Doctors’ Notes



Roseola (or, Sixth Disease) is caused by the human herpes virus and related to the herpes simplex virus.

HHV does not cause cold sores or genital infections; it causes a high fever and rash.

Roseola is most common in children ages 6 months to 3 years old, and is much less common in children over 4 years.


Roseola normally starts with a fever above 103 degrees, mild upper respiratory symptoms (runny nose and congestion), some fussiness, and decreased appetite. The fever lasts on average 2-3 days but can last up to a week. Typically the fever ends suddenly, then a pinkish flat or raised rash will appear on the body, commonly starting in the trunk, then extending to the neck and arms, but it can also spread to the entire body. These spots will blanch (turn white) when you press on them. The rash is usually not itchy and lasts about 2-4 days.


RoseolaFever reduction is important to keep your child comfortable during this time. Depending on your child’s age, you can use acetaminophen or ibuprofen to control the fever.  Aspirin is not recommended for children. It’s also important to prevent dehydration by encouraging fluid intake, especially with a high fever present. Because Roseola is a virus, antibiotics will not help fight it.


Roseola is spread via droplets through the noses and throats of infected persons while talking, coughing, or sneezing. It can be spread even if a person has no symptoms. There is no way to completely prevent the spread of roseola, but good hand washing will help prevent the spread of any virus.


Keep your child home until fever free for 24 hours and when feeling better.

Call Us If:

  • Your child is very sleepy or lethargic
  • Your child is not voiding well or has not peed in 8 hours
  • Your child is extremely irritable
  • The rash is getting worse or changes in appearance
  • Your child has new or worsening cold symptoms
  • You have any questions or concerns

Call 911 If:

Your child has seizures, unconsciousness, jerking or twitching of arms and legs, possible loss of bowel/bladder control.

Jonette McClelland, a Certified Registered Nurse Practitioner, is a former Kids Plus Provider.