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Fever

Definition
Raised temperature i.e. Body temperature greater than 37.8ºC

Normal range
36.8ºC - 37.8ºC

How does it manifest?
Shivering, feeling alternatively hot and cold, shaking

What does it mean if my child has fever?
Your child may have an infection, either viral or bacteria. Infectious organisms interfere with the normal body temperature control mechanisms.

Can a child have a high temperature and yet he/she is not unwell?
Hot weather, very warm clothing, running around and screaming may make a child's temperature rise temporarily.

Can a child be ill and not have a high temperature?
Very young children can have normal temperature or low temperature and yet be seriously ill

What do you do when your child has fever?

  1. Take your child's temperature. You can use a mercury thermometer which is cheap (about Kshs. 20) but harder to use and read or a digital thermometer, which is more expensive (about Kshs.500). Place the thermometer in the child's mouth (more reliable) or under the armpit. Maintain the thermometer in place for one full minute if you are using a mercury thermometer and until you get a bleep for a digital thermometer.
  2. Be on the look out for other signs and symptoms of infection e.g. rash, lack of appetite, vomiting, irritability, irritation when the child is passing urine.
  3. Relieve the child of heavy clothing.
  4. Lay the child on the bed or on your lap and sponge his body with a wet cloth. Do not use cold water, use water from the tap
  5. Encourage the child to take fluids
  6. Administer paracetamol (15-20mg/Kg) or brufen (10mg/Kg), available over the counter
  7. Take the child to hospital if there are any other signs of illness and the fever is persistent

DO NOT:

    Use cold water to administer tepid sponging
  • Give the child aspirin - he may have a complication characterised by malfunction of the liver and brain.

Possible complications:

  • -Dehydration - because of loss of water from the skin and through fast breathing
  • Convulsions - especially if there is a family history. If this happens, be calm and follow the guidelines for convulsions
  • Reye's syndrome - a complication characterised by the malfunction of the liver and the brain. It has been associated with viral infection and the administration of Aspirin. It can result in death.

Fits (Seizures or Convulsions)

What is a fit?
A fit is characterised by involuntary stiffening and jerky movements of the body. A fit happens when there is an abnormal rise in the electrical activity of the brain

What are the other manifestations of a fit?

  • The jerky movements may only occur on one limb
  • The child is unarousable and will not respond to sound or touch.
  • He may cry out.
  • He may have frothing from the mouth
  • The eyes may roll and look upwards or just stare into space without blinking
  • He may breathe heavily and fast
  • After the fit, the child may become floppy and sleep
  • On examination, you may discover that he/she has passed stool or has urinated on her/himself.
  • Some of the fits may not be obvious and may just be characterised by staring gaze and deep breathing or just a short lapse in attention

What causes Convulsions

  • In most children, they may be due to fever in which case they are called febrile convulsions.
  • Epilepsy may be a reason for convulsions. Epilepsy is described as a tendency to suffer convulsions in the absence of any known illness or fever. These convulsions may have occurred at least twice within one year. The cause of epilepsy may be due to abnormalities present at birth, infections of the brain or after recovery from head injury but in most cases, the cause is unknown.
  • A child with head injury may have convulsions.

What do you do when your child has a fit?

  • Maintain calm
  • Turn his head gently to one side and place something soft underneath
  • Stay on site while the fit lasts and when he regains consciousness, re-assure him.
  • Do not attempt to put anything in his mouth or restrain his movements during the fit.
  • If he has fever, tepid sponge the child with a clean wet cloth and give the child paracetamol or brufen syrup when he regains consciousness
  • If the child is known to have epilepsy, make sure he gets his drugs as prescribed and if the fits recur, see the doctor.
  • Take the child to the doctor if he is NOT KNOWN TO HAVE EPILEPSY.