What is roseola?

Roseola is a common illness caused by a virus. It mainly affects children between 6 months and 2 years of age. The disease is usually mild. Many children get roseola and recover without feeling sick.

What are the symptoms?

A child with roseola has a fever and their temperature rises suddenly, sometimes higher than 39.5°C (103°F). The rapid rise in temperature may cause a febrile seizure, also known as a fever seizure. Although a seizure can be very scary, it should only last a few minutes, and does not do any harm. Your child’s temperature should return to normal within 3 to 5 days.

About 24 hours after your child’s fever has gone away, the roseola rash develops. You will see small pink or red dots on your child’s neck, chest, and body. The rash may last for up to 2 days. One of the key features of roseola is that the rash appears after the fever has ended. In most other childhood illnesses, the fever and the rash happen at the same time.

Although your child may go back and forth between feeling comfortable and acting upset, they usually eat and drink normally. Your child may have other symptoms such as a runny nose, diarrhea, vomiting, and swollen glands in the neck. However, not all children have these symptoms.

When should my child see a health care provider?

You cannot be sure your child has roseola until the fever goes away and the rash appears. If your child has a high fever and no other symptoms, you can call 8-1-1 to speak with a registered nurse. The nurse may recommend that you make an appointment with your health care provider or if they think your child’s illness is serious, they may recommend you take your child to the emergency department.

If your child seems to become sicker, has a high fever, a stiff neck, or is extremely sleepy, listless or irritable, take your child to the nearest emergency department right away. These symptoms may indicate a more serious illness.

If your child has had a seizure, see your health care provider as soon as possible to rule out a serious illness. If you cannot reach your health care provider, take your child to the nearest emergency department.

For more information about febrile seizures, see HealthLinkBC File #112 Febrile seizures (fever seizures).

How does roseola spread?

Roseola is spread through saliva and tiny droplets of fluid from the nose and throat of infected people when they talk, laugh, cough, or sneeze. It is not known how long children with roseola can spread the disease to others.

What is the home treatment for roseola?

Caring for your child may include:

• Keeping them comfortable. Keep clothing light, just a shirt and shorts or a diaper
• Treating the fever. Your child should rest in bed until the fever is gone. If their temperature is high, give your child acetaminophen or ibuprofen*
  
  Acetaminophen (e.g. Tylenol^®) or ibuprofen* (e.g. Advil^®) can be given for fever or soreness. ASA (e.g. Aspirin^®) should not be given to anyone under 18 years of age due to the risk of Reye syndrome.

  *Ibuprofen should not be given to children under 6 months of age without first speaking to your health care provider.

  For more information on Reye syndrome, see HealthLinkBC File #84 Reye syndrome.

• Having your child drink lots of fluids. Fever dries out the body, so make sure your child drinks lots of fluids. Food is less important. If your child is hungry, then eating is fine; but if your child does not have an appetite, it is ok for them to miss a few meals

Antibiotics cannot cure roseola. If your health care provider prescribes them, it means that the fever might be caused by a bacterial illness.

Your child can return to social activities, such as going to daycare or visiting the playground, as soon as the fever and the rash are gone. If your child is recovering from roseola and is returning to daycare, tell the caregivers about the recent illness.