Fever Control

The normal body temperature is around 98.2 to 98.8 F. A person is said to be suffering from fever when the body temperature rises to 100.0 F by mouth or 100.8 F rectum. Body temperature is at its lowest early in the morning. Women notice an increase of about 0.9 F (0.6 C) in body temperature during ovulation. Exercise and physical activity in hot weather can also raise body temperature. Fever is usually the body's reaction to an infection, be it urinary infection, viral infection or pneumonia. It is an indication that your body is fighting and working for you. But fever can also be indicative of a serious illness, especially in adults. Infants and children may develop fever as a reaction to vaccinations or immunization shots.

Elevated body temperature (fever) brings along with it overall physical discomfort such as body ache, shivering, headache and reduced appetite. Fever must not be allowed to rise more than 103 degree F or greater as it causes dehydration. Besides sudden rise in body temperature can bring on febrile seizures. This is especially so in the case of infants and small children. Febrile Seizures or convulsions tend to appear in the first 24 hours of fever. It is a reactive activity by the body till it adjusts to sudden rise in temperature.

• Antipyretics like Paracetamol may be given. Adult dosage: 500 mg twice/thrice a day depending upon the fever
  
• Ensure that the patient is given enough fluids and water
  
• Good rest is essential
  
• Do not use Aspirin to bring down fever
  
• Keep the patient comfortably dressed
  
• Give your feverish child something to do to feel better, like read or draw or watch TV
  
• Use of cold compress can bring down fever
  

Fever

Fever is an elevation of body temperature and defined as a core temperature higher than 38 C (100.4 F) in infants and higher than 38.3 C (100.9 F) in adults. Normal body temperature range is between 36 and 37.8 degree C (96.8 and 100.4 degree F). If a person has an oral temperature above 98.6 F (37 C), it is considered as fever. In some cases, there is a variation of up to 1 F (0.6 C). Fever is a symptom and not a disease. Fever, by itself is an indicator that the body is building an immune response to an infection. Most viruses and bacteria cannot survive at higher temperatures and fever is the body's fighting mechanism. Any body temperature up to 100 F is considered low grade fever. It is usually noticed along with sore throat, cough, joint pain, chills and nausea. Most fevers of this nature are self-limiting; and medication is given to provide comfort to the patient. Most of the time fever is only a symptom which can be treated symptomatically with antipyretics. Acetaminophen and ibuprofen are prescribed to control fever.

Fever results from the production of prostaglandin E2 (PGE2) in the hypothalamus due to endogenous or exogenous pyrogens. The cause is identified by physical examination and a thorough history - the onset of fever, level, duration, pattern if any and other symptoms.

Normally a person can sustain a body temperature of up to 104 degree F (40 degree C) with relative safety. But when the fever temperature rises above 104 ° it may cause cellular damage to brain, blood and internal organs. To prevent damage from high fever cooling treatments may be of help. Cold compresses, cold packs or sponge baths or ice bags /chemical cold packs are used to bring down the high fever.

Do not swathe a patient with fever in blankets but keep him comfortable. Bath in tepid water can help, but never ice cold water. The patient must be well hydrated. Some immunosuppressed or elderly patients might not exhibit a big rise in temperature in spite of a serious infection. Most often , CBC (complete blood count) is done to look for raised WBC count. Other useful indicators are urine test, gram stains and chest x-ray. If fever is also accompanied by abdominal pain, CT scan of the abdomen is suggested to look for possible appendicitis, diverticulitis and Cholecystitis.

The degree of fever elevation is not an indicator of the severity of the illness. Fever can be due to dengue, chikungunya, chicken pox, measles, malaria or other infections. Metabolic disturbances can cause body temperature to be elevated. In rare cases, fever is due to heart disease, serious illness, AIDS or cancer. Toxic shock, meningitis and peritonitis are other serious causes for high fever.

In some cases, the cause for fever is not easy to diagnose. Fever due to upper respiratory tract infection usually lasts for about 3-5 days.

Do not confuse fever with Hyperthermia, where the body temperature rises due to external sources. Here fever is also accompanied by palpitations, fainting, shivering, aches and confusion or hallucinations. When fever rises, the respiratory rate and heart rate rise. When children below 1 year suffer fever, they should be examined by a healthcare professional. Never use aspirin in children during a viral infection.

Fever in Infants

Fever in infants can be quite be quite alarming to parents. When an infant is running temperature, it is most likely a reaction to the body's defense against infection. Most often it is an ally of the body - responding to a viral or bacterial infection. However in rare cases, the fever can also be the harbinger of middle ear infection or urinary infection or even gastro-enteritis. Respiratory infections such as pneumonia, croup or strep throat can also bring on fever in infants. Fever in infants is also generally accompanied by symptoms such as flushed cheeks, rapid breathing and vomiting. The infant might be irritable and restless. In some cases, an infant can have raised body temperature due to overdressing. It is essential to remember that infants cannot regulate their body temperature as well as adults. Infants are likely to have mild fever due to immunization shots.

If the temperature exceeds 37 C, an infant is considered to have fever. High fever in infants is not alarming but needs to be tackled immediately. If the infant is unable to move and seems weak and listless, consult a physician at once. Keep on the lookout for purple spots on the body or fullness on the soft spot on the head. Symptoms such as swollen joints and rash must also be brought to the pediatrician's notice at once. Body temperature in an infant can be checked either in the armpit or rectum. Digital thermometer can be used to accurately read elevated body temperature. The American Academy of Pediatrics (AAP) does not advocate the use of ear thermometers in infants less than 3 months. Similarly glass mercury thermometers are avoided on account of possible mercury toxicity. Avoid plastic strip thermometers and pacifier thermometers since they are unlikely to be accurate.

Since most of the time fever in infants is self-limiting, do not medicate the infant yourself. Usually Paracetamol is prescribed for infants suffering from fever. Do not give aspirin to the infant, especially when there is a likelihood of a viral infection. Ensure that the baby is well hydrated. Breast milk must be offered frequently. Diluted formula can also be given. Tepid water sponge bath helps in lowering body temperature. Dress the infant in light clothing. Care should be taken not to allow the body temperature to rise rapidly as it can bring on febrile seizures.