By Sally Robinson and Keith Bly
Is fever good or bad? Fever is the result of inflammatory process of the body’s immune system.
The inflammatory process may be cause by infection or autoimmune diseases such as rheumatoid arthritis.
Fever is one of the main reasons that children are brought to the clinic or the emergency room.
Many mistaken beliefs about fever have persisted for decades.
In 1980, Dr. Schmitt coined the term “fever phobia” to help explain the unrealistic concerns about fever and how it can hurt children.
He found that 52 percent of parents bringing their children to the clinic with a fever of 104 degrees or less thought that the fever itself could cause serious neurological consequences.
Twenty years later, Dr. Crocetti and associates found that fever phobia still existed with 21 percent of parents thought brain damage was the primary harmful effect of fever and 14 percent listed death as a harmful effect.
Many parents believed that fever itself was an illness that could be cured with “fever reducers” and in their efforts to cure the fever used incorrect doses placing their children at risk for getting toxic doses.
Some benefits of fever are as follows:
• Decreases growth and reproduction of bacteria and viruses;
• Lowers the amount of iron available to bacteria;
• Enhances neutrophil (white cells) to move to the site of the infection;
• Increases the production of superoxides which can kill the germs; and
• Promotes T lymphocytes (another kind of white cell that fights infection).
Knowing that a child has a fever is only part of the story. It is important to know more about the history of the illness:
• Other symptoms such as coughing, vomiting, diarrhea;
• Was the child previously well with no history of recurrent serious illnesses?;
• Is the child eating and drinking?; and
• Is the child acting fairly normally?
Instances that should prompt the parent to seek medical help are as follows:
• Is the child hard to awake?;
• Is the child younger than 90 days?;
• Has the child had a seizure?;
• Is there a tender spot or is the child limping?;
• Has the fever lasted longer than a week?;
• Is the child having bloody diarrhea or persistent vomiting?; and
• The child looks and acts sick.
It is the cause of the fever, whether infection or an autoimmune disease, that hurts the child not the degree of fever.
It is the degree of illness not the degree of fever.
Fever itself is not a danger and actually may be a benefit in fighting the infection.
Treating the fever may make the child more comfortable but it is important to follow the directions for doses carefully.
It also is recommended that the parent use only one fever reducer.
Using both acetaminophen and ibuprofen has not been shown to be better in reducing
the fever and can lead to confusion and over dosage.
Sally Robinson is a clinical professor of pediatrics at UTMB Children’s Hospital, and Keith Bly is an associate professor of pediatrics and director of the UTMB Pediatric Urgent Care Clinics. This column isn’t intended to replace the advice of your child’s physician.