Fever a common illness in kids

Fever a common illness in kids

By Donya Betancourt

The Jakarta Post considers youngsters' health to be of the
utmost importance. After all, the future rests with our children.
Today, we start Kids' Health Corner, an interactive weekly column
to which readers can e-mail questions, comments and concerns to
features@thejakartapost.com or to the writer's e-mail address.

This column starts with one of most common illnesses in
children: fever.

SANUR, Bali (JP): Fever is one of the most common reasons for
a visit to the doctor. It may be a sign of a viral illness, a
minor bacterial infection or a life-threatening bacterial
process. While fever most typically indicates the presence of an
infection, on rare occasions it may be the presenting sign of
poisoning (aspirin) or a malignancy.

Question: What body temperature indicates a fever?

Answer: Normal body temperature is 37.0 C or 98.6 F. A fever
is more than 37.5 C (99.5 F) by oral thermometer, 37.0 C (98.6 F)
by axilla thermometer (placed in the armpit), 38.0 C (100.4 F) by
rectal thermometer.

Please remember to shake your thermometer to force the reading
down before taking your child's temperature. It is normal for
children to get hot after exercise but they should cool down
within 30 minutes. Remember it is not how high the fever is but
how rapidly the temperature goes up that causes a febrile
convulsion.

Fever in young infants (eight weeks or older) may be caused by
severe infection without many clinical findings. There may be a
history of excessive crying, irritability, lethargy or poor
appetite.

With an older child, clinical impression is more accurate.

There are many ways to take a temperature, which is the best?

For an infant or young child, it is best to take your child's
temperature with a rectal thermometer. For an older child or
teenager, an oral thermometer is the one to choose.

You may have heard of the new ear thermometers and the skin
thermometers. An ear thermometer is good for a child aged one
year or older because the ear canal is big enough and you can get
a proper reading from the ear.

Taking the temperature reading directly off the skin is
unreliable, especially if the skin is warm for other reasons
(e.g. sunburn). The temperature reading should give you a good
idea about the fever but it is not necessary to know if the fever
is exactly 100.8 F or 101.4 F.

What is a febrile convulsion?

A febrile convulsion is a seizure that happens when the fever
climbs too quickly. The symptoms are:
* sudden rise in temperature.
* listless and a vacant look, may be jittery.
* could be blue in the face.
* body may stiffen.
* limbs twitch.
* loss of consciousness.

Febrile seizures occur in 2 percent to 5 percent of children
from three months to six years of age during a febrile illness
that does not involve a central nervous system (CNS) infection.

The risk of seizure is greatest on the first day of illness,
and the convulsion often occurs before a fever is noticed.

Typically, a simple febrile seizure is generalized and brief
(about 15 minutes), and is almost always over before arrival at
the hospital.

The treatment is similar to that of fever. Lay the child down
with his face to the side and his/her head lower than the body.
Go to a doctor.

One-third of children who have a febrile seizure have at least
one recurrence, and one-half of these have a third convulsion.

Nearly one-half of recurrences happen within six months and 85
percent within one year of the initial seizure.

However, recurrence of febrile seizures does not increase the
risk of epilepsy.

How do I treat a fever?

1. Call a doctor immediately if the child has a febrile
convulsion and if the fever is accompanied by stiff neck, rash,
vomiting or diarrhea.

2. Reduce the temperature by:

* sponge bath with lukewarm water especially neck, armpits and
groin area because they have big blood vessels.

* do not use cold water as it constricts the blood vessels and
causes the body to retain heat.

* do not use alcohol because the fumes can lower the blood
sugar.

3. Medication:

* A 10 mg dose of Acetaminophen for every one kilogram of the
child's weight every four to six hours.

* In the case of fever exceeding 39.5 C (102.6 F) or not
responding to Acetaminophen, give one teaspoon of Ibuprofen for
every 10 kilograms of body weight every six hours.

* Acetaminophen suppositories are available in the case of
vomiting. However, I suggest a doctor is consulted concerning the
dosage suitable for your child.

* Give the child plenty of fluid. Never give Aspirin, as this
drug can trigger Reye's syndrome.

Remember a doctor should be contacted if the child is less
than eight weeks old, fever persists for more than two days in
other age groups, toxicity occurs regardless of age or degree of
fever, febrile convulsion develops or if the patient has a weak
immune system.

The writer, (drdonya@hotmail.com), is a pediatrician based in
Bali,