoea 

• Decreased appetite.

The Roseola Rash

After 3 to 5 days, the fever and other symptoms described above (if your child has any) will usually clear up, and a roseola rash may appear.

The roseola rash looks like a cluster of pinkish red spots, patches or bumps, and may be harder to see on darker skin tones. The rash may start on your child’s chest, back and abdomen, and it can then spread to the neck, face and arms.

It may look a little scary, but the rash isn't normally itchy or uncomfortable, and it usually fades away within a day or two.

The rash caused by roseola should fade if you roll a glass over it. If it doesn’t, seek urgent medical attention for your child as this could be a sign of meningitis.

How to Care for Your Child Who Has Roseola

Roseola usually clears up by itself within a week after the symptoms start appearing. There’s no special treatment for roseola, but there are some things you can do to look after your little one while they are feeling poorly:

• Make sure your baby or toddler gets plenty of rest if they are feeling unwell

• Keep your little one hydrated by giving them plenty of water to drink, or by breastfeeding or bottle-feeding regularly if your baby isn’t weaned yet.

• If it’s warm in your home, try to keep your little one cool, for example by using lighter bedding and blankets.

• Ask your doctor what medication you can give to lower your little one’s fever if it’s making them uncomfortable.

When to See a Doctor

Roseola usually disappears on its own, but see a doctor straight away if your child

• is less than 3 months old with a fever of 38 degrees Celsius or more, or is 3 to 6 months old with a fever of 39 degrees Celsius or higher

• has a fever that lasts five days or more

• has a rash that persists beyond three days

• seems lethargic

• won’t drink water or formula, or refuses to breastfeed

• has a convulsion (febrile seizure) as a result of a spiking fever (these are rare and usually harmless, but contact your child’s doctor right away to be on the safe side)

• has a weakened immune system

• has a rash that doesn’t fade if you roll a glass over it (this could be a sign of meningitis, which requires urgent medical attention).

Is Roseola Contagious?

Roseola is contagious. It can spread in the same way as a common cold – through saliva (for example, by sharing a cup with someone who is infected) or through respiratory droplets (so through coughs or sneezes).

Experts aren’t sure exactly when the contagious period starts, but it may be possible to spread the disease before any symptoms appear.

To try to help prevent your child from getting roseola, keep them away from people you know are infected.

To avoid your little one spreading roseola

• wash your child’s hands frequently

• get your little one to sneeze into a tissue and throw it away immediately

• don’t let anyone else use your child’s cups, plates or cutlery

• disinfect surfaces often.

The Bottom Line

Like many common childhood sicknesses, roseola is not usually anything to be worried about, and it’s unusual for roseola to return if your baby or toddler has had it once.

A little home care is usually all that’s needed, and your child will be their old self again before you know it.

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