When is fever an emergency. When to Seek Emergency Care for a Fever: Crucial Guidelines for All Ages

06.09.202309.07.2023 by alexxlab

When does a fever require immediate medical attention. How to recognize dangerous fever symptoms in infants, children, and adults. What temperature is considered dangerously high for different age groups. Which accompanying symptoms warrant an ER visit for fever.

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Understanding Fever: More Than Just a High Temperature

A fever is often misunderstood as merely an elevated body temperature. In reality, it’s a complex physiological response orchestrated by the body’s immune system. The hypothalamus, a small region in the brain, acts as the body’s thermostat, typically maintaining a normal temperature of around 98.6°F (37°C).

Why does the body induce a fever? It’s primarily a defensive mechanism against invading pathogens. By raising the body temperature, the immune system creates an environment less hospitable for viruses and bacteria to thrive. This elevated temperature enhances the efficiency of white blood cells and speeds up cellular processes involved in fighting infections.

However, not all fevers are caused by infections. Other potential triggers include:

Substance abuse, particularly amphetamines
Alcohol withdrawal
Environmental factors, such as heat stroke
Certain medications
Autoimmune disorders
Some cancers

While a mild fever is often a sign that your immune system is functioning properly, there are instances when a fever can become dangerous. At temperatures exceeding 105°F (40.6°C), proteins and fats in the body begin to denature, potentially leading to cellular damage. Prolonged high fevers can result in serious complications such as cellular stress, infarctions, necrosis, seizures, and delirium.

Critical Fever Thresholds: When Temperature Becomes a Concern

At what point does a fever transition from a helpful immune response to a potentially dangerous condition? The answer varies depending on age and overall health status.

For Infants (0-3 months)

Any fever in newborns and young infants is considered serious. Their immune systems are still developing, making them more susceptible to severe infections. A rectal temperature of 100.4°F (38°C) or higher in this age group requires immediate medical attention.

For Older Infants and Toddlers (3 months – 3 years)

For this age group, a fever of 102°F (38.9°C) or higher, especially if it persists for more than a day, warrants a doctor’s evaluation. If the fever reaches 104°F (40°C), it’s time to seek emergency care.

For Children (3 years and older)

Children in this age range can typically tolerate slightly higher fevers. However, a temperature of 103°F (39.4°C) or above, or a fever that lasts more than three days, should be evaluated by a healthcare professional.

For Adults

In adults, a fever is generally considered high when it reaches 103°F (39.4°C). However, any fever above 105°F (40.6°C) is a medical emergency and requires immediate attention.

Recognizing Dangerous Fever Symptoms in Infants

Infants, especially those under 90 days old, are particularly vulnerable to infections and require extra vigilance when it comes to fevers. Here are the key symptoms that warrant an immediate trip to the emergency room:

Changes in appetite or feeding patterns
Altered behavior or unusual sleepiness
Diarrhea or vomiting
Constipation
Presence of cold symptoms alongside fever
Skin rash or discoloration
Eye discharge
Difficulty waking for feedings
Respiratory distress

Can a fever be dangerous for a newborn? Absolutely. Their immature immune systems make them susceptible to rapid deterioration from infections. Any fever in a newborn should be treated as a potential emergency until proven otherwise by a medical professional.

Fever Warning Signs in Toddlers and Young Children

For children between 90 days and 36 months, the following symptoms accompanying a fever necessitate emergency care:

Any of the symptoms listed for infants
Fever in an unimmunized child
Signs of dehydration (dry mouth, sunken eyes, lack of tears when crying)
Seizures or convulsions
Severe headache
Stiff neck
Persistent vomiting

How can you tell if a toddler’s fever is serious? Pay attention to their behavior. A lethargic, irritable, or inconsolable child with a fever may be dealing with a more severe condition and should be evaluated promptly.

Fever Red Flags in Older Children and Adolescents

For children older than 36 months, these additional symptoms alongside a fever warrant immediate medical attention:

Severe abdominal pain
Persistent discomfort or pain in any part of the body
Difficulty breathing or chest pain
Severe sore throat or difficulty swallowing
Signs of dehydration despite attempts to increase fluid intake
Fever that persists for more than three days

Is a high fever always dangerous in children? Not necessarily. A child’s response to the fever is often more indicative of the severity of the illness than the temperature itself. A child with a moderate fever who is alert and drinking fluids may be less concerning than a child with a lower fever who is lethargic and refusing to drink.

Adult Fever: When to Seek Immediate Medical Care

For adults, the following symptoms accompanying a fever indicate the need for emergency medical evaluation:

Severe headache, especially if accompanied by neck stiffness
Abdominal pain
Difficulty breathing or chest pain
Confusion or altered mental state
Seizures
Severe muscle pain or weakness
Persistent vomiting
Skin rashes, especially if they’re rapidly spreading or painful

Certain adults are at higher risk for complications from fever and should seek medical attention promptly:

Those with compromised immune systems (e.g., HIV/AIDS, organ transplant recipients)
Patients undergoing chemotherapy
Adults over 65 years of age
Pregnant women
Individuals with chronic medical conditions (e.g., diabetes, heart disease)

Can a fever be life-threatening for adults? While less common than in children, severe fevers in adults can indeed be life-threatening, especially if they’re indicative of serious infections like sepsis or meningitis.

Understanding Fever in Special Populations

Certain groups require special consideration when it comes to fever management:

Immunocompromised Individuals

People with weakened immune systems, whether due to disease or medication, should treat any fever as potentially serious. Their bodies may not be able to mount an effective response to infections, making early intervention crucial.

Cancer Patients

Individuals undergoing chemotherapy or radiation therapy often have compromised immune systems. A fever in these patients could indicate a serious infection and requires immediate medical attention.

Elderly Adults

Older adults may not develop high fevers even when seriously ill. Any change in body temperature, along with altered mental status or decreased mobility, should be evaluated promptly.

Pregnant Women

Fever during pregnancy can potentially affect fetal development. Pregnant women with a fever should consult their healthcare provider promptly.

How does fever management differ in these special populations? The threshold for seeking medical care is generally lower, and treatment may be more aggressive to prevent potential complications.

Decoding Dangerous Fever Patterns

While the absolute temperature is important, the pattern of fever can also provide valuable information:

Persistent Fever

A fever lasting more than three days, even if it’s not particularly high, warrants medical evaluation. This could indicate a persistent infection or an underlying condition that needs treatment.

Fever That Doesn’t Respond to Medication

If over-the-counter fever reducers like acetaminophen or ibuprofen don’t bring the temperature down, or if the fever returns quickly after medication, this could signal a more serious infection.

Alternating Fever and Chills

This pattern, often described as “fever and rigors,” can be a sign of a serious bacterial infection or malaria in travelers returning from endemic areas.

Fever with Specific Patterns

Certain illnesses have characteristic fever patterns. For example, a fever that spikes every other day might indicate malaria, while a fever that worsens in the evening could be a sign of tuberculosis.

Why are fever patterns important in diagnosis? These patterns can provide valuable clues to healthcare providers about the underlying cause of the fever, potentially leading to faster and more accurate diagnoses.

The Role of Emergency Care in Fever Management

When you arrive at an emergency department with a fever, what can you expect?

Triage: A nurse will assess your vital signs and symptoms to determine the urgency of your condition.
History and Physical Examination: A doctor will ask about your symptoms and perform a thorough physical exam.
Diagnostic Tests: Depending on your symptoms, tests may include blood work, urine analysis, chest X-rays, or other imaging studies.
Treatment: This may involve intravenous fluids, antibiotics, or other medications as needed.
Observation: In some cases, you may be monitored for several hours to ensure your condition improves.
Discharge or Admission: Based on your response to treatment and test results, you’ll either be discharged with follow-up instructions or admitted to the hospital for further care.

How do emergency departments handle potentially contagious patients with fever? Many ERs have isolation rooms and protocols to prevent the spread of infectious diseases while providing necessary care.

Prevention and Home Management of Fevers

While some fevers require medical attention, many can be managed at home. Here are some strategies for prevention and home care:

Prevention

Practice good hygiene, including regular handwashing
Stay up to date on vaccinations
Maintain a healthy lifestyle to boost your immune system
Avoid close contact with sick individuals when possible

Home Management

Rest and stay hydrated
Use over-the-counter fever reducers as directed
Dress in light, breathable clothing
Keep the room temperature comfortable, not too warm
Use a cool compress on the forehead or wrists

Is it always necessary to treat a fever? Not always. Low-grade fevers in otherwise healthy individuals can often be left untreated, as they’re part of the body’s natural defense mechanism. However, treating a fever can help alleviate discomfort and reduce the risk of dehydration.

Remember, while these guidelines provide a general framework, they’re not a substitute for professional medical advice. If you’re ever in doubt about the severity of a fever or accompanying symptoms, it’s always better to err on the side of caution and seek medical evaluation. Your health and the health of your loved ones is paramount, and timely intervention can make a significant difference in outcomes when dealing with potentially serious illnesses.

When to Go to the ER with a Fever

What Is a Fever?

The term “fever” gets tossed around a lot, but the details of what a fever does for your body are not often discussed. A fever is usually a symptom of an underlying condition or infection. The part of your brain called the hypothalamus is responsible for controlling body temperature, and the normal body temperature lies at around 98.6°F or 37°C.

A fever occurs when your body is trying to kill a virus or bacteria that causes an infection. This is because a higher temperature makes the body a less welcoming host for replicating viruses and bacteria. A mild fever is a good indication that your immune system is doing its job, but fevers are not always brought on by infections. Other potential causes of fever include amphetamine abuse, alcohol withdrawal and environmental fevers like heat stroke.

When Should You Go to the ER for a Fever?

While it’s true that a fever typically means your immune system is hard at work, the fever can sometimes raise to unhealthy levels. When the body temperature exceeds 105°F, it exposes the proteins and body fats to temperature stressors that can interfere with their functioning. Prolonged exposure can lead to cellular stress, infarctions, necrosis, seizures and delirium.

To prevent these conditions from occurring, here are some signs that a fever warrants a trip to the ER.

For an Infant Younger than 90 Days Old

If changes in appetite are occurring along with the fever, you should seek emergency care.
If changes in behavior or sleeping patterns accompany the fever, you should seek emergency care.
If diarrhea or vomiting are occurring along with the fever, you should seek emergency care.
If your infant is constipated and has a fever, you should seek emergency care.
If your infant has a cold and a fever, you should seek emergency care.
If your infant has a rash or skin discoloration and a fever, you should seek emergency care.
If your infant has eye discharge, you should seek emergency care.
If your infant is having difficulty waking up to feed alongside a fever, you should seek emergency care.
If your infant is having difficulty breathing, you should seek emergency care.

For a Baby Between the Ages of 90 Days and 36 Months Old

If your baby is experiencing any of the symptoms above alongside a fever, you should seek emergency care.
If your baby is not immunized and has a fever, you should seek emergency care.

For a Child Older than 36 Months Old

If your child is experiencing any of the symptoms above alongside a fever, you should seek emergency care.
If your child is experiencing abdominal pain and has a fever, you should seek emergency care.
If your child is communicating feelings of persistent discomfort alongside a fever, you should seek emergency care.

For an Adult

If an adult is experiencing a painful headache and has a fever, they should seek emergency care.
If an adult is experiencing abdominal pain and has a fever, they should seek emergency care.
If an adult is having difficulty breathing or chest pain accompanied by a fever, they should seek emergency care.
If an adult has a compromised immune system and comes down with a fever, they should seek emergency care.
If an adult has had chemotherapy recently and has a fever, they should seek emergency care.
If the adult’s fever lasts for more than three days, they should seek emergency care.
If the adult’s fever rises above 103°F, they should seek emergency care.
If the adult’s fever is accompanied by nausea, confusion or a rash, they should seek emergency care as these symptoms may be caused by meningitis.
If the adult’s fever is accompanied by confusion, a rapid heartbeat or dizziness, they should seek emergency care as these may be signs of a heat stroke.

Please note that these lists are not all-inclusive. If you are doubtful that the fever will resolve on its own, it is best to have the condition examined by a medical professional.

What Will Advance ER in Dallas Do for a Fever?

At Advance ER, we offer top quality medical care 24/7, with emergency professionals who are experienced in treating all age groups. We are dedicated to giving every patient the best care available, and will work diligently to identify the cause of the fever and treat the underlying condition. Whether you are concerned about your child, a loved one or yourself, you can trust our integrative, advanced approach to health and wellness.

If you would like to learn more about Advance ER, please give us a call at (214) 494-8222, or find us online.

How To Know If You Should Go To The ER For A Fever

If you are otherwise healthy and alert, having a low-grade fever may not necessarily be cause for concern. However, an elevated temperature can be indicative of another process or illness that needs to be treated. A severe or prolonged fever can even cause complications on its own. Because there are a number of possible causes of fever, many of which trigger a similar set of symptoms, it can be challenging to self-diagnose your condition. The expert team of board-certified physicians at both of iCare ER & Urgent Care’s convenient locations in Frisco and Fort Worth, TX provides prompt and reliable evaluation, diagnosis, and treatment for patients presenting with fever. Find out more about the possible causes of fever here, and learn what situations may warrant a visit to the ER for fever.

What is a fever?

For most adults, a normal body temperature is between 97°F and 99°F, though 98.6°F is generally accepted as the standard of normal. When a patient’s body temperature becomes elevated to 100.4°F or higher, he or she is considered to have a fever. Oftentimes, a fever indicates that the body is fighting off a virus, infection, or another pathogen. Common symptoms of a fever include:

Sweating
Chills
Headache
Body aches
Fatigue
Loss of appetite

What causes a fever?

There are a variety of potential reasons why a person’s body temperature may become elevated, either temporarily or for several days or weeks. Some of the most common causes of a fever include:

Virus
Infection
Cold and/or flu
Stomach bug
Recent vaccination
Heat exhaustion

How long does a fever last?

Depending on the cause of the fever, the patient’s overall health, what treatments are given, and other factors, a fever can last anywhere from several hours to several weeks. For some of the most common illnesses, such as the flu, most people demonstrate an elevated temperature for about 2 – 4 days.

How high is too high for a fever?

Fever of 103°F or above is considered high grade and should be treated immediately. However, even a low-grade fever may be a sign of a dangerous problem for infants and babies. If you are concerned about fever in your infant, your child, or yourself, visit your nearest Fort Worth or Frisco emergency room within iCare ER & Urgent Care’s unique dual-hybrid facility.

When should you go to the ER for a fever?

For patients who are otherwise healthy, alert, and have an obvious explanation for their low-grade fever – such as a cold – at-home remedies and monitoring may be sufficient. However, any fever above 103°F should be treated immediately in the ER. In addition, if you or your child are experiencing any of the following symptoms in conjunction with a fever, a trip to the ER is warranted:

Confusion
Severe pain (abdominal pain, headache, muscle pain, etc.)
Sensitivity to light
Skin rash or irritation
Protracted nausea or vomiting
Inability to eat or drink
Difficulty breathing
Chest pain
Seizure
Inability to stay awake
Fever of 103°F or higher
Fever lasting longer than 3 – 4 days (children)
Any fever (infants)

How is a fever treated in the ER?

To determine the cause of your fever, one of our board-certified ER physicians in Frisco or Fort Worth will perform a thorough examination, take a detailed health history, measure certain vital signs, and possibly draw laboratory studies. Depending on the severity of your condition, the cause of your fever, and other factors, your physician will recommend the most appropriate course of treatment, which may include antibiotics, other medications, fluids, and rest.

Get prompt treatment and rapid relief for your fever by visiting your nearest emergency room in Frisco or Fort Worth, TX

Although some fevers can be treated at home, many cases of fever may indicate a serious problem and should be evaluated immediately. If you are concerned about a high-grade fever or any fever that is accompanied by abnormal or protracted symptoms, visit your nearest iCare ER & Urgent Care center in either Fort Worth or Frisco, TX to be evaluated by one of our professional board-certified physicians for your acute illness and to get the effective treatment and rapid relief you deserve.

WHO declares Ebola outbreak an international emergency – RBC

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Lassa fever – Nigeria

Outbreak summary

Nigeria is currently experiencing a major outbreak of Lassa fever, during which during the period from the 1st to the 15th epidemiological week of 2023 (week ending 16 April) There were 4702 suspected cases, five probable cases and 877 confirmed cases. Among cases with a confirmed diagnosis, 152 deaths were registered (case fatality rate 17%). Lassa fever is endemic in Nigeria and parts of West Africa, where the African polynipple rat is a major reservoir of the Lassa virus.

The implementation of anti-epidemic measures in connection with the current outbreak is difficult because the country currently has to respond to a number of emergencies at the same time.

The disease is characterized by a wide variety of symptoms, and therefore the diagnosis can be difficult. Most infections (about 80%) caused by the Lassa virus are asymptomatic or mild. However, the infection can cause severe disease with multiple organ dysfunction, with or without bleeding. Therefore, laboratory testing is required to confirm the diagnosis.

Laboratory-confirmed cases of Lassa fever have been reported in states bordering Cameroon (Adamawa, Benue, Cross River and Taraba) and Benin (Oyo and Niger). The overall risk at the regional and global levels is assessed as low because the main route of transmission of Lassa virus is through contact with food or household items contaminated with rat excrement. There is a low level of human-to-human transmission.

Lassa fever epidemiological situation

Nigeria is experiencing a major outbreak of Lassa fever with 4702 suspected cases, five probable cases and 877 cases reported during the period 1st to 15th epidemiological week 2023 (week ending 16 April) with a confirmed diagnosis. Among cases with a confirmed diagnosis, 152 deaths were registered (case fatality rate 17%). The number of cases with a confirmed diagnosis increased by 20% compared to the same period in 2022 (733 cases).

Cases have been reported in 101 Local Government Areas (LGAs) in 26 of 36 states, including the Federal Capital Territory (FCT). Three states have a high concentration of confirmed cases (72%): Ondo (32%), Edo (29%) and Bauchi (11%). Laboratory-confirmed cases of Lassa fever have been reported in states bordering Cameroon (Adamawa, Benue, Cross River and Taraba) and Benin (Oyo and Niger).

Lassa fever epidemiology

Lassa fever is an acute viral hemorrhagic disease caused by the Lassa virus. The virus is most commonly transmitted to humans by direct contact with infected rodents of the genus Mastomys or by contact with food or household items contaminated with the urine or droppings of infected rodents. Accordingly, the virus is transmitted to a person through cuts and scratches or by inhalation of dust particles contained in the air. Person-to-person transmission can occur through direct contact with the blood or body fluids of an infected person, but is rare. Secondary transmission in health care settings can occur when the disease is detected late and treatment is started, and when adequate infection prevention and control (IPC) measures are not followed.

Most Lassa virus infections (about 80%) are asymptomatic or mild, but in about 20% of cases the virus can cause severe disease, sometimes with multi-organ dysfunction with or without bleeding. Without proper laboratory testing, the diagnosis of Lassa fever is difficult due to the variety of possible symptoms of the disease, from asymptomatic infection to multiple organ failure and death.

In patients hospitalized with severe disease, the case fatality rate is typically between 1% and 15%. The disease is particularly severe in the later stages of pregnancy, with rates of maternal death and/or fetal loss exceeding 80% during the last trimester. Maintenance therapy with rehydration and symptomatic treatment in the early stages of the disease is essential to increase the chances of survival. The antiviral drug ribavirin is used to treat Lassa fever, but its effectiveness has not been proven. To date, there is no vaccine against Lassa fever.

The disease was first reported in 1969 in Borno State, Nigeria, where it is endemic. Transmission of infection is observed throughout the year. However, large seasonal outbreaks occur during the dry season, usually from December to April.

In 2023, 42 cases were reported among healthcare workers in 11 states during the period from the 1st to the 15th epidemiological week. During epidemiological week 15, 2023 (April 10–16), 141 new cases with suspected Lassa fever, nine new confirmed cases, and one new confirmed case with a fatal outcome (case fatality rate of 11%) were reported.

The implementation of anti-epidemic measures in connection with the current outbreak is difficult because the country currently has to respond to a number of emergencies at the same time. These include outbreaks of COVID-19, diphtheria, meningitis, measles, cholera and ongoing humanitarian crises. In addition, the country is forced to solve security problems, which makes it difficult to carry out anti-epidemic measures in a timely manner.

Public health response

The Nigerian Centers for Disease Control and Prevention (NCDC) and health authorities in affected states are taking the lead in controlling the outbreak. On January 28, 2023, the National Center for Emergency Situations (ECS) of the NCDC became operational, and Rapid Response Teams (RRTs) were sent to the states of Bauchi, Benue, Ebonyi, Edo, Ondo and Taraba.

Anti-epidemic measures include:

surveillance: detection, monitoring of cases and outbreaks of the disease and laboratory testing;
care for the sick;
preventive measures: educating the public about personal hygiene, food safety and rodent control in the place of residence and work;
response: prescribing antiviral drugs, supportive care to confirmed patients, and tracking contracted individuals to identify those who may have been exposed to the virus.

To strengthen the response to the Lassa fever outbreak in Nigeria, the NCDC, in collaboration with WHO and other partners, developed a national outbreak prevention and control action plan. This plan includes measures to improve surveillance, increase the efficiency and capacity of national laboratories, increase public awareness and ensure greater access to treatment and care services for patients.

WHO risk assessment

Lassa fever is an acute hemorrhagic fever disease that is endemic in West Africa. Confirmed outbreaks and sporadic cases of Lassa fever have been reported in Benin, Burkina Faso, Côte d’Ivoire, Guinea, Ghana, Liberia, Mali, Sierra Leone, Togo and Nigeria. In some regions, rodents of the genus Mastomys are eaten.

Nigeria is a Lassa fever endemic country and has developed the capacity to control outbreaks of this disease, but the overall risk at the national level is currently assessed as high due to several factors:

increase in the number of confirmed cases compared to the same period in previous epidemic seasons;
reduced national capacity due to the need to respond to a range of current health emergencies, which has overburdened the country’s health system and limited the availability of medical resources;
lack of personal protective equipment (PPE), which poses a high risk of spread of healthcare-associated infections;
delays in transporting biomaterial specimens for laboratory testing in several states resulting in delayed confirmation of diagnosis and provision of treatment and care;
Poor health infrastructure, poor sanitation and continued presence of virus-carrying rodents;
insufficient information and education of the public and health care workers about Lassa fever, which can lead to further delays in diagnosis and treatment and increases the risk of infection and the likelihood of death.

Overall regional and global risk is assessed as low because Lassa virus is transmitted to humans primarily from animals and there is low human-to-human transmission.

WHO guidelines

Prevention of Lassa fever involves good hygiene at the community level to control the entry of rodents into homes. Effective measures include keeping grains and other foodstuffs in rodent-proof containers, removing waste disposal sites from homes, keeping homes clean, and keeping pet cats.

When caring for patients in health care settings, regardless of the suspected diagnosis, health care workers should always follow standard infection prevention and control measures. These measures include practicing hand and respiratory hygiene, using personal protective equipment against splashes or other contact with infectious materials, using safe injection practices, and ensuring the safe burial of the deceased.

Healthcare workers caring for patients with suspected or confirmed Lassa fever should take additional infection control measures to prevent contact with patients’ blood and body fluids, and with infected surfaces or materials, such as clothing and bedding. When in close contact with patients with Lassa fever (within one meter), healthcare workers need face protection (face shield or surgical mask and goggles), a clean, non-sterile long-sleeved gown, and gloves (sterile gloves are required for some medical procedures).

There are currently no registered vaccines to protect people against Lassa fever. In the early stages of the disease, the antiviral drug ribavirin may be an effective treatment for Lassa fever, but the evidence is conflicting. Evidence on the effectiveness of ribavirin as a post-exposure prophylactic for Lassa fever is not available.

WHO continues to recommend that all Lassa fever endemic countries improve their early case detection and treatment in order to reduce the number of deaths.

Based on available information, WHO does not recommend any restrictions on passenger or trade traffic for Nigeria.

Additional information

WHO. Health issues. Lassa fever (in English)
WHO.