Health Articles:

The Facts about Fevers

by Dr. Shahrzad Z. Orona, ND

There are many misconceptions about fevers. Unfortunately, many parents have not been properly educated about fevers, and therefore, at the first sign of a raised temperature, they give antipyretic (fever-reducing) medications to their children.

This is a topic that comes up frequently in my practice-especially during the cold and flu season. However, I find that when parents are educated, rather than filled with fears about fevers, they are much more likely to use antipyretic medications such as Tylenol or Motrin when appropriate for comfort rather than solely for fever suppression.

The main misconception on which many other misconceptions are based is that all fevers are bad or harmful to children. This is definitely not true. Fevers turn on the body's immune system and are one of the ways the body can protect itself. Most fevers are actually good for children and help the body fight infection.

Mounting a fever is an innate response to pathogens in many mammals, birds, reptiles, and fish. It has been theorized that the survival of a species depends on its ability to mount a fever. Fever inhibits the growth of certain bacteria and viruses. Interestingly, varicella lesions are believed to take slightly longer to crust over if antipyretics are used.

The following is a table that may help to better define your child's fever:

100°F to 102°F	Low grade fever. Beneficial.
102°F to 104°F	Moderate grade fever. Beneficial.
Over 104°F	High fever. Causes discomfort, but is harmless.
Over 105°F	High fever. Higher risk of bacterial infections.
Over 108°F	Serious fever. The fever itself can be harmful.

It should be stated that any fever can be serious for a newborn and you should contact your pediatrician or hospital's emergency room if your child is less than 6 months old.

A fever is defined as an oral temperature greater than 99.5degrees Fahrenheit. To convert from an axillary (under the arm) temperature to an oral temperature you simply add 1.0 degree. To convert from a rectal temperature to an oral temperature you subtract 0.7 degrees (or roughly 1.0 degree).

Mode of measuring temperature	Temperature signifying a fever
Oral	Higher than 99.5 degrees Fahrenheit
Axillary	Higher than 99.0 degrees Fahrenheit
Rectal	Higher than 100.4 degrees Fahrenheit
Ear	Read thermometer's manual to establish whether it uses a rectal or oral mode

Here are some of the many myths and facts about fevers.

Myth: Fevers cause brain damage or fevers over 104°F (40°C) are dangerous.

Fact: Fevers with infections don't cause brain damage. Only body temperature over 108°F can cause brain damage. The body temperature goes this high only with high environmental temperatures. An example of this would be a child confined in a closed car on a hot day.

Myth: All fevers cause febrile seizures.

Fact: Only 4% of children have febrile seizures. Most children with febrile seizures have them within the first 24 hours of a bacterial or viral illness. Children who have febrile seizures are typically between the ages of 6 months and 4 years old, with the peak occurrence being between 17 to 22 months old. Having a febrile seizure before the age of one increases the likelihood of another febrile seizure. Febrile seizures in children over the age of 7 are very rare.

Myth: Febrile seizures cause permanent harm to children.

Fact: Febrile seizures are usually benign but are frightening to parents and child. They usually last less than 15 minutes. They cause no permanent harm. Children who have had febrile seizures do not have a greater risk for developmental delays, learning disabilities, or seizures not associated with fevers. Typically, the child loses consciousness, falls down, becomes stiff, and has jerking of the arms and legs. Should a child have a febrile seizure, they should be taken to the hospital immediately following the seizure in order to be examined.

Myth: Without treatment, fevers will keep going higher.

Fact: Due to the brain's “thermostat” -the hypothalamus- fevers from infection top out at 105°F or 106°F or lower.

Myth: With treatment, fevers should come down to normal body temperature.

Fact: With treatment, fevers usually come down 2-3°F.

Myth: If the fever doesn't break- returning the temperature to normal- the cause is serious.

Fact: Fevers that don't respond to fever medicine can be caused by viruses or bacteria. Whether the medicine works or not doesn't relate to the seriousness of the infection.

Myth: If the fever is high, the cause is serious.

Fact: If the fever is high, the cause may or may not be serious. If your child looks very sick, the cause is more likely serious.

Appearance	Decreased response to stimulus. Change in appearance. A rash that won't blanch. Difficulty breathing other than from a congested nose. Delirium.
Activity	Unable to be awakened. Child has difficulty staying awake. Unable to move neck (straighten knees, chin to chest)
Cry	Cry is whimpered, moaning, or persistent. Unable to be soothed.
Hydration	Eyes and/or fontanelles are sunk in. Mouth is hot and dry. Fewer diapers are used with concentrated looking/smelling urine.

Myth: The exact number of the temperature is very important.

Fact: How your child looks is what's important, not the exact temperature. (See chart above)

Myth: The fever is the illness.

Fact: The fever is merely a sign of an illness. Reducing the fever in no way reduces the illness.

Myth: Temperatures between 98.7°F and 100.0°F are low grade fevers.

Fact: The normal temperature changes throughout the day. It peaks in the late afternoon and evening. A low grade fever is 100°F to 102°F.