Roseola is an acute disease of infants and young children that is characterized by a high fever and skin rash.

Causes, incidence, and risk factors

The disease is common in children 3 months to 4 years old, most commonly in those between 6 months and 1 year. It is caused by a virus, called human herpesvirus 6 (HHV-6), although similar syndromes are possible with other viruses. It occurs throughout the year. The incubation period is 5 to 15 days. A fever lasting 3 (sometimes up to 7) days generally precedes the appearance of the rash, and may be as high as 105 degrees Fahrenheit. Febrile Convulsions may occur when the fever is high.

Roseola begins with a high fever that generally responds well to acetaminophen. Between the 2nd and 4th day of illness, the fever falls dramatically, and a rash appears (often as the fever falls) on the trunk and spreads to the limbs, neck, and face. The rash lasts from a few hours to 2 days.


  • An abrupt onset of high fever  
  • Irritability  
  • A rash erupts on the 4th or 5th day of the illness (the fever has usually resolved or is dropping by the time the rash appears)

Signs and tests

  • A history of roseola in the community  
  • A physical exam of rash  
  • Swollen Lymph nodes on the back of the scalp (occipital nodes)


There is no specific treatment. The disease usually resolves without complications. Measures should be taken to control a fever. Acetaminophen and cool sponge baths may be given. If Convulsions occur, call your health care provider, or go to the closest emergency room.

Expectations (prognosis)

The vast majority of children with roseola fully recover.


  • Febrile seizure  
  • Encephalitis (rare)  
  • Aseptic Meningitis (rare)

Calling your health care provider

Call your health care provider if your child has a fever of 103 or higher, even if your child appears relatively well.

Go to the emergency room or call the local emergency number (such as 911) if Convulsions develop.


The viruses that cause roseola are spread either through fecal-oral contact or via airborne droplets. Careful handwashing can aid in the prevention of spread of these viruses.

Johns Hopkins patient information

Last revised: December 7, 2012
by Sharon M. Smith, M.D.

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