Is Roseola Contagious?

Roseola may be caused by several different viruses and it is contagious. Roseola infantum is skin rash accompanied by fever, usually in infants.

Roseola infantum is a common childhood disease caused by human herpesvirus 6 (HHV-6). Roseola infantum patients are typically 9- to 12-month-old infants who develop a high fever, sometimes accompanied by a seizure (febrile seizure). After three days, the fever quickly resolves and a rash that looks like measles appears.

Symptoms of roseola infantum include:

• Sudden onset of high fever (104°F/40°C)
• Fever lasts 3 days
• Seizures occur in about 15% of patients
• Fever disappears quickly and a mild, pink, measles-like rash (morbilliform exanthem) appears
• Rash is either small, pale, pink bumps, or flat, red areas 1-5 mm in diameter
• Rash may last two days
• Red bumps can occur inside the mouth on the soft palate and the base of the uvula (Nagayama spots)

Other symptoms that may accompany the fever and/or rash include:

• Irritability
• Crying more
• Eating and drinking less
• Vomiting
• Cough
• Diarrhea
• Feeling unwell (malaise) 
• Bulging fontanelle (“soft spot” on a baby’s head)

Human herpesvirus 6 (HHV-6) causes most cases of roseola in infants. 

Other causes of roseola include:

• Human herpesvirus 7 (HHV-7)
• Enteroviruses (coxsackieviruses A and B, echoviruses)
• Adenoviruses 
• Parainfluenza virus type 1

Roseola may be caused by several different viruses and it is contagious. It is transmitted from person-to-person through respiratory secretions or saliva. People can get the infection from sharing eating utensils or cups with an ingested person, and children can easily spread the virus by sharing toys. 

Roseola is contagious even if a rash is not present and a person is usually contagious until about 2 days after the fever goes away.

Roseola infantum is diagnosed with a physical exam and tests may include:

• Blood tests
  • Complete blood cell (CBC) count
  • Blood cultures
• Urinalysis
• Virologic studies 
• Cerebrospinal fluid (CSF) examination by a spinal tap

A seizure workup may be recommended in cases where a fever is accompanied by a febrile seizure.

There is no medical treatment or cure for the human herpesvirus 6 (HHV-6) infection that causes roseola infantum. Most of the time, roseola infantum is a mild, benign condition and it goes away on its own. 

The goal of treatment for roseola is to relieve symptoms and may include fever reducers such as acetaminophen (Tylenol). 

The rash that accompanies roseola usually does not require treatment.