Health
How to Deal with Fever
I provide valuable perspectives on fever treatment from various sources, especially within the pandemic context.
“Hippocrates Was Right: Treating Fever Is a Bad Idea” is the title of a presentation by medical doctor Paul Offit on the YouTube channel of the College of Physicians of Philadelphia. He provides a historical overview of the topic with eye-opening statements.
Fever is a natural response our body produces when we are sick. Most of us have experienced it at different ages. Some people get treatment, and some don’t. In many countries, the most common treatment of fever is using paracetamol and ibuprofen, which might have other names in various countries.
People feel uncomfortable when experiencing fever. So, for patients who desire quick treatment, some medical experts usually believe that not treating fever can provide better outcomes for various reasons.
However, there are always exceptions, as pointed out in some studies in this article. So, there is not a universal agreement on this.
I experienced fever many times in my childhood, especially with flu or cold. But interestingly, I never needed medical treatment for my fever. Our parents gave us fever-reducing tablets and kept us hydrated.
I remember using Vicks on our chest. The smell of Vicks always reminds me of my childhood sick days. I also observed it in my family members, and we did not need medical intervention.
However, fever attracted my attention the most when one of my family members was recently exposed to the Covid-19 virus, as I shared in this personal story.
Fever was the initial indicator and a potent sign of the Covid virus in this case. We were glad to observe this symptom which helped us seek emergency medical advice during this frightening incident.
Since we experienced a Covid situation the first time, seeing the high temperature in my partner concerned me significantly.
I called several clinics. Even though health professionals refrained from giving advice, they did not recommend I should consider paracetamols to drop the fever. Their firm recommendation was to call emergency and get the relevant medical crew to make an informed decision.
I followed the advice and called an ambulance. Interestingly, one of the doctors mentioned the term hyperthermia. Moreover, the paramedics also confirmed the complexity of fever in the Covid situation.
I understood that sometimes people confuse fever with hyperthermia. In this condition, the set point for body temperature remains unchanged. Another related term to fever and hyperthermia is “hypothermia”.
In this condition, body temperature drops below 35 Celsius. It is considered a medical urgency as the condition might adversely affect the function of the heart, nervous system, and respiratory system. The primary treatment, in this case, is warming the body until it reaches around 37 Celsius.
In this post, I explain the reasons for treating and not treating fever in general from scientific papers and the perspectives of experts. Fever is an indicator of health conditions, so we need to take it seriously when we are sick. By the way, the adjective “febrile” means showing the symptoms of a fever.
First, let me define fever so that we think on the same page. Fever is a sensation produced by our immune system as a protection mechanism. This sensation manifests as increased body temperature. As I mentioned in this article, our body temperature is highly regulated by homeostasis. So, seeing a significant increase from the normal temperature range is a good fever signal.
However, there are also other signs of fever, such as shivering, chills, perspiring, muscle pain, irritability, headache, dehydration, and weakness. Apart from these feelings, the most effective way of finding symptoms is by measuring temperature. Measuring higher temperatures than 37 Celsius degree or 98.6 Fahrenheit indicates fever. For example, 38C or higher can be a good indicator.
People usually use forehead or ear thermometers for convenience. Nonetheless, oral and rectal thermometers are believed to be more accurate. When we were raising kids, nurses recommended using rectal ones for infants in my country. I am not sure about the practice in other countries. It is always great to attain advice from qualified healthcare professionals to get accurate results.
Let me give you perspectives from a few scientific resources that I reviewed related to this topic. Most of the scientific papers I reviewed consider fever as stimulating both innate and adaptive immune responses.
The perspectives underline that it is integrated into our neural circuitry and physiology. The standard view is fever has an essential role in dealing with certain conditions in the body — no one disputes this. So, the key message is fever is not accidental but by design in our evolution. However, its treatment is disputable.
Fever has been known as an indicator of infection and inflammatory diseases in medicine for a long time. As mentioned in this historical resource, febrile temperatures are closely linked to the inflammatory response as heat is one of the four cardinal signs of inflammation, along with pain, redness, and swelling.
In general, fever is believed to be a lifesaver in treating some diseases. Interestingly, in the early 20th century, medically induced fever was used to treat some diseases, as discussed in this resource. So not only natural but also artificial fever is used as a treatment for infectious diseases. Fever is a cornerstone diagnostic sign in medical practice.
Fever helps in early and appropriate therapy and allows physicians to follow the infection course, as highlighted in this paper.
Even though fever is believed to be beneficial in creating the optimal environment for healing in most cases, it is not considered universally helpful.
For example, this study concludes that “in the most severe cases of SIRS, the natural development of hypothermia may be more advantageous than the development of fever, not only when SIRS is induced aseptically by LPS, but also when it is induced septically by E. coli. The advantages of hypothermia over fever include, but are not limited to, suppression of endotoxemia and of the lung infiltration by neutrophils.”
One exception is fever in septic patients. Septic means infected with microorganisms such as harmful bacteria. This review on BMC aims to delineate the advantages and drawbacks of fever in septic patients.
It points out that “in recent years, fever control in critically ill patients by medications and/or external cooling has gained widespread use, notably in patients suffering from neurological injuries. Nevertheless, such a strategy in septic patients is not supported by relevant data.”
The paper highlights that “in response to sepsis, experimental and clinical studies argue that fever plays a crucial role in increasing the clearance of microorganisms, the immune response, and the heat shock response. Moreover, fever is a cornerstone diagnostic sign in clinical practice, which aids in early and appropriate therapy, and allows physicians to follow the infection course.
Fever is a natural response of immune systems not only in humans but also in animals. I believe most of us experience fever several times, especially in our childhood. In addition to children, we may observe fever in our pets too.
In general, fever is not considered dangerous. People usually treat it with over-the-counter medication such as paracetamol or ibuprofen. Avoiding heat, staying hydrated, and resting is recommended when experiencing generic fever. Intriguingly, some healthcare professionals told me that waiting just a few hours before taking over-the-the-counter medications might boost the immune system.
The common perspective is fever is a natural response to threats to the body. However, it becomes serious when it relates to sudden sickness or an infectious disease. It is riskier for infants and even young children. Therefore, getting timely medical advice is highly recommended in these situations.
The advice from this paper titled Let fever do its job: The meaning of fever in the pandemic era published in Oxford Academic is “For infections with novel SARS-CoV-2, the precautionary principle applies unless evidence suggests otherwise, we advise that fever should be allowed to run its course.”
The rationale behind the recommendation of these researchers is that “Observational trials in humans suggest a survival benefit from fever, and randomized trials published before COVID-19 do not support fever reduction in patients with infection. Like public health measures that seem burdensome and excessive, fevers involve costly trade-offs, but they can prevent infection from getting out of control.”
Another immediate research requirement is related to inflammation considering the Covid situation. Some preliminary studies indicate that fever can reduce inflammation caused by the Covid virus. However, there are no clinical trials on it. Therefore, it is recommended to conduct new research to gain insights into the effects of fever on Covid. I hope independent researchers and research institutes take these promising hypotheses seriously in these critical times.
I started this post with a presentation from a medical doctor and want to finish it with important messages from another medical doctor who has 1.8 million followers on YouTube. Dr. John Campbell posted an informative video about fever leveraging perspectives of oncology and immunology Professor Sharon S. Evans. He also reviewed a paper titled “Fever and the thermal regulation of immunity: the immune system feels the heat”.
Dr Campbell speaks in simple language so anyone can understand his reviews.
Thank you for reading my perspective.
I wish you a healthy and happy life.
Please note that this story is not health advice. I shared my reviews, observations and perspectives for information purposes only. If you have related diseases, please consult your healthcare professionals.
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I am a technologist, postdoctoral researcher, author of several books, editor, and digital marketing strategist with four decades of industry experience.
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