Thursday, March 09, 2006
A high fever is a bad thing, and other myths

By Dr. Anthony Policastro
Nanticoke Memorial Hospital,
Medical director

There are a lot of myths and misunderstandings about fever.
Myth 1: Fever is caused by infections. This is not true. Fever is part of the body's immune system. It helps fight infections. Viruses and bacteria grow best at 98.6 degrees. Our body knows that. Raising the body temperature slows their growth down. Thus fever is a protective mechanism. It is a good thing.
Myth 2: We treat fever because it helps the infection. This is not true. We treat fever purely to make the patient comfortable. People with fever feel bad. We lower the temperature purely to make them feel better. Since fever is a good thing, treating it might actually help the infection. The viruses and bacteria will grow better if the temperature goes down.
Myth 3: Once the fever comes down with Tylenol or Motrin, it should stay down. This is not true. Tylenol and Motrin temporarily lower the temperature. When they wear off, the fever comes back. It is the body's way of saying that it is still fighting the infection.
Myth 4: If someone has a fever they should always get medication to lower it. This is not true. Fever helps fight the infection. We treat it to make the patient comfortable. If they have a fever, but are not uncomfortable, there is no reason to treat it.
Myth 5: A high fever means a more serious infection than a low fever. This is not true. The body will decide which temperature it needs to control the growth of the infecting organism. For example, appendicitis rarely causes a fever above 101 degrees. Once the appendix ruptures, the fever frequently goes much higher. Both times the body has decided what is the right temperature to be at. Roseola is a minor childhood viral illness. It is often associated with temperatures of 104 degrees or higher.
Myth 6: Motrin works better than Tylenol to reduce fever. This is not true. In most cases, they do the same thing. In some patients Tylenol works better. In other patients Motrin works better. The big difference is that Tylenol needs to be given every four hours and Motrin needs to be given every six hours.
Myth 7: A high temperature will harm the patient. This is only partially true. While very high temperatures can harm a patient, most infection-related temperatures do not come close to that. Temperatures above 106.4 degrees can be harmful. I have only seen seven such patients in 33 years of pediatrics. Since the body raises the temperature, it usually keeps it a safe level. The times when temperatures become problems are special situations. Heat stroke is one example of that kind of situation. In that case, it is not the body raising the temperature. The temperature is raised because of the outside heat.
Myth 8: A high temperature will cause a seizure. This is only partially true. Some children between the ages of 6 months and 4 years may have a seizure with a fever. Other age groups do not have this concern. In addition, since the body is raising the temperature, it usually keeps it at a level below the seizure level. Each child has a different temperature at which he/she will have a seizure. There is no specific temperature at which this happens. Most of the time, these seizures occur when the child first gets the high fever. That is sometimes how you know the child is sick. Once they have the fever, it is less likely to happen.
Myth 9: A cool bath will lower a fever. This is only partially true. A lukewarm bath with one inch of water in the tub will lower a fever in 45 minutes. However, for the first five minutes, the body reacts with a slight increase in the fever. If a child has a temperature just below the one that causes a seizure, this slight rise in temperature right after a bath can cause a seizure. I have seen it happen many times. No bath should be used unless Tylenol or Motrin has been given 30 to 45 minutes before. Alcohol baths cause seizures and can lower blood sugar. They are a definite no-no.
Myth 10: A fever that lasts more than 24 hours is bad. This is not true. The body's immune system takes 72 hours to clear an infection. Most fevers last for that 72-hour period. When the fever lasts beyond that, it is time to ask why.
Myth 11: Children who get fevers often have an underlying medical problem. That is partially true. There are some rare children with immune problems who get frequent fevers because of that. They are not often seen. The usual story is a child between the ages of 6 months and 2 years who gets a fever every two weeks. This is normal.
A child loses the immunity he/she gets from the mother across the placenta at 4 to 6 months of age. The child then gets infected with viruses and bacteria that cause 72 hours of infection. The child is well for 10 days while the immune system is turned on. Then the child gets sick for 72 hours and is well for 10 days. This continues until he/she reaches age 2. By that time he has been exposed to most of the common infections. He then gets infected less often. This pattern of fever every two weeks is normal. It is more likely in children who go to day care and are exposed to more infections. This is my top-10-plus-one list of fever myths. There are indeed others. The best thing to do when you are treating a fever is to remember that fever is a good thing. It is there to help fight the infection.

Relay for Life, to raise funds to fight cancer, to be May 19
The American Cancer Society Relay For Life of West Sussex is just around the corner. Register your team today by calling the American Cancer Society at 410-250-4426. This "celebration of life" brings the Sussex community together in a unified effort to fight cancer. Former and current cancer patients, their families, businesses, civic organizations and the public are invited to take part in this team event. Relay For Life takes place from 6 p.m. on May 19, until 8 a.m. on May 20, at the Nanticoke Hospital Cancer Center parking garage. Relay For Life is the American Cancer Society's version of an athletic relay, but with a new twist. Relay For Life is a family-oriented event where participants enjoy the camaraderie of a team and also raise funds to support the activities of the American Cancer Society. Participants camp out at the relay site, and when they are not taking their turn walking, they take part in fun activities and enjoy entertainment. Teams from companies, churches, organizations, hospitals and schools collect donations and can win individual and team prizes for their efforts. "Relay For Life brings the progress against cancer to the forefront," said Mary Catherine Hopkins, event chairwoman. "Many participants are our family, friends and neighbors who have dealt with cancer themselves. Their involvement is proof of the progress that has been not only reducing death rates, but also in the quality of life following cancer treatment. "The funds raised enable us to continue our investment in the fight against cancer through research, educations, advocacy, and patient services," said Mary Lee Groton, chairwoman. "Thanks to the generosity of corporate sponsors like Trinity Transport Foundation, the money raised goes directly to the American Cancer Society's lifesaving programs." Information about how to form a team or become involved in Relay For Life is available from the American Cancer Society at 875-7308, or 1-800-ACS-2345, available 24 hours a day, seven days a week, or visit the Web site The American Cancer Society is the nationwide community-based voluntary health organization dedicated to eliminating cancer as a major health problem by preventing cancer, saving lives and diminishing suffering from cancer through research, education, advocacy and service.

Lecture series to address rehabilitation from injury
Nurses, athletic trainers, physical and occupational therapists and their assistants can earn required credits for continuing education by attending the eighth annual Distinguished Lecture Series at Delaware Tech, Owens Campus, Georgetown, on Saturday, March 18. This year's topic, "Evidence-Based Rehabilitation of Sports Injuries," will help clinicians use current medical knowledge to design effective treatment programs for common sports-related injuries. Participants will explore how to help both the weekend warrior and the elite athlete return to active sports in less time with fewer office visits through functional progressive interval programs. Discussion will include an introduction to evidence-based medicine and its five basic steps. Presenter Dr. Jeff Konin is a licensed physical therapist and certified athletic trainer who has given numerous speeches and written various textbooks, chapters and published manuscripts related to sports medicine. He works as an associate professor of health sciences and assistant athletic director for sports medicine at James Madison University in Harrisonburg, Va., and serves as the director of the National Center for Youth Sport Injury. The seminar fee of $99 includes handouts, lunch and refreshments. For more information, or to register, contact corporate and community programs by calling 854-6966.

Representative from drug program to speak
A representative from the Delaware Prescription Assistance Program will be at the CHEER Community Center on Sand Hill Road, Georgetown, to offer education and outreach support to those needing assistance in understanding the new prescription drug program. The representative will be at the center:

  • Tuesdays, March 14 and 28 from 11:30 a.m. to 1:30 p.m.
  • Tuesdays, April 11 and 25 from 11:30 a.m. to 1:30 p.m.
For more information, call 854-9500.