What is roseola?
What causes roseola?
Who gets roseola?
How do HHV6 and HHV7 cause disease?
What are the common findings?
How is roseola diagnosed?
How is roseola treated?
What are the complications?
How can roseola be prevented?
What research is being done?
by Hal B. Jenson, M.D.
Chief, Pediatric Infectious Diseases
University of Texas Health Science Center
San Antonio, TX
by Charles T. Leach, M.D.
Associate Professor of Pediatrics
University of Texas Health Science Center
San Antonio, TX
Roseola, also known as "roseola infantum" or "exanthem subitum," is a viral infection
that is characterized primarily by a high fever and a rash.
Human herpesvirus type 6 (HHV6) and, sometimes, human herpesvirus type 7 (HHV7)
cause roseola. Both are members of the herpesvirus family of viruses.
Almost all children are infected during early childhood with HHV6 and HHV7, but
only about one-third of children develop signs of roseola. The peak age for developing
roseola is 6 to 15 months of age. More than 95% of cases occur in children younger
than 3 years of age.
HHV6 and HHV7 are transmitted from person-to-person by direct contact or by contaminated
secretions of the nose and the mouth. These viruses are spread through the blood
throughout the body, which causes the rash.
The majority of children with roseola develop a characteristic illness with a very
high fever (from 100F to 103F) for approximately three days, which is followed by
the onset of a rash the day that the fever resolves. In contrast to what is usually
expected with such a high fever, most children, during the fever, behave quite normally
and continue with their usual play activities. Some infants may become irritable
and have a decreased appetite. In classic cases, the rash typically appears within
24 hours after the fever resolves and then fades over one to three days; however,
only approximately 25% of infected children may actually develop the rash.
Roseola is diagnosed primarily on the characteristically high fever followed by
the development of the rash once the fever resolves. Unfortunately, this makes it
very difficult to diagnose roseola during the course of the fever because, typically,
there are no other symptoms.
There is a blood test that is available, but, usually, this is not used for diagnosis
because either the illness has resolved completely after a few days, or the diagnosis
can be made by the physician with some certainty because of the characteristic high
fever followed by the rash.
There is no specific treatment for roseola. Antibiotics are not helpful because
a virus causes roseola. Viruses cannot be treated with antibiotics. The disease
is usually mild with complete recovery. Fever should be treated with acetaminophen
The major complication of roseola in children is the development of febrile seizures.
During the time of the high fever, especially early in the infection, children may
have seizures that are caused by the very high fever. Febrile seizures occur in
2% to 3% of all children, and usually are a problem between 6 months and 3 to 4
years of age. Many cases of febrile seizures that occur only once in a child are
probably due to roseola.
A vaccine for roseola is not available. There is very little information on how
to prevent roseola; however, outbreaks are uncommon. The spread of roseola can be
prevented by minimizing exposure to children who have symptoms of the disease, and
by good handwashing after exposure to the disease.
Research is being conducted on the transmission of human herpesvirus 6 and to characterize
how the virus causes roseola.
About the Authors
Hal Jenson, M.D.
Dr. Jenson graduated from George Washington University School of Medicine in Washington,
He also completed a residency in pediatrics at the Rainbow Babies and Children's
Hospital of Case Western Reserve University in Cleveland, Ohio, and a fellowship
in pediatric infectious diseases and epidemiology at Yale University School of Medicine.
Dr. Jenson has an active research program on the biology of Epstein-Barr virus and
other human and non-human primate herpes viruses.
He is active in the general pediatric and infectious diseases teaching and clinical
activities of his Department and Division, is a co-editor of Nelson Textbook of
Pediatrics and of Pediatric Infectious Diseases: Principles and Practice, and authors
the book Pocket Guide to Vaccination and Prophylaxis.
Charles T. Leach, M.D.
Dr. Leach received his medical degree at the University of Utah School of Medicine
and completed his pediatrics residency as well as a fellowship in pediatric infectious
diseases at UCLA.
He is currently Associate Professor and Director of Research in the Department of
Pediatrics at the University of Texas Health Science Center at San Antonio.
Dr. Leach conducts scientific research in the areas of herpes virus infections,
pediatric AIDS, and infectious diseases among residents of the Texas-Mexico border.
Copyright 2012 Hal B. Jenson, M.D., and Charles T. Leach, M.D., All Rights Reserved
The information contained in these topics is not intended nor implied to be a substitute for professional medical advice, it is provided for educational purposes only. You assume full responsibility for how you choose to use this information.
Always seek the advice of your physician or other qualified healthcare provider before starting any new treatment or discontinuing an existing treatment. Talk with your healthcare provider about any questions you may have regarding a medical condition. Nothing contained in these topics is intended to be used for medical diagnosis or treatment.
By using this website, you accept the information provided herein "AS IS." Neither RemedyConnect nor the providers of the information contained herein will have any liability to you arising out of your use of the information contained herein or make any express or implied warranty regarding the accuracy, content, completeness, reliability, or efficacy of the information contained within this website.
RemedyConnect, Inc. has created this privacy statement in order to demonstrate our firm commitment to your privacy. The following discloses our information gathering and dissemination practices for this website: http://www.remedyconnect.com.
We do not acquire any more information about website visitors than is required by law or is otherwise necessary to provide a high level of service efficiently and securely. Our site's registration form requires users to give us contact information (e.g., their name and e-mail address) and demographic information (e.g., children's birth months, but not birth dates). We use customer contact information from the registration form to (1) send the user pertinent medical and parenting information and (2) allow your local health provider lists of who is registering on that provider's site as a parent/guardian, staff member, doctor, or visitor. Users may opt-out of receiving future mailings; see the choice/opt-out section below.
We use your IP address to help diagnose problems with our server and to administer our Website. Your IP address is used to help identify you and to gather broad demographic information.
Demographic and profile data is also collected at our site. We may use this data to tailor the visitor's experience at our site, showing them content that we think they might be interested in, and displaying the content according to their preferences.
Our site may use order forms to allow users to request information, products, and services.
We will respect your doctor's right to privacy. A doctor typically does not give his/her e-mail address to the parents/guardians of patients. We will not provide the e-mail addresses of doctor(s) in the local practice to users of their site without the doctor(s)' permission. Their site is restricted to use by whomever they wish, and they may deny access to their site to one or more prior users. In unusual cases, doctors may change their private site's access code and arrange for us to e-mail the new access code to approved users.
This site contains links to other sites. RemedyConnect.com is not responsible for the privacy practices or the content of such Websites. See Disclaimers.
We will provide individually-identifiable information about website users to third parties only if we are compelled to do so by order of a duly-empowered governmental authority, we have the express permission of the visitor, or it is necessary to process transactions and provide you services from our affiliates: Live Agent Answering Service, Digital Answering Service, Medical Answering Service and Pediatric Answering Service.
This site may make chat rooms, forums, message boards, and/or news groups available to its users. Please remember that any information that is disclosed in these areas becomes public information and you should exercise caution when deciding to disclose your personal information.
This site has security measures in place to protect the loss, misuse and alteration of the information under our control. For further information regarding our security, please contact us at email@example.com. If you have any concerns regarding the security of information, please do not provide any information to RemedyConnect, Inc. until you are comfortable with our security measures.
You may correct or update your User Registration information at any time, by visiting the User Registration section and providing your personal password that you set at registration. If need be, please email us at firstname.lastname@example.org.
Our site provides users the opportunity to opt-out of receiving e-mail communications from our partners or us, except communications approved by your doctor's practice office. To so opt-out, please email us at email@example.com. To be removed as a user, please email us at the same address. If need be, you may mail requests to us at RemedyConnect, Inc., 9200 E. Mineral Avenue, Suite 100, Centennial, CO 80112. Our telephone number is 303-793-0703.
If you have any questions about this privacy statement, the practices of this site, or your dealings with this Website, you can contact us by email at firstname.lastname@example.org or by mail at our address above.