Fever is a term used in many different ways. Some people mean it to be just a temperature, others mean shivering or hot and cold or flu-like symptoms.
Unfortunately, while most fevers are caused by viruses and almost all are harmless, they can also be a sign of more significant illness. If you have any doubts at all, you should call healthline on 0800 611 116 or see a doctor. Never fear to call an ambulance if you are worried. Dial 111.
- Worsening symptoms despite treatment
- Convulsions or fitting
- Severe or worsening headache
- Breathing problems
- Severe or worsening pain
- Rash (link to meningitis society)
Adults who have a fever will often feel a little 'vague', may have a headache or aching joints and may feel alternately hot and cold. Uncontrollable shivering (rigors) are unusual and often associated with more severe illness.
Children with a fever are often irritable and may feel hot to touch. They may be more prone to crying and want to sleep more than usual. Temperatures up to about 40 Celsius are quite common.
The degree of a temperature is not necessarily an indicator of severity of illness. Patients with any of the worrying signs listed above should see a doctor at once regardless of their temperature. Despite commonly held opinion, there is no evidence that fever itself is harmful and there have been a few studies that suggest that treating fevers with paracetamol may delay recovery from viral illness. We recommend that you do not treat a fever unless the patient is miserable - if it isn't bothering the patient it does not need medication.
Even though they say they feel cold, children with a fever should NOT be wrapped up warm. Light clothing is appropriate. Cold sponging actually does more harm than good and should be avoided.
Almost all patients with a fever will feel better if they receive paracetamol. Ibuprofen may be added in most cases for temperatures that do not settle quickly (but do check our guidance for dose and safety notes).
It is not necessary to measure temperatures repeatedly as the overall condition of the patient is much more useful as a guide to wellness. The cheapest and most reliable way to measure temperature is with a digital thermometer in the armpit. Tympanic thermometers are fast but not as simple to use and may produce unreliable results. Forehead colour strip thermometers are a waste of money.
Patients with fever become dehydrated which makes them feel awful and can be dangerous. Offer plenty of non-alcoholic fluids. It is generally best to avoid sugary drinks. Rehydration salts are rarely necessary as water alone is just as good in almost all cases though where vomiting and diarrhoea are combined they could be considered.
For children, a return to normal activity levels and temperament once the fever settles is a good sign.
The Next Day
Most fevers in adults and children will settle within about 48 hours. If fever lasts longer than this, you should see a doctor.
All children under 2 with a fever should see a doctor although this can wait until morning if the child appears otherwise well and no worrying signs are present.
Most patients with a fever and localised pain should see a doctor. Pain associated with a fever might be a sign of a more significant bacterial infection.
Remember not to take any chances. We see a lot of patients who worry that they may be wasting our time with a fever. THIS IS NEVER THE CASE! If you have any doubts at all, please come and see us or visit the 24 Hour Surgery after hours.
Adults and children with viral illnesses are most infectious when they have a fever. Please stay away from work or school if you have a temperature.
If you attend the surgery with a fever, please let the receptionist know and we will provide a mask to wear or place you in a separate room to wait.