Difference Between Measles and Roseola

Measles and Roseola are two distinct infections caused by different viruses; the key difference between them is that Measles is a highly contagious infection caused by the measles virus whereas Roseola (exanthema subitum) is a common disease of young children, caused by human herpes viruses, HHV-6, and HHV-7, which are referred to collectively as Roseolovirus.

What is measles?

Measles is a highly contagious infection caused by the measles virus. Initial signs and symptoms of measles include very high fever, respiratory symptoms including cough, runny nose, and red eyes. Two or three days after the initial symptoms, small white spots may appear on the mucosa of the mouth which are known as Koplik’s spots. Typically a reddish, maculopapular rash which usually starts on the face and back of the ear lobes spreads to the rest of the body. This begins three to five days after the initial symptoms. The incubation period is around 10–12 days and the symptoms last about 7–10 days. Complications may occur in about 1/3 of the cases due to the involvement of the other organs and may include diarrheal illness, blindness, inflammation of the brain (encephalitis), pneumonia, etc.

Measles is an airborne disease which spreads easily through respiratory droplets of an infected person. It may also be spread via direct contact. Measles can be easily diagnosed by its typical appearance. However, in atypical cases, antibody levels in the serum against the virus are important in the diagnosis. It is a self-limiting condition and cured by the body’s immune system, and it will ensure long-term immunity. Isolation to prevent the infection and supportive care is important during the illness. Antibiotics may be used if a secondary bacterial infection such as pneumonia is present. It is a vaccine-preventable disease and recommended by WHO for infant immunization programs.

Figure 1: Measles virus attaching to an epithelial cell

 Although it is well-established that the measles virus causes this illness, there are people who deny this fact. Measles can be fatal for malnourished children and immuno-compromised children such as infected with HIV.

What is Roseola?

Roseola is a viral infection that usually affects children by age 2. However, it has been known to occur in eighteen-year-olds, whose manifestations are limited to a mild rash following a febrile illness. The symptom begins with a sudden high fever which can cause rarely febrile fits with the sudden rise in body temperature. However, in many cases, the child appears normal despite very high temperatures. When the fever is subsiding, a red rash appears which begins on the trunk, spreading to the legs and neck. The rash is non-itchy, lasting up to 1 to 2 days. As complication, liver dysfunction has been reported in rare cases.

Figure 2: Electron micrograph of HHV-6, which can cause Roseola

Roseola is self-limiting illness and correcting of the hydration during high fever is important. Paracetamol could be given to reduce the temperature. Aspirin should not be used due to the risk of Reye’s syndrome which is a serious form of encephalitis-like condition occurs with NSAIDs in children. These are no effective vaccines against this infection.

What is the difference between Measles and Roseola?

Definition of Measles and Roseola

Measles: Measles is an infection caused by the measles virus, which causes an illness displaying a characteristic skin rash known as an exanthem. Measles is also sometimes called rubeola, 5-day measles,  or hard measles.

Roseola: Roseola is a common disease of babies or young children, in which several days of very high fever are followed by a rash.

Characteristics of Measles and Roseola


Measles: Measles is caused by the measles virus

Roseola: Roseola is caused by HHV-6 and HHV-7

Age Group

Measles: Measles has no age specification.

Roseola: Roseola typically affects children between 6 months to 2 years of age.

Fever Pattern

Measles: Measles has a very high fever with associated upper respiratory symptoms.

Roseola: Roseola child looks normal despite very high temperatures during the initial stage.

Koplik’s Spots

Measles: It is typically seen with measles.

Roseola: Not associated with roseola.

Pattern of the rash

Measles: measles rash begins behind the ears and face.

Roseola: In roseola, the involvement of the face is not seen.


Measles: Measles is associated with a serious complication such as encephalitis and pneumonia.

Roseola: Roseola is a milder disease with no associated serious complication.

Vaccine Prevention

Measles: Measles is vaccine preventable

Roseola: Roseola does not have an effective vaccine.



roseola. (n.d.) Gale Encyclopedia of Medicine. (2008). Retrieved August 192015 from http://medicaldictionary.thefreedictionary.com/roseola

Measels. (n.d.) Gale Encyclopedia of Medicine. (2008). Retrieved August 19 2015 from http://medicaldictionary.thefreedictionary.com/Measels


Image Courtesy:

“MeaslesOsmosisPic5” By Osmosis – Osmosis https://en.wikipedia.org/wiki/File:Measles.webm (CC BY-SA 4.0) via Commons Wikimedia

“Hhv-6 (1)” By Bernard Kramarsky (Photographer) – by the National Cancer Institute (Public Domain) via Commons Wikimedia