Medical Conditions



Roseola (Human Herpesvirus 6 and 7)

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What is roseola?

A viral infection causing fever or rash in infants and children that primarily occurs between 6 and 24 months of age

What are the signs or symptoms?

  • High fever (above 103°F [39.4°C] measured orally, axillary, or rectally) lasting 3 to 7 days.

    • Fever may cause seizure activity.

    • Often, the child is not very ill when fever is present.

  • Red, raised rash lasting from hours to several days that becomes apparent the day the fever breaks (usually the fourth day).

  • Not every infected child will have fever and the rash; in fact, many children have no symptoms at all.

  • Human herpesvirus 7 may react with human herpesvirus 6 or cause infections with or without symptoms.

What are the incubation and contagious periods?

  • Incubation period: 9 to 10 days for human herpesvirus 6; incubation for human herpesvirus 7 is unknown.

  • Contagious period: After infection, the virus is present in the saliva on and off for the rest of a person’s life.

How is it spread?

  • Respiratory (droplet) route: Contact with large droplets that form when a child talks, coughs, or sneezes. These droplets can land on or be rubbed into the eyes, nose, or mouth. Most of the droplets do not stay in the air; they travel 3 feet or less and fall onto the ground.

  • Nearly all children have had human herpesvirus 6 infection by the time they are 2 years old; human herpesvirus 7 infection may occur later in childhood.

  • Most likely source of transmission to children is healthy adults. Saliva from three-fourths of adults without symptoms contains infectious virus.

How do you control it?

Use good hand-hygiene technique at all the times listed in Chapter 2.

What are the roles of the teacher/caregiver and the family?

  • Report the infection to the staff member designated by the child care program or school for decision-making and action related to care of ill children. That person, in turn, alerts possibly exposed family and staff members to watch for symptoms.

  • Inform parents/guardians about the nature of the illness and that, while the fever phase of the illness can cause concern, once the rash appears, the child is in the recovery phase.

Exclude from group setting?

No, unless

  • The child is unable to participate and staff members determine they cannot care for the child without compromising their ability to care for the health and safety of the other children in the group.

  • The child meets other exclusion criteria.

Readmit to group setting?

Yes, when all the following criteria have been met:

When exclusion criteria are resolved, the child is able to participate, and staff members determine they can care for the child without compromising their ability to care for the health and safety of the other children in the group.

Listing of resources does not imply an endorsement by the American Academy of Pediatrics (AAP). The AAP is not responsible for the content of external resources. Information was current at the time of publication.

The information contained in this publication should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.

Quick Reference Sheet from Managing Infectious Diseases in Child Care and Schools: A Quick Reference Guide.

© 2017 American Academy of Pediatrics. All rights reserved.

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