"Unless you have a fever, you're going to school."
I can hear my mother saying those words as clearly as if it were yesterday. How many of us automatically reach up to feel our kids' foreheads the minute they complain that they don't feel well?
Fever is the defining symptom on which most of us seem to base the seriousness of an illness. This is not a new trend. In 1980, Dr. Barton D. Schmitt, a professor of pediatrics at the University of Colorado, published a now-classic article stating that parents thought untreated fevers could rise to critical levels and have serious neurological effects. He termed this "fever phobia."
More recently, a group at Johns Hopkins revisited this issue and determined that fever phobia persists today. One reason for this is that parents tend to have the misconception that fever is a disease rather than a symptom or sign of illness.
Fever is merely an elevation in body temperature. Although a number above the oral measurement of 98.6 degrees or the normal rectal measurement of 99 degrees is considered elevated, our normal body temperature can deviate from those by a degree and can change throughout the day.
Fever is the body's natural defense against bacteria and viruses, which cannot live at higher temperatures. According to Dr. Perri Klass, "fever is positive evidence of an active immune system, revved up and helping an array of immunological processes work more efficiently. It does not harm the brain or body and, even untreated, fevers rarely rise higher than 104 or 105 degrees."
Almost all experts agree that fevers in infants younger than 3 months are a serious concern, because of the risk of a bacterial infection. Children and adults who have histories of cancer, heart disease, AIDS or other serious illnesses, or who are on immunosuppressant therapy, should seek medical attention if they develop a fever. Roughly 5 percent of children are at risk for seizures with fever, although these mostly end up not being harmful.
Dr. Michael Crocetti, an assistant professor of pediatrics and lead author of the Johns Hopkins study, says, "Although I do a tremendous amount of education about fever, its role and benefit in illness, it doesn't seem to be something parents hold onto from visit to visit."
Consider these tips from the experts at the Mayo Clinic the next time your child comes down with a fever:
■ Call the doctor for any fever in an infant younger than 3 months.
■ Never give aspirin to children 18 or younger.
■ For a fever lower than 102 degrees (orally) in children 3 to 23 months old, encourage rest and plenty of fluids. No medicine is needed. Call the doctor if a child is unusually lethargic or uncomfortable. For fever higher than 102, consider acetaminophen, and for children older than 6 months, you can try ibuprofen. Call a doctor if the fever doesn't respond to medicine.
■ For children 2 to 18 years old with a fever lower than 102, encourage rest and plenty of fluids. Call the doctor if the child is irritable, lethargic or is significantly uncomfortable. For fever higher than 102, consider acetaminophen or ibuprofen, and call the doctor if the fever doesn't respond or lasts longer than 3 days.
■ For adults older than 18 with a fever lower than 102, encourage rest and plenty of fluids. Call the doctor if symptoms include severe headache, stiff neck, shortness of breath or any unusual symptoms. For fever higher than 102, consider acetaminophen or ibuprofen and call the doctor if there is no response, lasts longer than three days or is consistently higher than 103.