Fever - 10 Alert Pointers

Fever is usually caused by a viral infection and can be treated with home remedies like rest, soft nutritious diet, good hydration and paracetamol medication. The indicators below should alert one to seek medical opinion immediately.

1. High-grade fever with chills or sweats
2. Severe weakness, inability or difficulty in fluid/food intake
3. Severe headache, pain in/below/behind the eyes, ear pain, or neck stiffness
4. Nausea, vomiting or abdominal pain
5. Joint pains, swelling or stiffness
6. Breathlessness, chest pain, wheezing or wet cough with phlegm
7. Rashes or bleeding spots on the body or nose bleeds
8. Reduced urination, or cold extremities
9. Neurological signs – Confusion, loss of orientation, delirium, or convulsions
10. Fever beyond five days or returning after a few days of being absent

High-risk patient group– (have more chances of complications).

• Children below 2 years of age,
• Pregnant women
• Elderly>70 years
• Those suffering from diabetes, or conditions affecting liver, lungs, heart or kidney.
• Immune-suppressive conditions, medicines or treatments

Note – Fever with sore throat, cough, and breathlessness may be due to Coronavirus (COVID-19 Pandemic)

Taking Temperature Accurately and Properly

Taking the temperature accurately and documenting fever is an important part of many diseases or infections. Oral thermometers can be digital or mercury types calibrated in Celsius or Fahrenheit.

Accurate recording of temperature is very important to avoid undue panic or errors in clinical decisions.

The following points should be kept in mind while recording temperature:

1. Hygienic use: Preferably use different thermometers for different family members if suffering from an infection simultaneously. Before and after using the thermometer wipe the tip with cotton dipped in 70% alcohol disinfectant or wash the tip in running water with disinfectant hand wash. Pat dry with a clean cloth.
2. Technique: Place the thermometer under the tongue for 1 minute for the mercury thermometer or till the beep is heard in the digital thermometer. Then remove and note reading immediately.
3. Precautions: Do not take temperature immediately after gargling, taking steam, and hot or cold food/drinks. Avoid eating or drinking anything for at least five minutes before you take the temperature.
4. Interpretation: Normal body temperature is around 98.6°F or 37°C (with normal variation range of 1° to 2°F or ½° to 1°C), being lower in the morning and higher towards the evening. Fever requiring treatment with antipyretics like paracetamol is considered to be a temperature of 100.4°F (38°C) or above. Temperature above 102°F (39°C) is considered high-grade fever.
5. Device care: Make sure the digital thermometer battery is not low as that can give inaccurate readings. Mercury thermometers should be read at eye level for correct values. Make sure thermometers are not too old or cracked (especially in mercury thermometers for fear of leakage and inadvertent oral intake).

Note: Air gun or non-contact thermometer is for screening purposes, and do not have the accuracy for recording, monitoring, and deciding treatment during an illness.

Read about common causes of fever, with recommended precautions and care-

Mosquito-borne fevers

Common cold and Flu

Water-borne diseases

Pneumonia