In his monthly column, Dr. Kent Herbert answers your questions related to health care matters. Simply submit your question to marylou@newfalconherald.com. Itís your chance to ask the doc.Question: My child had a high fever recently. What should I do to treat it and at what point should I be worried?Answer: Fever is a natural and harmless body function, but also one that leads to a great deal of worry. A normal body temperature ranges between 96-100 degrees throughout the day and a temperature above 100.4 degrees is considered a fever. Fever occurs when white blood cells release chemicals that reset the brainís thermostat to a higher setting, causing the body temperature to rise. When this happens, people often experience shivering, goose bumps and a sensation of feeling cold, commonly known as the chills. When the brainís thermostat is reset back to normal, such as when the fever breaks or when medications like acetominophen are taken, the temperature begins to decline. The presence of a fever usually indicates that one has an infection, which may be viral and get better on its own, or bacterial and sometimes require medical treatment.There are many misconceptions about fever. Contrary to common belief, fever by itself is not harmful. In a recent study, 84 percent of people believed that fever can cause harm to a person, and 18 percent felt that fevers can cause brain damage. In fact, fever itself is the bodyís natural response to an illness, and the only medical reason to treat a fever is to make a person feel better. Another misconception is that a fever, if not treated, will rise out of control. The body has a built-in limit on how high a fever can rise, which is usually around 105 – 106 degrees in most people. Fevers at this level always sound scary, but many people, especially children, can tolerate them without any problem.Many people are concerned that fevers, especially high ones, may represent a serous illness. However, there is no correlation between how high a fever is and how serious an illness may be. In fact, many viral illnesses, which are minor and will go away on their own, come with the highest fevers, even up to 105. On the other hand, people with life-threatening illnesses and infections may present with only a low-grade fever or none at all. Instead of relying on the presence of or the degree of a fever, other symptoms and behaviors must be used to determine whether or not an illness is serious. These include changes in oneís alertness and level of activity, the ability and willingness to take fluids and other objective signs such as diarrhea, vomiting, runny nose, cough, ear pain, neck pain and shortness of breath. The temperature by itself means less than these factors when assessing the seriousness of an illness.In some people, especially children, fever can be associated with brief seizures. These occur in about 2 to 5 percent of children, typically between the ages of six months and 6 years. These seizures are not dangerous, do not cause brain damage and do not lead to epilepsy. Some research indicates that febrile seizures, as they are called, are caused more by rapid increases in temperature than the fever itself. Therefore, it may be better to have a consistent, untreated fever, than to cause a fever to rise and fall with treatment.Children under the age of three months represent a special group and any fever at this age should be reported to and evaluated by a doctor. Also, aspirin should never be used in young children, as it may lead to Reyeís syndrome, a serious neurological disorder. Acetominophen is typically the medication of choice to treat a fever. Alternating acetominophen and ibuprofen has become popular, but its safety has recently been questioned and is not routinely recommended.In any situation, it is important to look at the big picture when assessing an illness. Fever is one of many factors to consider and by itself relatively unimportant. Simple measures, such as treatment with acetominophen, can be used to lower oneís temperature, but only if the fever is uncomfortable. Treating a fever wonít shorten the illness, protect one from harm or give clues as to the serious of the illness. As always, you should call your doctor with any concerns regarding fevers, but be reassured that the fever typically means your body is functioning as it is supposed to.Dr. Kent Herbert, board-certified family physicianFalcon Family Medicine7641 McLaughlin Rd.Falcon, CO 80831(719) 494-2006(719) 494-8448 faxwww.FalconFamilyMedicine.com
