6th disease

Roseola in Children: Symptoms, Course, and Treatment

Roseola, also known as roseola infantum or exanthema subitum, is a viral infectious disease typical in early childhood, most often affecting children between 6 and 36 months of age. The causative agent is human herpesvirus type 6 (HHV-6), from which the disease gets its name.

Symptoms of Roseola

The disease begins with a sudden onset of high fever—often reaching 39–40 °C (102–104 °F)—without prior warning signs. The incubation period is about 5–12 days, during which the child carries the virus but may not show any symptoms yet.

The high fever usually lasts for around 3 days and may be accompanied by:

• Enlarged lymph nodes,

• Laryngitis,

• Diarrhea, fatigue, restlessness,

• And in some children, febrile seizures.

As the fever subsides, a characteristic pink, blotchy rash (exanthem) appears, primarily on the trunk and sometimes on the limbs. It typically does not affect the face. The rash is usually not itchy and fades within 2–3 days without leaving marks. In some cases, the illness presents only with fever and no rash.

Roseola in Adults

Although this illness most commonly affects children, adults can also become infected—especially if they have not encountered the virus before or have weakened immune systems. The course of illness in adults is similar: it starts with a high fever, followed by the appearance of a rash. Additional symptoms in adults may include:

• Marked fatigue,

• Loss of appetite,

• Sore throat,

• Swollen lymph nodes.

In adults, roseola may resemble the flu, and recovery may take longer—sometimes over a week. High fever during pregnancy can pose a risk to fetal development, so it is advisable for pregnant women to consult a doctor if they experience symptoms suggestive of roseola.

Treatment

Since roseola is a viral illness, treatment is primarily symptomatic. Key measures include fever and comfort managements as instructed here, ensuring adequate fluid intake, rest, and comfortable clothing. If febrile seizures occur, a medical consultation is necessary.

Transmission and Prevention

The virus is transmitted via droplets—such as saliva spread through coughing or sneezing. Roseola is highly contagious, particularly in groups of young children. A child may already be infectious during the incubation period, before any symptoms appear. Once the rash and other symptoms subside, the child is no longer contagious.

There is no vaccine for roseola. Prevention mainly relies on supporting natural immunity and maintaining a healthy lifestyle. The good news is that after the infection, the body builds lifelong immunity, making reinfection unlikely—though the virus remains dormant in the body, as with other herpesviruses.