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Southern Cross Medical Library

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Roseola (roseola infantum or sixth disease)

Roseola is a common viral illness affecting babies and young children, usually between six months and three years of age.  Approximately 90% of children will have been infected with roseola by the age of two years.

Also known as roseola infantum or sixth disease, roseola is usually a mild illness causing fever and skin rash. Treatment normally involves relieving symptoms while the illness runs its course.      

Transmission and incubation period 

The majority of cases of roseola (about 85%) are caused by a virus called human herpesvirus 6 (HHV-6), though it can also be caused by human herpes virus 7 (HHV-7).  These viruses are in the same family as the viruses that cause cold sores and chicken pox. 

Roseola is spread from person to person in respiratory fluids and saliva, or by direct contact with infected persons or items.  It is commonly spread by coughing and sneezing. Once infection with the virus has occurred, the incubation period (the time until symptoms appear) is between nine to 10 days.  It is not known exactly how long a person is contagious for once they have been infected with the virus.    

Signs and symptoms

The first symptom of roseola is typically a high fever (up to 40ºC). The fever lasts for between three and five days. Often this is the only noticeable symptom, though some children may have a sore throat and/or a runny nose.  They may also be tired and irritable.

After about five days, the fever starts to subside and a rash appears on the body. The rash usually starts on the chest, back and abdomen, then spreads to the arms and neck. It usually has flat pink spots or patches, though these may occasionally be raised. The rash lasts about three days, and then fades.


Usually a diagnosis is based on clinical signs and symptoms, and by ruling out other causes for the symptoms.  A blood test can confirm the diagnosis but this is not done routinely when roseola is suspected.  


Most cases of roseola require only supportive treatment.  As the condition is caused by a virus, antibiotics will be of no benefit in combating it.  Supportive treatment includes: 

  • Paracetamol to relieve fever
  • Rest
  • Tepid baths for high temperature
  • Adequate fluid intake.


Roseola does not usually cause complications.  However, some infants may experience seizures (febrile convulsions) if their temperature becomes very high. In rare instances the illness can cause swelling of the lymph nodes, liver and spleen. Very rarely, inflammation of the brain (encephalitis) can occur.   

Further information and support

For further information and support about roseola contact your GP, practice nurse, or:
PlunketLine - Freephone: 0800 933 922 (24 hrs a day, 7 days a week)
Healthline - Freephone: 0800 611 116 (24 hrs a day, 7 days a week) 


Anderson, K.N., Anderson, L.E. & Glanze, W.D. (eds.) (2006) Mosby’s medical, nursing, & allied health dictionary (6th ed.) St. Louis: Mosby-Year Book, Inc.
Carson De-Witt, R. (2006) Roseola. The Gale Encyclopedia of Medicine, Third Edition. Jacqueline L. Longe, Editor. Farmington Hills, MI. Thompson Gale.
Ngan, V. (2013) Roseola. Hamilton: New Zealand Dermatological Society –

Last Reviewed – 12 July 2013
Go to our Medical Library Index Page to find information on other medical conditions.