Fever part 3: Dispelling fever phobia

Worry about fevers is the most common reason for an urgent call or visit to a pediatrician. Parents worry about fevers because it makes their child look and feel ill, but also because they’re concerned that the fever means there is a serious medical problem going on, or that the fever is going to harm their child.

Historically, fever did once mean that something terrible could be going on. One of the most common causes of fever world-wide, malaria, is no longer seen in the developed world thanks to improved mosquito control. Likewise, many other serious fever illnesses have become rarities thanks to improved sanitation (like typhoid fever, plague, and dysentery.) Vaccinations now protect against most of the more serious bacterial infections (including meningitis and blood poisoning), as well as many viral infections that had been so devastating in the past (like polio and measles.) Other potentially serious infections have now become easy to identify and treat (scarlet fever, pneumonia, kidney infections.) Compared to a century ago, we are far more able to access reliable health care that can accurately diagnose and treat almost any illness. So while it made sense for parents 100 years ago to worry that a fever could mean the death of their child, this fear is not justified today.

If your child does have a fever, how can you tell if it’s caused by something serious?

In the past, a general rule was that the height of the fever predicted how serious the underlying problem was—so a fever of 105 was far more of a worry than 101. But in a fully vaccinated, otherwise healthy child, this “rule” doesn’t hold true. Even a 105 fever in a healthy child is quite unlikely to be from any serious condition. The best way to determine how likely it is for a child to have a serious medical issue causing a fever isn’t to look at the number on the thermometer, it’s to see how the child acts when the fever goes back towards normal. Give a dose a fever-reducer, wait 30 minutes, then see how Junior feels. If he’s doing much better, it’s very unlikely that you have a serious infection to worry about. We’ll cover this in more detail in the next (and last) installment of my fever series.

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