Situation
Aunty Fatima’s nephew, Josiah is 3 years old who got a cold and hasn’t been feeling well over the past few days. His mom has given him some paracetamol (Panadol) but it hasn’t improved his condition. His mum is worried about him as she heard that the fever might go to his head if it’s not controlled. So Aunty Fatima recommends that he get a cold shower or at least get a good rub down with Bay rum.
What is a fever?
A fever or temperature is a sign that your body is fighting an infection. It is the result of the body releasing lots of chemicals and brain changes to help you body kill the bugs/infection. When this happens, more blood goes to the skin, heat is lost with water and the child feels cold. Most children are easily managed with Panadol (paracetamol) and rest as their own body would fight the infection. However, sometimes kids like Josiah may not be able to deal with the bugs in his system. It is not recommended to use the height of temperature alone to identify a child as having a serious illness.
Instead, below are some of the signs Aunty Fatima should look for in Josiah if he is very unwell (1):
- Kids < 3 months with a temperature of 38°C+
- Kids > 3 months with a temperature of 39°C+
- Uncontrolled fever lasting more than 5 days
- Fast breathing with “weird” sounds
- A new rash or child looks “dry”
- Neck stiffness or floppy/unconscious/drowsy, “not their normal self”
What is a febrile convulsion?
Aunty Fatima heard stories from the “old people in her village” about fevers “going to the head” and causing their kids to have a seizure (fit). A febrile seizure or febrile convulsion is an uncommon situation in kids between the ages of 6 months and 6 years where kids like Josiah have a fit because their body is very hot. If this happens, parents should let the child be seen by a doctor and steps should be put in place to control these episodes.
How does paracetamol work?
Panadol (paracetamol) is a good drug and works to bring temperatures down but other drugs like Ibuprofen can be used to help control the temperature. However, whether or not paracetamol reduces the chance of kids like Josiah having a febrile convulsion, is still being researched. (3)
Is a cold shower or a rub down of any use?
A cold shower causes less blood flow to the skin and may prevent normal loss of heat. There is very little research into whether cold showers, sponge baths (tepid sponging), with or without alcohol (bayrum) helps control fevers. Some studies suggest that it is no better than using paracetamol (Panadol) and therefore it is not recommended for reducing fever if medication is available. (1,3)
What should she do?
At home, Aunty Fatima should offer Josiah regular fluids, check for any rashes which don’t disappear when a glass is pressed on it and keep checking on Josiah at night.(1) If Josiah’s parents are concerned about his health they should take him to see a doctor as there are many illnesses (some very serious) which can present with a child with a fever as the only symptom.
Conclusion
There are many viruses (bugs) which can cause Josiah to get a fever. If Josiah gets most of these, he would get better on his own. However if there are signs that Josiah has difficulty breathing, blacks out or develops a rash, or if Aunty Fatima is worried about him, it is important that she gets him to see a doctor as soon as possible.
References
- National Institute for Health and Care Excellence. Feverish illness in children: assessment and initial management in children younger than 5 years. NICE 2013 May:CG160 PDF link at: http://www.nice.org.uk/guidance/CG160 accessed on 12/11/15.
- Al-Nouri, Luay, and Khalid Basheer. “Mothers’ perceptions of fever in children.”Journal of tropical pediatrics 52.2 (2006): 113-116.
- Meremikwu, M. M., and A. Oyo-Ita. “Paracetamol for treating fever in children.” (2009).
*Image:
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