Fever in infants and young children

Fever is common in children but is not necessarily harmful, nor is it always evidence of a serious illness. Fever is a sign that the body’s inflammatory response has been turned on. The most common cause of this is a viral or bacterial infection. Fever, or higher body temperature is thought to be adaptive and beneficial in that it helps neutralize the infecting microbe.

Fever symptoms can include:

• rapid breathing and heart rate
• glossy eyes and flushed or marbled skin
• lethargy

For children of any age, parents and caregivers should be attentive to changes in eating or sleeping habits, coughing, pain or other marked changes in a child’s behavior.

When does a child have a fever?

When does a child have a fever?

A child is considered feverish when he or she has an oral or rectal temperature of 38.2 Celsius (100.7 Fahrenheit) or higher.

When to seek medical advice

When to seek medical advice

Same day: we recommend heading to a network walk-in clinic or to the Emergency Department in the following cases:

• Children younger than 3 months with an oral or rectal temperature of 38. 2 Celsius (100.7 Fahrenheit) or higher should be seen by a doctor the same day
• In children over 3 months old with  an oral or rectal temperature of 38.2 Celsius (100.7 Fahrenheit) or higher, medical advice should be sought same-day if fever accompanied by the following: the child appears uncomfortable or in distress despite administering a fever reducer (acetaminophen or ibuprofen), the child complains of headache and stiff neck, the child refuses to drink, for prolonged periods of time, the child has had a convulsion (seizure)
• Children with chronic diseases or who have weak immune systems should also be seen early

Call Info Santé at 811, consult your pediatrician or family doctor, or head to your nearest network walk-in clinic in the following cases:

Mild flu symptoms, gastroenteritis and fever that generally lasts 3 to 5 days can be treated at home and do not require medical attention.

However:

• If your child’s fever is persistent after 3 days without any apparent cause, or;
• If fever remains present after 5 days along with other symptoms (such as runny nose, coughing, sore throat, etc. ), consult your pediatrician or family doctor, or head to your nearest network walk-in clinic.

Call 9-1-1

Don’t hesitate to call 9-1-1 if ever your child’s condition deteriorates seriously.

How to best care for a feverish child

How to best care for a feverish child

• Your child may not feel like eating much with a fever. To prevent dehydration, give your child plenty of fluids — water, juice, soup, flavored gelatin or ice pops.
• Use acetaminophen or ibuprofen if your child’s temperature is causing him or her discomfort. Reducing the fever does not change the natural course of the illness, but often makes the child more comfortable. A comfortable child is more likely to drink and eat which is important in fighting an infection. Be sure to follow the package’s instructions for your child’s age and weight. Do not give children and teenagers aspirin or aspirin-containing products, because they have been linked to Reye’s syndrome, a serious condition that can lead to coma and death.
• Dress the child lightly and use lighter bedclothes to avoid overheating.
• About 5% of children between 6 months and 6 years of age sometimes have seizures or convulsions (called febrile seizures) when they have a  fever. These seizures are seldom harmful and are caused by the combination of a virus and a change in temperature in a susceptible child. During a seizure, protect children from hurting themselves by keeping them away from nearby objects and making sure they are breathing freely. These seizures most often stop by themselves within a minute. Report the seizure to your child’s doctor. If the seizures continue, go to the emergency room.

How do I take my child’s temperature?

How do I take my child’s temperature?

There are several ways to take your child’s temperature. Our experts recommend rectal and oral methods because of their accuracy, and advise against checking temperature more than once a day. Additional temperature readings add little value.

The right method depends on your child’s age. Use this chart to help you decide which method to use:

An accurate temperature reading is especially important during the first 3 months of your child’s life. During this time, a rectal thermometer remains the most accurate way to measure your child’s temperature. 

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When to Call the Doctor for Your Child’s Fever

¿Le inquieta que su niño tenga fiebre? Le explicamos lo que necesita saber.

Advice From Our Experts

May 15, 2020

by 

Katie Sweeney

Nervous about your child’s fever? Here’s what you need to know. 

What should you do if your child has a fever? When should you call the doctor? And how is fever related to COVID-19 and a new, rare condition in kids called multisystem inflammatory syndrome in children (MIS-C)?

Christopher Tolcher, MD, FAAP, a pediatrician with Agoura-West Valley Pediatrics—part of the CHLA Health Network—shares the facts on fever and what parents need to know.

What counts as a fever?

A normal body temperature for a child ranges from 97 to 100 degrees, with an average of around 98.6 F. When a person’s temperature reaches 100.4 or above, it’s a fever. (With an oral thermometer, anything over 99.5 is considered a fever.)

Fever is good

Christopher Tolcher, MD

Fevers are common in children. And while a fever is never fun, in most cases it’s nothing to fear. It’s part of the body’s way of fighting an infection.

“Fever helps the immune system,” Dr. Tolcher explains. “It slows down the spread of viruses and bacteria. It helps the body make more antibodies and chemicals that fight the infection, and it helps the immune system’s cells move around better in the body.”

How high is too high?

“Fevers are almost never dangerous, with the exception of ‘hyperthermia’, or a high body temperature from the body’s being unable to cool off in a very hot environment,” he says. “A fever has to reach 107 to cause damage to tissues. That’s extremely rare.”

That said, if your child’s fever reaches 105, call your doctor. “It doesn’t mean the child is in danger,” he adds, “but the child should be checked by the doctor that day to see what’s going on.”

When to call the doctor

Call your child’s doctor right away for:

• A fever that lasts more than four to five days
• A fever (over 100. 4) in a newborn younger than 2 months old
• If you can’t reach your doctor, go to the emergency department.
• A fever of 105 or higher in a child of any age, including teens
• A fever in an infant (less than a year old) over 102 for more than two days—without a clear reason for the fever

If your child has a fever AND any of the following signs, call your doctor right away or go to the emergency department:

• Widespread, red or purple rash
• Stiff neck and bad headache
• Severe pain, including bad abdominal pain
• Shortness of breath
• Extreme weakness or altered mental state
• Dehydration (diapers are dry, child is not peeing much and urine is very dark)

Fever and seizures

Children under 5 can sometimes have a seizure during a fever. “Seizures are scary as heck to watch, but most of the time, you don’t need to go to the ER,” Dr. Tolcher says.

• If your child has a seizure that lasts less than two minutes, call your doctor.
• If a seizure lasts more than four to five minutes, call 911.

COVID-19, MIS-C and Kawasaki disease

• COVID-19. In children, COVID-19 symptoms can be similar to colds and flu and can include fever, runny nose and cough, and sometimes vomiting and diarrhea. If you think your child might have COVID-19, call your doctor.
• MIS-C. MIS-C is a new health condition seen in some children who have been infected with the novel coronavirus and recovered—but later had an immune response that caused high levels of inflammation in their body. The symptoms are very similar to Kawasaki disease. MIS-C and Kawasaki disease are not contagious, but can be life-threatening.

Call your doctor if your child has any fever for more than four or five days. Also call your doctor if your child has a high fever AND any of the following: cracked red lips, red tongue, red eyes, swollen hands and feet, rash, abdominal pain or enlarged lymph nodes.

“I want to reassure parents that MIS-C is rare,” he adds. “We need to watch for it, but don’t freak out.”

Tips for treating a fever

• Treat the child, not the number. “Focus on how the child is doing, not the number on the thermometer,” Dr. Tolcher says. “If the fever is 100.5, but the child is crying from a headache or earache, give a pain reliever. But if they have a 104 and aren’t that bad, just give them fluids and keep them comfortable.”
• Don’t over-bundle. Too many layers and heavy blankets will raise the fever higher—and make your child more miserable. The child should dress comfortably. Lightweight pajamas and light blankets are fine.
• Give plenty of fluids. “The body burns through water a lot faster when it has a fever, which is why extra fluids are important,” Dr. Tolcher explains. “You don’t want your child to get dehydrated.”

Tip: Watch how much your child is peeing. If your child’s urine is dark, or your child is not peeing as often as normal, give more fluids. Good options: water, clear soups, electrolyte solution or popsicles.

• Focus on comfort. “You don’t have to get the fever down to 98.6,” Dr. Tolcher says. “If a child has a 104 and a lot of body aches, giving one medicine will bring it down two or three degrees. That’s enough. You just want to make the child more comfortable.

“If you aggressively try to keep it down to 98.6, you slow the immune response to the infection,” he notes.

• Be careful with dosing medicine. Keep track of what medicine you give and when. You don’t want the child to get extra doses. And don’t exceed the dosing intervals on the medicine label. If the directions say wait six hours, wait at least six hours.

The best medicines for fever are acetaminophen (Tylenol) or ibuprofen (Advil). Never give aspirin. If COVID-19 is suspected or diagnosed, acetaminophen should be your first choice.

The bottom line? Keep your child comfortable, hydrated and at home. “We all need to rest when we’re sick,” Dr. Tolcher says. “That’s one of the benefits of fever. It slows you down and gets you to take a break.”

Hemorrhagic fever with renal syndrome (HFRS)

Measures to prevent hemorrhagic fever with renal syndrome (HFRS)

The Office of Rospotrebnadzor in the Perm Territory reminds owners of garden plots and residents of the region who plan to visit the forest, legal entities and individual entrepreneurs to prevent hemorrhagic fever with renal syndrome (HFRS).

Hemorrhagic fever with renal syndrome is a natural focal infection. The pathogen parasitizes in the body of small mammals and together with them forms foci of the disease that exist in nature for an indefinitely long time. Natural foci of HFRS in the Perm Territory are territorially located in the forest-steppe zone and forests of the southern territories of the Territory, bordering the Republic of Bashkortostan, the Udmurt Republic, the Kirov Region, are confined to massifs of deciduous forests and occupy a significant part of the territory of the Territory (about 60% of the territory of the Territory).

Perm region is endemic for this disease. HFRS diseases occur throughout the year. The lowest incidence rate occurs in February-April, in May the number of cases increases and reaches a maximum in September-October, then a gradual decline occurs. The nature of seasonality is determined by the number and species composition of rodents, the degree and frequency of contact of the population with the source of infection. The incidence rate in different years depends both on the number of rodents and on climatic and social factors (development of forest areas).

In 2022, 128 cases of HFRS were registered, the rate was 4.9 per 100 thousand population, there is a 4.5-fold increase in incidence compared to 2021 (1.07 per 100 thousand population), the indicator in the region is at the level of the Russian Federation (RF – 4.7 per 100 thousand population).

The reservoir of the HFRS pathogen in nature is small mammals (hereinafter referred to as MM, the main carrier is the bank vole). An analysis of the results of accounting work showed that the relative number of SMs in 2022 is 13.8% (average hit percentage), which is 2.9 higher than the same period last yeartimes (2021 – 4.7%), but at the level of average long-term indicators (13.9%). With a successful wintering of MM in 2023, , the epidemiological situation is expected to worsen in terms of the incidence of HFRS in the population of the region.

Infection of a person occurs by the air-dust route when the dried feces of infected rodents enter the respiratory tract with dust. Foodborne infection is possible through products contaminated with rodent secretions. Infections most often occur during a short stay on vacation in the forest, when working in gardens, vegetable gardens and cottages, at the place of residence, in houses located near the forest, in production related to work in the forest or near it, in the countryside, during transportation hay and straw, etc.

The disease begins suddenly – with chills, fever, severe headaches, aching muscles and joints, loss of appetite and general weakness. Subsequently, vomiting, nausea, dizziness, insomnia join.

If you do not seek medical help in time, severe forms of the disease can develop, which pose a serious danger to human life.

Preventive measures:

• when working with a large amount of dust (demolition of old buildings, loading of hay, straw, grass, dismantling of stacks of boards, logs, heaps of brushwood, cleaning of premises, etc.), it is necessary to use gloves and a respirator or a cotton-gauze bandage;
• cleaning of premises should be carried out only with a wet method;
• strictly observe the rules of personal hygiene;
• products must be kept inaccessible to rodents, stored in a metal, tightly closed container. Food products damaged by rodents cannot be used for food without heat treatment;
• do not drink water from open reservoirs;
• Never touch live or dead rodents without gloves or rubber gloves.

Legal entities, individual entrepreneurs, heads of horticultural non-profit partnerships, citizens must provide:

• improvement of the organization’s territories, sites and adjacent territories;
• organizing and carrying out deratization measures against mouse-like rodents on their territory, ensuring that buildings and structures are rodent-proof;
• carrying out preventive deratization measures against mouse-like rodents on their territory, including cleared areas of forests from debris, dead wood, dead wood, dense undergrowth, in autumn and spring.

An outbreak of mouse fever is predicted in Tatarstan 04/08/2023

Society

07:30 | April 8

8

Photo:
KazanFirst

Author of the article:
Anastasia Marukhina

Along with the onset of the dacha-barbecue season, the risks of contracting natural focal infections rise sharply. One of them is HFRS or mouse fever. According to doctors, Tatarstan residents become infected with this disease more often than with tick-borne encephalitis and other infections. Last year alone, the incidence of HFRS increased by almost 3 times.

This year, Tatarstan is waiting for the peak incidence of hemorrhagic fever with renal syndrome (HFRS) or, as it is popularly called, mouse fever. This statement was made by the republican Rospotrebnadzor.

– The infection is very important for us, for our region. HFRS has a cycle of three to four years. In 2022, we recorded the peak incidence. In the current year, we also expect an increase in the number of cases, given that, according to the forecast, an increase in the number of rodents is also expected, – warned the deputy head of the Office of Rospotrebnadzor in the republic Lyubov Avdonina at one of the press conferences.

Today the republic is in 3rd place in terms of the number of cases of mouse fever among the regions of the Volga Federal District. The results of the incidence of last year increased by 2.7 times compared to 2021. So, for 12 months, 293 cases of HFRS were registered, the incidence rate was 7.9 per 100 thousand of the population. Moreover, men are more likely to become infected with mouse fever. They account for 80% of all cases. Children (5%), women and the elderly get sick less often.

This year’s results can only be guessed at. So far, there are no Tatarstans infected with the fever in the region. The Rospotrebnadzor recalled that the incidence of HFRS is characterized by pronounced seasonality: from May to December.

European bank voles are the main reservoir, vector and source of human infection. The virus is contained in their blood and most intensively excreted from their body with urine, feces and saliva. Dried excretions of rodents rise into the air with dust when cleaning the premises, felling the forest, collecting brushwood for a fire, working with hay, as well as while smoking and eating with unwashed hands and enter the human body. It is worth saying that HFRS is not transmitted from person to person.

– Entering the human body, the virus spreads to the endothelium, the lining of blood vessels and the lungs. Violation of their permeability can lead to the formation of microthrombi. All this can cause intoxication of the body, a cytokine storm, – explained the director of the Scientific and Clinical Center for Precision and Regenerative Medicine of the Institute of Fundamental Medicine and Biology of KFU, corresponding member of the Academy of Sciences of the Republic of Tatarstan Albert Rizvanov.

The incubation period of the disease can last more than 10 days. Often, people confuse mouse fever with SARS due to similar symptoms. The patient’s body temperature rises to 38-40 degrees, he experiences a headache, pain throughout the body and in the lower back, and vomiting. Some patients have nasal congestion, cough, scleritis.

– It is quite difficult to make a diagnosis of HFRS at the first stage, since clinical manifestations are still not enough, – said the chief specialist in infectious diseases of the Ministry of Health of the Republic of Tatarstan Khalit Khaertynov.

The second stage includes the appearance of redness on the face and neck, possibly the appearance of conjunctivitis. Some patients lose visual acuity. These symptoms last from 1 to 9 days.

– The next step is kidney damage. In this period, pain in the lower back appears, there is a decrease in the amount of urine. There are visual disturbances. The duration of this period ranges from 5 to 10 days, then there comes a period when kidney function is restored, – the source said, adding that the healing process takes place under the obligatory supervision of a doctor. – Despite the fact that the infection is not transmitted from person to person, patients with HFRS are hospitalized in an infectious diseases hospital. Treatment is complex with antiviral drugs.

Experts urge people from Tatarstan to immediately consult a doctor in case of signs of mouse fever, as with timely treatment, the disease progresses more easily and the ability to work is restored faster.

Rospotrebnadzor called Tatarstan a natural focus of hemorrhagic fever with renal syndrome. The department explained that the republic is located in two zoological zones – forest and steppe. These two zones are the habitat of rodents, they account for more than 50% of all infections.

According to Albert Rizvanov, this year there is a high risk of infection in two locations – in the forests southeast of the village of High Gora and in the forests east of the village of Smak-Korsa. The expert explained that KFU scientists collected material and determined in which areas which strain of hantavirus is present. Biological material was taken from patients, with the help of which it was possible to identify which strain of hantavirus (the virus that causes HFRS – Ed.) is present in patients.

– Having carried out a genetic analysis, we determined that this strain could have arisen precisely at the border of different regions, – the source said, adding that the information received in the future will help develop effective methods for preventing the disease.

You can catch mouse fever not only in the forest and fields. There are also household types of infection (about 30%), that is, you can “catch” the virus even at home, as well as in garden plots.

– Infection can occur anywhere, at any time, Lyubov Avdonina warned.

It is worth saying that, unlike many other diseases, it is impossible to protect yourself from hemorrhagic fever with renal syndrome by vaccination. There is no vaccine for the virus.

– No specific prevention of HFRS has yet been invented, – confirms Khalit Khaertynov.

According to the infectious diseases specialist, people from Tatarstan must take precautionary measures. When visiting the forest, fishing, hunting, wash your hands before eating, do not touch mice or their corpses with your hands. If facilities for handwashing are not available, use liquid skin antiseptics or wet wipes.

It is necessary to carry out wet cleaning in apartments and houses, especially for suburban areas. At the same time, Rospotrebnadzor recommends wearing a respirator mask, wearing gloves, special clothes and shoes. The same recommendation applies to other work, accompanied by the release of dust.

Residents of rural areas, as well as urban residents living in private houses, should carry out home deratization. Regularly clean the area from household garbage, food waste, deadwood, plant and bulky waste that attract rodents and are a refuge for them. And also to carry out the planned extermination of rodents with the help of poisoned bait and mousetraps.