Now that autumn is upon us, and winter is around the corner, people will start to have fevers with increasing frequency. Fever, a natural human response to infection, is produced by the hypothalamus in response to chemicals in the blood stream released in association with infection. In fever, the theory goes, the human body sets a higher temperature in order to make things unpleasant for infectious invaders like viruses and bacteria. In the medical world, fever in humans is a temperature over 100.4 degrees Fahrenheit (or 38 degrees Celsius).
But fever isn’t really the problem. Rather, the unique effects of the illness are the cause of greatest concern for physicians. Take strep (or streptococcal) throat, for example. Also known as exudative pharyngitis, the problem isn’t the fever, or even the sore throat. It’s that a small set of patients with a strep throat infection may later develop disease of their heart valves or kidneys as a consequence of the infection. And what about pneumonia? The fever isn’t the danger. The inability to breathe is the more important issue.
Humans of every age who have fever may have pneumonia, meningitis, urinary tract infections or numerous dangerous infections that have spread to their bloodstream, resulting in shock. (This is called sepsis.)
Fortunately, the very good news is that the majority of fevers are due to viral illnesses that are self-limited. That is, the unfortunate folks afflicted with hot and cold chills and muscle aches get better no matter what we do — or don’t do, for that matter.
Fever is easily measured with inexpensive home thermometers. Rectal thermometers are best, followed by oral. Newer ear and forehead scanners are convenient and reasonable, but not quite as accurate as the more invasive ways of taking a temperature.
When experiencing the discomfort of fever, it is best treated with drugs such as acetaminophen (the active ingredient in Tylenol) and ibuprofen (the active ingredient in Motrin and Advil). Remember: No aspirin under age 19, as it can cause a dangerous side effect called Reye’s syndrome.
Fever should be treated for the comfort of the adult or child who is ill. Sponging or bathing with tepid water is another way to manage fever, along with hydration and appropriate clothing; that is, undress when you’re hot, bundle up when you’re cold.
When should you or your loved one go to the doctor for fever? Well, if you’re concerned, don’t hesitate to seek care. Furthermore, fever in infants should be evaluated by a doctor, especially in the first three months of life, when it’s very hard to interpret infants’ symptoms and when their immunity is inadequate. Likewise, those of any age on immune-suppressing drugs should be seen by a doctor when running a fever.
Fever should be evaluated if it persists for a couple of days. A physician should also be consulted when other symptoms are associated with fever — like confusion, headache, vomiting, abdominal pain, chest pain, new rash, neck stiffness or difficulty breathing. But if you (or your loved one) are just uncomfortable and achy, it’s reasonable to stay home, eat soup and enjoy your favorite book or movie.
The bottom line is that fever is frightening, but is a normal part of human illness. And as the “fever season” settles in, we might as well get used to it and learn when to worry, and when to simply endure the shakes and chills for yet another year.