I've seen a lot of people in the past couple of weeks who are pretty sick with the flu.  Many of them have experienced a fever.  Unfortunately, me and my family have not been exempt from this experience in recent weeks.  The worst symptom of the flu is often the fever.  It can create chills, shivering, increased heart rate, loss of appetite, body aches, sweats, and general malaise. 


A fever is the body's natural response to a bacterial or viral infection.  A fever increases metabolic rate and can speed up the healing process.  More white blood cells, like macrophages (cells that eat foreign invaders), are produced and released at a faster rate during a fever.  The biochemical process that causes fevers is quite complicated but one of the key players is interferon.  It's a protein that is released from cells that are infected with a virus or bacteria in order to help protect other non-infected cells.  Interferon triggers a cascade of events that eventually lead to the part of the brain that controls body temperature, the hypothalamus, to reset the body's thermostat.

In most cases, fever is not a dangerous situation.  A fever as high as 105° in a child, while uncomfortable, is the sign of a healthy response.  In adults a fever up to 103° is considered safe and healthy.  In fact, in some cases it may be beneficial to try to raise the temperature if a fever is only 100-101°.   The biggest concern with fevers in children is seizures.  The main cause of febrile seizures is dehydration and electrolyte imbalance.  Staying hydrated during a fever is the number one goal.  This will not only help with overall headache and body aches but it also helps to avoid febrile seizures in young children.

The loss of appetite that comes with having a fever is the body's means of conserving energy. The body spends 60% of its energy on digestion and when digestion is slowed down or not needed then that energy can be used to fight infection.

It's important to try to avoid suppressing a fever for as long as possible.  Medication to help lower a fever like acetominophen and ibuprofen can be used if fever is very high for a prolonged period or gets too high too quickly.  Here are some tips to safely manage a fever:

1. Hydrate - encourage drinking of electrolyte replacement drinks that can be made into popsicles as well. 
2. Enhance a fever if needed with chamomile, ginger and yarrow tea.
3. Monitor the temperature frequently, especially in a child.  The most accurate way to obtain the temperature in a young child is rectally.
4. Rest - No matter how busy you are you must conserve energy and stay in bed.  To keep young children still try putting on their favorite video.  Often the aches and malaise that come with the fever don't allow for much activity.
5. Observe for signs of dehydration.  Babies should urinate at least once every 6 hours, children and adults should urinate at least once every 12 hours.  Sunken eyes, dry mouth, dark urine, little to no tears when crying, lethargy, dizziness and even confusion are all signs of dehydration.

If your child experiences a febrile seizure:

• Seek medical help immediately, not tomorrow morning. Call 911.
• While waiting for emergency help, keep your child upright and make sure their airway stays open and they are able to breathe.  Watch for changes in your child's breathing and/or color.
  
• Stay with your child and speak reassuringly.
• Clear the area around your child to prevent injury. Do not try to hold your child down. Restraining a thrashing child can cause additional injury. Try placing a soft pillow or blanket under your child's head. Loosen clothing to prevent injury and ease discomfort.
• Do not try to force anything into your child's mouth. You might cause choking, or suffer a bite yourself.
• If vomiting occurs, turn your child's head to the side so that there is no risk of your child choking on inhaled vomit. If possible, keep your child's whole body turned on the side as well.

To cool a really high fever naturally and help a child or adult with a fever try a wet sheet wrap.  For a small child a pillow case can be used.  Get the sheet or pillow case soaking wet with cold water.  Be sure to wring it out so that it isn't dripping wet.  Wrap the child very quickly in the sheet or pillow case and cover the wet sheet with a warm blanket, preferably wool.  It's most important to wrap the torso, so their arms can be free if they aren't comfortable being wrapped tightly.  They will object at first to the cold wet sheet, but will immediately be comforted by the cooling sensation.  They will most likely fall asleep shortly after being wrapped up.  Let them sleep as long as they can in the wrap; two hours or more is best.  If they will tolerate it all night long that is ideal.  For an adult lay the dry blanket on the bed and place the wet sheet on top of that.  Lay down on the wet sheet and wrap yourself up snugly or have someone help you.  Again, sleep in this for as long as you can tolerate it, preferably overnight.  The sheet will be dry in the morning.  This technique can be used to help "break" a fever. 

(My 3 year old son resting comfortably with a cold, wet pillowcase on his back.)

Remember, keeping a fever elevated will help to shorten the length of time you or your child will be sick.  It may be uncomfortable now, but you'll be grateful in the long run.