Infant Illnesses | Spotlight on roseola

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"Roseola is a very common viral infection that causes high fever and a typical skin rash". (Getty Images)
"Roseola is a very common viral infection that causes high fever and a typical skin rash". (Getty Images)
  • If your child has developed a rash and is also battling a fever, he or she may have roseola. 
  • It's so common that most children will have developed it by the time they reach preschool. 
  • A local expert shares the symptoms and what parents need to know to keep the viral infection in check. 

    Having a newborn baby is overwhelming enough and if they show signs of illness, it can be really scary.

    Parent24 put together a series on common infant illnesses to guide you when your baby is sick.

    Together with a local paediatrician or doctor, we'll help you decide when to panic. It's probably not as serious as you think, but let's be sure.

    Catch more instalments of our #infantillness series here

    A typical concern: 

    "What is this red rash my 6-month-old has suddenly sprouted? She's also been burning up with a fever. I'm not sure what this could be."


    Your baby might have roseola. 

    According to paediatrician, Dr Iqbal Karbanee, roseola is "a viral infection that causes high fever and a typical skin rash". 

    The paediatrician, who is also the CEO of the telehealth service, Paed-IQ BabyLine, says that roseola is so common that "the majority of children entering preschool have been exposed and most likely have developed immunity". 

    "Most children will have been infected by the age of two years," he told Parent24

    What causes roseola

    Dr Karbanee explains that roseola is caused by "two strains of virus from the Herpes family of viruses" and commonly occurs in infants at the six-month mark. 

    "Babies under the age of six months are relatively protected by antibodies that they have acquired from their mother in the womb. These antibodies fade by six months of age. The commonest age infants are affected is from six months to 15 months," he advises. 

    Also read: Spots and rashes on baby? Here's what's normal and when to visit a doctor

    Symptoms to look out for: 

    According to Karbanee, typical symptoms of roseola include:

    • high fever,;
    • loss of appetite;
    • rashes;
    • general ill feeling.

    Similar conditions

    While common, Dr Karbanee tells Parent24 that the symptoms of roseola "are very non-specific signs", adding that "it is virtually impossible to tell them apart in the early stages of the illness". 

    However, the "distinctive" rash (see image below)  is what sets it apart from other infant illnesses, he says. 

    baby with rash

    "Only if and when the rash appears can a diagnosis be made with any certainty," Dr Karbanee says, warning that not all cases of roseola will include the rash. 

    "It is important to note that not all children with roseola will develop the skin rash. In fact some infants may just have a fever for a day or two and then recover," he says. 

    How long will it last?

    "The fever last between three and five days and, if the rash does appear, it will take about a week to fade completely," Karbanee assures.  

    How is it spread?

    In terms of transmission, Dr Karbanee says roseola spreads quite easily, typically through respiratory droplets. 

    "These are spread via coughing, sneezing, saliva and sharing closely," he says. 


    "The vast majority of cases can be treated at home," Karbanee advises. 

    And while you may be concerned about your baby's skin, Karbanee warns that your focus should be on managing their fever. Parents can do this by keeping their baby hydrated and ensuring they stay home. 

    Read Dr Karbanee's tips for making a rehydration solution here

    When to call the doctor

    "If the fever persists for more than three days, the rash changes and looks like bruises, baby is refusing all fluids and looks lethargic and ill, then it is best to get a medical opinion," he says. 

    Also see: All about fevers

    Tips and advice for parents

    "While roseola is a very common childhood illness, the spread can be limited by keeping the child at home till the fever and/or skin rash subsides. Parents should always ensure they and the caregivers are equipped to deal with fever and understand how to bring baby’s body temperature down correctly. Parents should have a thermometer at home as well as suppositories for temperature control". 

    You can also ask a doctor or paediatrician directly via Health24 here: Ask an Expert


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