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The Importance of Fever
Childhood fevers can be frightening, mostly because they are misunderstood. A fever is an increase in body temperature above the "normal range." But the definition of "normal" can vary from person to person. Body temperature also varies with different levels of activity and at different times of the day. Medical texts differ in their definition of the highest "normal" body temperature, which can range from 98.6 to 100.4°F. It is generally accepted that a fever is defined as an "early morning temperature greater than 99°F or a temperature greater than 100°F at any time of the day." REF: Harvard Medical School's Inteilhealth.
There are several causes of fever, but it is most commonly associated with dozens of different viruses, bacteria and parasites that cause upper respiratory infections, pneumonia, diarrhea, and urinary tract infections.
When infectious micro-organisms invade the body, it is fever that gets our attention. Yet, despite its universal recognition, little is known about how is occurs. The currently held view is that when an infectant enters the body, the body activates its innate immune responses, which include the release of a complex mediators with equally complex names: cytokines, pyrogenic molecules that including tumor necrosis factor alpha (TNFα), interleukin (IL-1β) and interleukin (IL-6). These substances signal the part of the brain called the hypothalamus to raise the body's thermostat, which in turn leads to chills and shivering to increase the metabolic rate. Heat loss is minimized by restricting blood flow to the skin, giving it a pale appearance. Fever sufferers may lose their appetite and most feel lethargic, achy, and tired.
However, contrary to the reflex need to give an aspirin to make a fever stop, an elevated temperature can be an expression of the immune system working at its best. The number of white blood cells is increased and cascades of molecules to flood the blood stream, in rapid pursuit of the host's invaders. Fever impairs the ability of bacteria and viruses to replicate, creating an inhospitable environment for the invading organisms. By turning up the heat, invading microbes cannot replicate and by definition, die off. Fever results in winning the war against a wayward microbe.
If parents understood the importance of fever and how to appropriately support their child during a fever, parents would acquire a comfort level with caring for an ill child. They would rid themselves of unnecessary stress, unnecessary doctor and emergency room visits and most of all, their child would benefit from infection-fighting fevers. The concern of parents about fever is not justified but is understandable without appropriate information. Health education to counteract "fever phobia" should be a part of routine medical care for children.
When is fever harmful?
In addition to the beneficial effect of fever on the immune system, it is important to note that the body has a way to protect itself from excessively high temperatures. Many parents are unaware of this process and believe that temperatures will continue to rise to potentially lethal levels if left untreated. In the absence of overwhelming factors, such as extreme dehydration and unsafe circumstances, such as being locked in a closed automobile, a normal children's temperature will not rise out of control to potentially lethal levels. Therefore, it is exceedingly rare for a child's temperature to exceed 107°F (41.7°C) in the event of a routine infection.
The fear most parents have about a high fever-defined as a sustained temperature of greater than 104°F for several days-is the concern about developing seizures. A febrile seizure manifests as abnormal jerking movements all over the body without evidence of central nervous system infection. Febrile seizures occur most commonly in children between the ages of three months and five years of age and usually last five minutes or less). About 3 percent of all children experience a febrile seizure sometime during childhood. Febrile seizures occur most commonly due to a sudden rise in temperature and not due to a prolonged fever, unless the child is dehydrated.
This susceptibility is not well understood. Of those children who have a first-time febrile seizure, about one-third experience a recurrence. Risks for recurrence are elevated for children who experienced the first seizures at age 16 months or younger, and who have a family history of febrile seizures. In general, 30 to 40 percent of children who have had a febrile seizure are likely experience one more. If a child has had two febrile seizures, there is a 50 percent chance that an additional episode will occur at some time in the future. Although frightening, febrile seizures are almost always benign. Nonetheless, if a child experiences a febrile seizure, it is important to seek medical attention immediately. In addition, if your child is under six months of age or if an older child has had a fever of more than 104°F for more than four or five days, a healthcare provider needs to be consulted.
