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When Your Child Has Roseola

Infant with roseola rash on neck, arms, and torso.

Roseola is a common viral infection in children under age 2. It is also known as sixth disease. Roseola is not a major health problem. It goes away on its own without treatment. But you can help your child feel better.

What causes roseola?

Roseola is most often caused by a virus in the human herpes virus family. It is spread by droplets in the air when an infected person sneezes or coughs. It most often affects children ages 6 months to 2 years. 

What are the symptoms of roseola?

Symptoms happen in stages. The stages are:

  • Stage 1. Your child will have 3 to 7 days of high fever, such as 102°F ( 39°C) to 104°F ( 40°C). Your child is likely to feel cranky and uncomfortable during the fever. While your child has a fever, he or she can spread the virus to other children.

  • Stage 2. A rash appears on the neck down to the torso after the fever goes away. The rash is red and can be raised or flat. It may spread to the face or arms and legs. The rash does not hurt. It tends to get better and worse over 3 to 4 days. Your child may feel cranky or itchy during the rash stage of roseola. He or she is not contagious during the rash stage.

How is roseola diagnosed?

There is no test for roseola. It can’t be diagnosed until the fever has gone away and the rash has shown up. Your child’s healthcare provider will examine your child. In some cases, a child may have some tests to check for other causes of fever.

How is roseola treated?

Roseola will go away on its own. To help your child feel better:

  • Make sure he or she gets plenty of rest and fluids.

  • Give acetaminophen or ibuprofen to help relieve fever or discomfort, if advised by the healthcare provider. Do not give ibuprofen to a baby age 6 months or younger, or to a child who is dehydrated or vomiting often. Don’t give your child aspirin. Giving aspirin to a child with a fever could cause a serious condition called Reye syndrome.

  • Give your child an anti-itch medicine (antihistamine) if the rash is itchy.

Returning to daycare

Once the fever has been gone for 24 hours, your child is no longer contagious. So even if your child still has the rash, he or she can go to daycare.

What are long-term concerns?

Roseola is rarely a problem for children who are otherwise healthy.

Call your child’s healthcare provider 

Contact the healthcare provider right away if your child has any of these:

  • Fever (see Fever and children below)

  • A seizure caused by the fever

  • Fever that returns after rash has gone away

  • Rash that gets much worse or does not begin to fade after 4 to 5 days

  • Rash that lasts longer than several weeks

Fever and children

Use a digital thermometer to check your child’s temperature. Don’t use a mercury thermometer. There are different kinds of digital thermometers. They include ones for the mouth, ear, forehead (temporal), rectum, or armpit. Ear temperatures aren’t accurate before 6 months of age. Don’t take an oral temperature until your child is at least 4 years old.

Use a rectal thermometer with care. It may accidentally poke a hole in the rectum. It may pass on germs from the stool. Follow the product maker’s directions for correct use. If you don’t feel okay using a rectal thermometer, use another type. When you talk to your child’s healthcare provider, tell him or her which type you used.

Below are guidelines to know if your child has a fever. Your child’s healthcare provider may give you different numbers for your child.

A baby under 3 months old:

  • First, ask your child’s healthcare provider how you should take the temperature.

  • Rectal or forehead: 100.4°F (38°C) or higher

  • Armpit: 99°F (37.2°C) or higher

A child age 3 months to 36 months (3 years):

  • Rectal, forehead, or ear: 102°F (38.9°C) or higher

  • Armpit: 101°F (38.3°C) or higher

Call the healthcare provider in these cases:

  • Repeated temperature of 104°F (40°C) or higher

  • Fever that lasts more than 24 hours in a child under age 2

  • Fever that lasts for 3 days in a child age 2 or older

Online Medical Reviewer: Michael Lehrer MD
Online Medical Reviewer: Raymond Kent Turley BSN MSN RN
Online Medical Reviewer: Rita Sather RN
Date Last Reviewed: 8/1/2019
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