Fever

Body temperature can fluctuate modestly among individuals and even throughout a single day. Conventionally, the average body temperature is 37 degrees Celsius or 98.6 degrees Fahrenheit. Using an oral thermometer, a reading of 37.8 degrees Celsius or 100 degrees Fahrenheit is commonly classified as indicative of a fever. 

Alongside a raised temperature, various other symptoms and signs could be present, contingent on the underlying cause of the fever.

• Sweating
• Chills and shivering
• Headache
• Muscle aches
• Loss of appetite
• Irritability
• Dehydration
• General weakness

Taking a temperature

To measure body temperature, you have various thermometer options such as oral, rectal, ear (also known as tympanic), and forehead (or temporal artery) thermometers. Oral and rectal thermometers usually offer the most precise assessment of one’s core body temperature. Ear and forehead thermometers, while handy, tend to deliver less exact readings. For infants, a rectal temperature is somewhat more reliable, if feasible. When communicating a temperature reading to your healthcare professional, it’s advisable to specify both the numerical value and the type of thermometer employed.

Fevers in isolation aren’t necessarily a reason for immediate concern or for ringing up a doctor. However, there are specific instances when it’s prudent to seek medical counsel, whether for your infant, child, or yourself.

Infants and toddlers

For infants and toddlers, a fever can be especially worrisome. You should contact your child’s healthcare provider under the following conditions:

• If the child is under 3 months old and has a rectal temperature of 38 degrees Celsius (100.4 degrees Fahrenheit) or above.
• If aged between 3 and 6 months and either has a rectal temperature exceeding 38.9 degrees Celsius (102 degrees Fahrenheit), or has a lower temperature but appears notably irritable, lethargic or uneasy.
• If between 7 and 24 months old and has a rectal temperature over 38.9 degrees Celsius (102 degrees Fahrenheit) that persists for more than a day, but without other symptoms. Should other symptoms like a runny nose, cough, or diarrhoea also be present, contacting healthcare sooner is advisable

Children

There’s generally no reason to be overly concerned if your child has a fever yet remains responsive. Indicators of responsiveness include maintaining eye contact with you, reacting to your voice and facial expressions, and being able to drink fluids and engage in play.

Contact your child’s healthcare provider in the following situations:

• The child seems lethargic, disoriented or fails to make adequate eye contact with you.
• Displays significant discomfort due to persistent vomiting, intense headaches, sore throat, or stomach pain.
• Has developed a fever after being confined in a hot vehicle. Immediate medical attention is crucial in such cases.
• Experiences a fever that persists for more than three days.
• Suffers a seizure in conjunction with the fever. Call 115 emergency services if the seizure extends beyond five minutes or if recovery is not swift.

Adults

Contact your healthcare provider if your temperature reaches or exceeds 39.4 degrees Celsius (103 degrees Fahrenheit). Immediate medical intervention is advised if any of the following symptoms accompany a fever:

• Intense headache
• Skin rash
• Extreme sensitivity to bright light
• A stiff neck, aggravated by bending your head forward
• Cognitive disorientation, bizarre behaviour, or slurred speech
• Continuous vomiting
• Breathing difficulties or chest discomfort
• Pain in the abdomen
• Pain during urination
• Convulsions or seizures

Body temperature typically maintains a balance between heat generation and heat dissipation. The hypothalamus, an area in the brain acting as the body’s ‘thermostat,’ oversees this equilibrium. Even in a healthy state, body temperature experiences minor fluctuations throughout the day, often lower in the morning and rising in the late afternoon or evening.

When confronted with illness, the hypothalamus may elevate the body’s temperature. This triggers intricate mechanisms to increase heat production and minimise heat loss. Shivering is one such mechanism for generating heat. Bundling up in a blanket assists the body in retaining warmth.

Fevers that stay below 40 degrees Celsius (104 degrees Fahrenheit) and are linked with common viral infections like flu or influenza can actually aid the immune system and are generally not detrimental.

Various factors can cause a fever or increased body temperature, including:

• Viral or bacterial infections
• Heat exhaustion
• Specific inflammatory conditions, such as rheumatoid arthritis, which involves inflammation of joint linings (synovium)
• Malignant tumours
• Certain medications like antibiotics or those used for treating hypertension or seizures
• Some vaccinations, including those for diphtheria, tetanus, acellular pertussis (DTaP), pneumococcal diseases, or COVID-19

Children aged between 6 months and 5 years are at a heightened risk of experiencing a seizure triggered by a fever, commonly known as a febrile seizure. Roughly one-third of children with one febrile seizure are likely to experience another, most frequently within the subsequent 12 months.

A febrile seizure might entail a loss of consciousness, symmetrical limb shaking, eyes rolling back, or rigidity of the body. While this can be deeply unsettling for parents, most febrile seizures don’t result in long-term harm.

Should a seizure occur:

• Position your child on their side or stomach, ideally on a flat surface like the floor
• Clear the area of any objects with sharp edges
• Loosen any constricting clothing
• Gently hold your child to minimise the risk of injury
• Avoid putting anything into the child’s mouth and refrain from trying to halt the seizure
• Dial 115 or your local emergency service if the seizure lasts beyond five minutes or if your child doesn’t seem to recover well post-seizure
• Seek immediate emergency or urgent care if it’s your child’s inaugural febrile seizure

If emergency care isn’t needed, consult your child’s healthcare provider for a thorough evaluation at the earliest opportunity.

Reducing the likelihood of developing fevers may be possible by minimising exposure to infectious agents. The following pointers may assist:

• Ensure you and your children are vaccinated per the recommended schedule, particularly for diseases like influenza and COVID-19
• Adhere to public health protocols such as mask-wearing and maintaining social distance
• Establish a regular handwashing routine for yourself and educate your children to do likewise. This is particularly important before meals, post-toilet use, after being in crowded spaces or in the proximity of an unwell individual, following contact with animals, and while using public transport
• Instruct your children on the proper method of washing hands, ensuring that both the front and back of each hand are thoroughly cleaned with soap and completely rinsed under flowing water
• Keep hand sanitiser handy in case soap and water aren’t available
• Exercise caution to avoid touching facial orifices like the nose, mouth, and eyes, as these are primary entry points for bacteria and viruses that can cause infections
• Implement proper respiratory etiquette by covering your mouth when coughing and your nose when sneezing. Educate your children to do the same. If possible, turn away from people when coughing or sneezing and use your elbow to contain the germs
• Refrain from sharing drinking vessels, water bottles, or eating utensils with your child or children