Fever
- Fever in Thailand
A fever occurs when your temperature rises above
its normal range. What's normal for you may be a
little higher or lower than the average temperature
of 37 C. That's why it's hard to say just what a
fever is. But a "significant" fever is usually
defined as an oral or ear temperature of 38 C or a
rectal temperature of 39 C. If you're an adult, a
fever may be uncomfortable, but it usually isn't
dangerous unless it rises above 39 C. For very
young children and infants, however, even slightly
elevated temperatures may indicate a serious
infection. In newborns, a subnormal temperature -
rather than a fever - may be a sign of serious
illness.
Screening and diagnosis
Your doctor will
likely diagnose the cause of your fever based on your other symptoms and
a physical exam. Sometimes you may need additional tests to confirm a
diagnosis. If your doctor suspects pneumonia, for instance, you may have
a chest X-ray following your physical exam. In other cases you may have
blood or urine tests to check for signs of infection.
If you have a
low-grade fever that persists for three weeks or more, but have no other
symptoms, your doctor may recommend a variety of tests to help find the
cause. These may include blood tests and X-rays.
Complications
A rapid rise or
fall in temperature may cause a febrile seizure in a small percentage of
children younger than age 5. Although they're alarming for parents, the
vast majority of febrile seizures cause no lasting effects.
If a seizure
occurs, lay your child on his or her side. Remove any sharp objects that
are near your child, loosen tight clothing and hold your child to
prevent injury. Don't place anything in your child's mouth or try to
stop the seizure. Although most seizures stop on their own, call for
emergency medical assistance if the seizure lasts longer than five
minutes.
If possible, try
to time the seizure using your watch or a clock. Because they're so
alarming, seizures often seem to last longer than they really do. Also
try to note which part of your child's body begins to shake first. This
can help your doctor understand the cause of the seizure. Your
pediatrician should see your child as soon as possible.
Treatment
Medical treatment
will depend on the cause of your fever. Your doctor will likely
prescribe antibiotics for bacterial infections, such as pneumonia or
tonsillitis. For viral infections, including stomach flu (gastroenteritis) and mononucleosis, the best treatment is often rest
and plenty of fluids.
Your doctor may
also suggest taking over-the-counter medications, such as acetaminophen
(Tylenol, others) or ibuprofen (Advil, Motrin, others) to lower a very
high fever. Adults may also use aspirin. But don't give aspirin to
children. It may trigger a rare, but potentially fatal, disorder known
as Reye's syndrome.
Prevention
The best way to
prevent fevers is to reduce your exposure to infectious diseases. One of
the most effective ways to do that is also one of the simplest —
frequent hand washing.
Teach your
children to wash their hands often, especially before they eat, and
after using the bathroom, spending time in a crowded public place, or
petting animals. Show them how to wash their hands vigorously, covering
both the front and back of each hand with soap, and rinsing thoroughly
under running water. Carry hand-washing towelettes with you for times
when you don't have access to soap and water. When possible, teach your
kids not to touch their nose, mouth or eyes — the main way viral
infections are transmitted.
Self-care
Because your body
loses more water with a fever, be sure to drink plenty of fluids to
avoid dehydration. Water is best, but if it's hard to get your children
to drink water, encourage them to drink juices or eat frozen ice pops.
Adults and children should also get enough rest. Don't be concerned with
treating a fever just because it's a fever. Often, a low-grade fever is
actually helping fight off an infection. In addition, follow these
guidelines for both children and adults:
For
temperatures less than 38.8 C
Don't give
any medication for a fever in this range unless advised by your doctor.
And don't give children aspirin because of the risk of Reye's syndrome.
Instead, wear comfortable, light clothing and try bathing in lukewarm
water. At bedtime, cover yourself or your children with just a sheet or
light blanket.
For
temperatures between
38.8 C
and 40 C
Take
acetaminophen or ibuprofen according to the label instructions or as
recommended by your doctor. If you're not sure about the proper dosage,
be sure to check with your doctor or pharmacist. Adults may use aspirin
instead. Be careful not to give too much medication. High doses or
long-term use of acetaminophen may cause liver or kidney damage, and
acute overdoses can be fatal. If you're not able to get your child's
fever down, don't give more medication. Call your doctor instead. Side
effects of aspirin and other nonsteroidal anti-inflammatory drugs such
as Motrin and Advil include stomach pain, bleeding and ulcers.
For
temperatures greater than
40 C
Give
adults or children acetaminophen or ibuprofen following the
manufacturer's instructions or as recommended by your doctor. Adults may
use aspirin instead. If you're not sure about the dosage, check with
your doctor or pharmacist. Be careful not to give too much medication.
Acetaminophen is
available in liquid, chewable and suppository forms for children, but
it's often easiest to give medications in liquid form. For a small
child, use a syringe with measurements on the side and a bulb on the
tip. Gently squirt the medicine in the back corners of your child's
mouth.
Use a sponge bath
of lukewarm water to try to bring your own or your child's temperature
down. Recheck the temperature every 30 minutes. When it's less than 38.8
C, you can stop sponging. If your child shivers in the bath, stop the
bath, dry your child and wait. Shivering actually raises the body's
internal temperature — shaking muscles generates heat. If the fever
doesn't moderate or your child has a febrile seizure that lasts longer
than five minutes, seek immediate medical care.
Taking a
temperature
To check
your or your child's temperature level, you can choose from several
types of thermometers, including electronic thermometers and ear
(tympanic) thermometers. Thermometers with digital readouts and those
that take the temperature quickly from the ear canal are especially
useful for young children and older adults. Because glass mercury
thermometers harm both humans and the environment, they're being phased
out and are no longer recommended.
Although it's not
the most accurate way to take a temperature, you can also use an oral
thermometer for an armpit (axillary) reading. Place the thermometer in
the armpit with arms crossed across the chest. Wait five minutes. The
axillary temperature is about one degree less than an oral or rectal
temperature.
Use a rectal
thermometer for infants. Place a dab of petroleum jelly on the bulb. Lay
your baby on his or her tummy. Carefully insert the bulb one-half inch
to 1 inch into your baby's rectum. Hold the bulb and your baby still for
three minutes. Don't let go of the thermometer while it's inside your
baby. If your baby squirms, it could go deeper and cause an injury.
Dengue
Fever
Dengue fever is an infectious disease
carried by mosquitoes and caused by any of four related dengue viruses.
This disease used to be called break-bone fever because it sometimes
causes severe joint and muscle pain that feels like bones are breaking,
hence the name. Health experts have known about dengue fever for more
than 200 years.
Dengue fever is found mostly during and
shortly after the rainy season in tropical and subtropical areas of
- Africa
- Southeast Asia and China
- India
- Middle East
- Caribbean and Central and South
America
- Australia and the South and
Central Pacific
An epidemic in Hawaii in 2001 is a
reminder that many states in the United States are susceptible to dengue
epidemics because they harbor the particular types of mosquitoes that
transmit it.
The World Health Organization estimates
50 to 100 million cases of dengue infection occur each year. This
includes 100 to 200 cases reported annually to the Centers for Disease
Control and Prevention (CDC), mostly in people who have recently
traveled abroad. Many more cases likely go unreported because some
doctors do not recognize the disease.
During the last part of the 20th
century, cases of dengue began increasing in many tropical regions of
the world. Epidemics also began occurring more frequently and with more
severity. In addition to typical dengue, dengue hemorrhagic fever and
dengue shock syndrome also have increased in many parts of the world.
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