Motherhood isn’t easy and no one ever said it would be, right? Every now and then, a new surprise appears – and it’s not always a pleasant one, as is the case with infant roseola. Your baby is fine, playing, and suddenly you notice they’re feverish, lethargic, and looking unwell! There you go, they have a fever – but why?

Infant roseola is considered one more harmless illness that affects little ones and it usually appears with fever even before any rash develops. It’s most common in babies around 6 months old and can show up up to 3 years of age, with peak incidence at age 2. The disease is also known as sudden rash or sixth disease, because it’s another type of herpes – in this case, roseola is caused by human herpesvirus type 6 (HHV-6), or more rarely, by herpesvirus type 7.

The disease is transmitted through direct contact between children, through the air, bodily fluids, and even saliva when sharing personal items like cups or toys that go in the mouth. Since the first symptom is fever, it can be harder to diagnose in the first days. The pinkish rashes only start to appear about 4 to 5 days after persistent fever, and they only show up when the fever goes away.

Symptoms and Treatment for Infant Roseola

The main symptom of infant roseola is fever, which is the initial alarm letting parents know something isn’t right with their baby’s body. The incubation period for the disease is 5 to 15 days, so it can be hard to know where or when your baby was exposed, since the skin rash only appears after a while. Characteristic symptoms include:

  • High and sudden fever – It ranges from 38 to 42 degrees Celsius (100.4 to 107.6ºF), and is continuous. It can last up to 4 days and then disappear suddenly.
  • Mild diarrhea and loss of appetite – it’s common for the baby to seem more tired, with less energy, and not feel hungry during this time.
  • Pink rashes – When the fever starts to subside, small pink spots will appear on the baby’s body. They mainly start on the trunk and neck, and begin to fade away toward the extremities.

Because the pediatrician will not be able to diagnose roseola as soon as the fever appears, they will usually recommend that the baby be observed during the period when the spots are expected to show up as a precaution. If the fever doesn’t go away and the spots don’t appear as expected over the next 3 or 4 days, the pediatrician should be visited again for further evaluation.

As with all viral infections, there is no cure other than measures to reduce or relieve the most bothersome symptoms. On days of high fever, it’s best to keep the baby well hydrated by offering plenty of fluids. The use of antipyretic (fever-reducing) medication is also recommended if the temperature is very high, and remember that this process requires lots of patience, as your baby will generally be more irritable and fussy. Usually, roseola does not cause itching. However, should this symptom occur, the pediatrician may prescribe antihistamine creams to reduce discomfort.

To control body temperature, opt for lukewarm baths, light and comfortable clothing, and avoid using blankets or comforters even during cooler weather. Infant roseola will go away just as suddenly as it appeared, but your child should not have contact with other children during this time because it is contagious. That’s why it’s not advisable to send them to daycare or preschool until all symptoms have disappeared.

See also: Symptoms of Chickenpox in Children and Adults

Photo: Tom Simpson, Bethany Petrik