The sixth disease rash on a baby's stomach.
After a fever subsides, sixth disease will often cause a red rash.

What to Know About Sixth Disease

As parents, caring for our children is a value innate within us. We instinctively cater to each one of our child’s needs and make sure that they are free from any form of discomfort. That’s why parents are usually vigilant for the slightest signs of unease in our children. And perhaps, this is the same reason why we have a degree of familiarity when it comes to the common medical conditions that usually affect our children.

Fever is the general sign telling us that something is wrong with our child. This is also one of the commonly encountered red flags when it comes to childcare. Rashes, due to being somewhat observable with the naked eye, is another symptom that raises concern among parents. The underlying cause of both fever and rashes can be attributed to a multitude of reasons and factors. Thus, either of them could be related to several medical conditions. For this article, we will discuss a specific illness presenting both of these symptoms: the sixth disease.


What Is Sixth Disease?

Sixth disease, more commonly referred to as roseola and also known as roseola infantum and exanthema subitem, is a viral illness that usually affects children between the ages of six months to two years.

It was given the name sixth disease due to the previous observation that this was typically the sixth disease developed by children. Coincidentally, those who have shown signs of acquiring this illness managed to clear all symptoms on the sixth day.

On the other hand, it is rarely possible for adults to acquire this disease. Sixth disease is characterized by a sudden onset of high fever, which lasts three to five days. When the fever starts to settle down, it is followed by a development of a distinct rash. The flat, rose-pink, non-itchy rash usually lasts for another one to two days.

What Virus Causes Sixth Disease?

The sixth disease is commonly caused by two types of herpes virus strains: Human Herpesvirus 6 (HHV-6) and Human Herpesvirus 7 (HHV-7). These two, collectively known as Roseolovirus, belong to the same family of viruses known as the Herpes Simplex virus (HSV). However, they are not the types that cause genital herpes and cold sores, which the HSV is notorious for.

The primary mode of transmission for HHV-6 and HHV-7 is through respiratory droplets and secretions. Therefore, avoidance of infected individuals and having a regular handwashing routine is the best way to avoid acquiring this illness.

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Symptoms to Watch Out For

The initial symptoms for the sixth disease start with a sudden onset of fever ranging from 39C to 40C or 102.2F to 104F, which usually lasts for three to five days. When the fever starts to subside, a rash will follow. These rashes tend to last one to two days but may take longer before it completely fades.

Along with this pattern, the condition may be accompanied by one or more of the following symptoms:

  • Cough
  • Sore throat
  • Runny nose
  • Swollen lymph nodes in the neck area
  • Decreased appetite
  • Mild diarrhea
  • Swollen eyelids
  • Irritability in infants and children

The sixth disease is considered to be a mild illness. Not everyone infected by the Roseolovirus exhibited signs of illness, as their antibodies may have managed clearing up the virus even before the body starts to develop the initial symptoms. Also, for people who contract the virus, the majority of these cases do not create long-term repercussions for the individual.

However, due to the risk factors, this illness can develop complications, such as febrile seizures. One known risk factor for this disease is a compromised immune system.

Treatment and Care

This disease usually does not require professional intervention as it often goes away by itself. Also, there is no vaccine for sixth disease available at this time.

Most medical intervention focuses on its accompanying symptoms or presence of any risk factor, and on prevention of complications. Home treatment for the sixth disease also focuses on addressing the fever. Ibuprofen and acetaminophen are usually recommended to alleviate fever. Aspirin, on the other hand, must never be used on diseases of viral origin.


Should dehydration develop due to fever, increased oral fluid intake is encouraged, and oral rehydrating solutions may be given. Providing a sponge bath using warm water is optional, as there is little evidence suggesting that it helps to lower the fever.

As the rashes do not usually cause discomfort, further treatment is not necessary. However, should you notice any of the following complications, it is crucial to seek immediate medical attention:

  • The fever lasts beyond seven days
  • If the rashes do not gradually diminish after three days
  • Temperature is higher than 103F or 39.4C
  • If you notice any signs of febrile seizure
  • If the child or person who contracted the disease has a compromised immune system