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June Russell's Health Facts


There is much misinformation out there about fever and what to do about it. What is a fever, and what actually causes it? Normal body temperature is 98.6 degrees F, but this is just an average. Some people are normally higher, and some normally lower. A fever is defined as a body temperature above 100.5 degrees F. Therefore, a body temperature of 99.5 degrees or 100 degrees F is not a fever and should not be a cause for worry in otherwise normal children. While fever is a cause for concern, it is rarely a reason for panic. Fever is only a symptom, not a disease, most often scary and annoying, but in most cases not dangerous.

The body temperature is controlled by the hypothalamus, a section of the brain that acts just like your household thermostat. That is, if the body gets too cold, the thermostat sends out instructions to warm things up, and if it gets too hot, the thermostat tries to cool things down. When the body is faced with an infection, it responds in a number of ways. In addition to making antibodies that kill the offending germs, it sends various white blood cells to the location of the infection, where they act very much like soldiers at a battle. They help the antibodies destroy the invaders. In addition, they are able to kill the offending germs directly. The number and types of these white blood cells are one of the things that your doctor measures when he does a blood count. Fever can be thought of as one of the body's normal responses to infection. Because of this fact, we may have to reconsider the need to treat fever.

The only reliable way to take a young child's fever is rectally. The new high tech ear canal thermometers are easy to use and remarkable fast, but they tend to read a little high. The under arm is also quite inaccurate.

Not all fevers need treatment. Most children with temperatures lower than 102 degrees generally do not feel all that bad, although earaches and sore throats may hurt. The increased body temperature may actually be beneficial in fighting off the infection. Children with a temperature above 102 degrees are often uncomfortable because of the fever and may need treatment - a child with a fever who is feeling and behaving well does not need to be given medication.

The old favorite remedy, aspirin, should not be used to treat fever in children under 16 years of age because of its association with Reye's Syndrome (a syndrome of rapidly worsening neurological symptoms and liver degeneration) in children with viral illness and chicken pox. Instead of aspirin to treat fever today we have acetaminophen and ibuprofen, both of which are sold under a variety of brand names. Alcohol rubs are a bad idea as it is scary and uncomfortable, and can cause serious side effects in young infants. Alcohol rubs make kids shiver, which is the body's way to generate large amounts of heat, the last thing you want to do if your child has a fever. Instead sponge the child down in the tub with lukewarm water for a few minutes - but careful not to allow the child to get cold enough to shiver. Also a child should not be bundled up, as it will make him hotter and can raise the temperature of young infants.

Some cautions: A temperature over 100.5 degrees F in a child under 3 months of age is always a concern. They rarely get fevers, even when they are sick, so a fever is unusual even in the presence of illness, and they can change very rapidly. One minute they are okay and a few minutes later they can become seriously ill. There is little warning. You should quickly alert your pediatrician to any abnormal temperature in an infant under three months of age.

Infants between 3 months to 3 years of age present a similar dilemma, only not such an urgent one. A pediatrician has the training and experience to distinguish medically serious conditions from minor viral illnesses in children. Make notes and call your pediatrician if concerned. Every child and every situation is different, and you and your pediatrician must work together to choose the appropriate course of action. ("My Baby's Got a Fever!" Herschel Lessin, M.D., - Dec. 2001)

In general, it is unwise to reduce a fever unless the person (child or adult) is absolutely miserable and if the fever is over 102 or 103. There is an exaggerated concern that many parents have regarding fever. They are unaware that there is no brain damage until the temperature gets beyond 105 or so. Now, I do get concerned when the temperature is above 102, but would hold off using aspirin or Tylenol unless the person was feeling very uncomfortable. These drugs actually inhibit the body's immune response and actually tend to prolong the illness rather than resolving it more quickly. ("Sponging, Fans Do Little To Bring Down Fever," Dr. Joseph Mercola, - Nov. 2001)

On average, flu symptoms lasted 5.3 days in participants who did not take aspirin or acetaminophen, compared with 8.8 days in people who took the anti-fever drugs. (Researchers at the University of Maryland schools of medicine and pharmacy in Pharmacotherapy, Dec. 2000) This report is on - Nov. 2001)

A basic fever, one due to minor bacterial or viral illness, can be an expression of the immune system working at its best. Some research supports the theory that when fever is blocked, survival rates from infection decline. Fever increases the amount of interferon (a natural antiviral and anticancer substance) in the blood. Fever also impairs the replication of many bacteria and viruses, so a moderate fever is a friend.

However, it makes sense to avoid suppressing moderate fevers with drugs, while continuing to monitor for dramatic increases in temperature and worsening of any other symptoms. Don't cajole or coerce your children into eating during fevers if they don't feel hungry, but encourage fluids, because dehydration alone can drive up fever. For the few children (about 3%) who have febrile seizures, pediatricians can help parents block high temperatures by giving ibuprofen or acetamiinophen when fevers start.

If you give over-the-counter medicines for reducing fever and discomfort follow the package instructions. Bundle if child feels cold, but dress lightly so the child can throw off the covers when they feel the need. ("Fever in Children - a Blessing in Disguise," Linda B. White and Sunny Mavor, originally printed in "Mothering Magazine," excerpted from"Kids, Herbs, and Health: A Parents' Guide to Natural Remedies. on - June 2001).

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