Fever is defined as a high body temperature of more than 37.5degrees Celsius or a low body temperature (in children) of less than 35 degrees Celsius. The person may present with the following symptoms
- Feeling warm to touch
- Feeling cold and chills
- Shivering, Chills/rigors
- Tiredness/fatigue
- Thirst
- Sweating and flushed skin, or cool/clammy skin
- General malaise or body aches
- Headache
- Aching muscles and joint pain
- Symptoms of illness (nausea/vomiting, cough)
Danger Signs of fever:
- Confusion/delirium
- Stiff neck or is very sensitive to light or severe headache (may be a sign of meningism)
- Bulging fontanel on baby’s head
- Fits or seizures (occurs with VERY high fevers)
- Respiratory problems ( Rapid breathing or difficulty breathing)
- Ulcers in the mouth or throat (may be a sign of measles)
- Severe vomiting or diarrhea
- Severe dehydration (sunken eyes, “tenting” of the skin when pinched, lethargy)
- Generalized rash
- Has blue lips or skin and is not breathing
ALERT: measles and malaria are common causes of fever in Malawi and two major causes of death in children. Because of this, ALL CALLERS WITH A FEVER SHOULD BE REFERRED TO THE HEALTH FACILITY
If a child has a fever above 40 degree Celsius (104 F):
- Cool the child down immediately to avoid a seizure
- Remove them from sun – place them in a cool, dark room with a fan or breeze
- Place the child in cool water (or apply cool, wet cloths to their head and armpits – DO NOT use cold water or ice)
- Give the child dose of Panadol (paracetamol) as recommended by a health provider
A VERY high fever in children can cause seizures (and eventually brain damage). If a child is extremely hot, cool them down and then take them to the health center.
Attention Hotline Staff: The following section may be used for client education but DO NOT attempt to diagnose the client or suggest at-home care unless they have already been evaluated in a health facility and cleared for at-home treatment by a health care provider
A fever or a high temperature is not by itself an illness. It's usually a sign of an infection. Fevers can be caused by minor infections or very serious illnesses, so treatment of a fever will depend on what is causing the fever. The cause of a fever must be determined by a provider in the health facility.
Common Symptoms of Fever:
- Chills/rigor
- Tiredness/fatigue
- Thirst
- Sweating and flushed skin, or cool/clammy skin
- General malaise or body aches
- Headache
- Aching muscles and joint pain
- Symptoms of illness (nausea/vomiting, cough)
Recommend the following strategies if the person has already been evaluated at the health center, and has a fever that is not caused by a serious illness that requires medical treatment…
How to manage symptoms of fever (at home):
- Cool the person using fans, or sponging the skin with cool or lukewarm water and allowing them to air-dry
- Ensure the person is well hydrated with fluids (like: clean water, fruit juice, light porridge, rice water or coconut milk)
- If a baby has a fever continue breast feeding and maintain adequate nutrition and hydration
- Ensure the person gets plenty of rest
- Administer paracetamol as recommended by a health provider, if appropriate
Fever may be caused by:
- Serious illness (like malaria, measles, meningitis or typhoid)
- A common cold
- Bacterial or viral infection (like an ear infection, chicken pox or pneumonia)
- Common childhood illnesses (like Fifths disease)
- Teething (may cause a slightly elevated temperature)
- Heat exhaustion
- Inflammation
- Acute HIV infection (the first symptom of HIV infection is typically a fever and cold symptoms – do not alarm callers, just refer them to the health center for further evaluation)
- Some medications
- Some immunizations (may cause a fever a few days after injection)
As stated previously, it is important to know what is causing a fever in order to choose the right course of action. A fever is the body’s natural response to infection.
Management of Fever: Treating the Cause of Illness
When a person with a fever is seen by a health provider, the provider will identify the cause of illness and administer medicine to treat the infection or illness. Treating the underlying infection will treat the fever. There are many ways to help a person with a fever feel better (see section above), but only treatment of the underlying illness will treat the fever.
Remember:
- Once you begin medication to treat the cause of a fever (like antibiotics), your fever may go away and you will start to feel better. It is important to continue to take the medicine as recommended, even if you feel better to fully treat the illness and prevent it from getting worse or returning
- Not all fevers are caused by illnesses that require medication. Some illness will go away with time and rest. You can use paracetamol (Panadol) at recommended by a health provider to manage symptoms while you are healing from the illness
How fevers are treated in the health facility:
- Blood tests will be taken to determine the specific disease that is causing the fever (and to make sure the correct medications are given to treat the disease)
- Antibiotics or other medications will be given to treat the cause of illness, depending on the results of the tests
- Rehydration may be required in cases of severe dehydration and may be administered in the form of ORS (oral rehydration solution) or intravenous fluid in more severe cases
- Medications like paracetamol may be given to reduce the fever and manage symptoms like headache, and chills
Fever Prevention:
- Sleeping under an insecticide impregnated bed net reduces your risk for malaria and fever
- Practicing good hygiene and infection control (frequent hand washing with soap) can reduce the spread of common illnesses, like bacterial and viral infections, colds and diarrhea