Why you don’t want to prevent your child’s (or anyone you love’s) fever:

EXTRACTS FROM MEDICAL LITERATURE:

“Not all fevers need to be trated but many physicians do so to relieve parental concern.”  (Eur J Ped 1994 Jun; 153 (6): 394-402)  time to get a grip, parents.....

“An elevation in temperature following bacterial infection results in a significant increase in host survival” (Science 1975 Apr 11; 188 (4184): 166-8)

“Many components of the nonspecific host defence response to infection such as leukocyte mobility, lymphocyte transformation, and the effects of interferon, appear to be enhanced by elevations in temperature that simulate moderate fevers.  In addition, some evidence indiccates that a fever in conjunction with the changes in plasma iron levels known to occur during infections is a synergistic host defence response.”  (Pediatrics 1980, No: 66 (5) : 720 - 723)

“Parental fever phobia and its correlates...surprising, higher socioeconomic status was not associated with a lesser degree of fever phobia...undue fear and overly aggressive treatment of fever are epidemic among parents of infants and young children, even among the highly educated and well-to-do.  considerable effort will be required on the part of pediatricians and other child health workers to reeducate that parents about the definition, consequences and appropriate treatment of fever.”  (Pediatrics 1985 June;75 (6) 1110-1113)

“There is no convincing evidence that naturally occuring fevers are harmful. In contrast, animal studies have shown that fever helps animals to survive and infection whereas antipyresis increases mortality.  Moreover there is considerable in vitro evidence that a variety of human immunological defences function better at febrile temperatures than at normal one.”  (The Lancet, Volume 337, March 9, 1991)

“Many cytokines are endogenous mediators of fever including interleukin (IL) -, 1 beta, IL-6 and others.  Tumor necrosis factor-alpha may be both an endogenous pyrogen and an endogenous antipyretic or cryogen.” (Neuroimmunomodulation 1995 Jul-Aug; 2 (4):216-223)

“There is overwhelming evidence in favor of fever being an adaptive host response to infection... as such, it is probable that the use of antipyretic/anti-inflammatory/alagesic drugs, when they lead to suppression of the fever, result in increased morbidity and mortality during most infections;  this morbidity and mortality may not be apparent to most health care workers...” Infect Dis Clin North Am 1996 Mar;10(1) : 1-20.)

Acetaminophen can induce pneumonia...’These finding suggest that allergic mechanism was involved in the pathogenesis of the pneumonitis.  Underlying immunological disorders may have enhanced the occurence.”  Nihon Kyobu Shikkan Gakkai Sasshi 1997 Sep; 35 (9) 974-9)  There are other reports of this as well...

“the results suggest that lung disease (rhematoid lung) associated with collagen vascular diseases may be exacerbated by drug-induced (acetaminophen) pneumonitis.”  Nihon Kyobu Shikkan Gakkai Sasshi 1997 Oct; 35 (10) 1113-1118)

“Despite our lack of knowledge about its therapeutic mechanism, it has been claimed to be a safe drug, especially for children...  paracetamol syrup (presumably for children)  is extensively prescribed in large volumes...There is mounting evidence that paracetamol is not the benign drug that it was formally thought to be... We would question the whole rationale of prescribing the drug in near epidemic proportions.  If it is to be used as a placebo, then it is a very dangerous placebo... The whole place of paracetamol prescribing for children has been questioned.  While there is little concern about its use in the short term as an analgesic, there is considerable controversy over its use as an antipyretic....there is little evidence to support the use of paracetamol to treat fever in patients without heart or lung disease.  Paracetamol may decreast antibody response to infection and increase morbidity and mortality in severe infections...too many parents and health workers think that fever is bad and needs to be suppressed by paracetamol when, indeed, moderate fever may improve the immune response...the use of paracetamol in children with acute infection did not result in an improvement in mood, comfort, appetite or fluid intake.”  (Family Practice, Volume 13, No 2, 1996)

“Fever is rarely harmful.  Only extremely high fevers of 42.2C or 108 F or higher have been known to cause brain damage.  Only fevers of 40.5C or 105F and higher need immediate attention, mainly because they are a clue that a serious infection could be present “(such as meningitis) (Sunday Star Times, May 3, 1998, C3)

“Paracetamol has no antipyretic benefits over mechanical antipyreses alone in ..malaria.  Moreover, paracetamol prolongs parasite clearance time, possible by decreased production of TNF and oxygen radicals. “ (Lancet 1997;350:704-709)

 

“The data suggest that frequent administration of antipyretics to children with infectious disease may lead to a worsening of their illness.” (Acta Paed. Jpn 1994 Aug;36 (4) 375-378)

“Fever is an important indicator of disease and should not be routinely suppressed by antipyretics...fever may actually benefit the host defense mechanism...fever is short-lived and causes only minor discomfort...routine antipyretic therapy should be avoided byt may be necessary in individual patients with cardiovascular or neurologic disorders.”(Infect Dis Clin North Am 1996 Mar;10 (1) 211-216)

“Studies of bacterial and viral-infected animals have shown that moderate fevers decrease morbidity and increase survival rate”  (Yale J Biol Med 1986 Mar-April; 59 (2) : 89-95)

“Antipyretic drugs are effective in diminishing fever, but have significant side effects and may suppress signs of ongoing infections”  (Arch Intern Med 1990, Aug; 150 (8): 1589-1597)

Meningococcal Disease:  “use of analgesics were associated with disease...analgesic use was defined as analgesics taken in the past 2 weeks, excluding, for cases, those taken for identified early symptoms of meningococcal disease.  These analgesics were predominatly acetaminophen products......because analgesics showed a stronger relationship with meningococcal disease, the use of analgestics may be a better measure of more severe illness than reported individual symptoms....we cannot exclude the possibility that acetaminophen use itself is a risk factor for meningococcal disease”  (Ped Infec Dis, Oct 2000, Vol 19, No 10, 983-990)

“Antipyretics prolong illness in patients with Influenza A....  The duration of illness was significantly prolonged”  Pharmacotherapy 2000, 20: 417-422)

“These results suggest that the systematic suppression of fever may not be useful in patients without severe cranial trauma or significant hypoxemia.  Letting fever take its natural course does not seem to harm patients with systemic inflammatory response syndrome, or influence the discomfort leve AND MAY SAVE COSTS.”  (wow!!!)  (Arch Intern Med 2001, Jan 8; 161 (1) 121-123)

And last, but not least, if you want to turn chickenpox into fulminant necrotising fasciitis - go ahead - and give tylenol/paracetamol. (Pediatr I(Pediatrics Vol 103, No 4, April 1999, 783-784 and 785-790)  (Infect Med1999 16 (5):307) Just two of many references for antipyretic induced complications of chickenpox.

ALL INFORMATION, DATA, AND MATERIAL CONTAINED, PRESENTED, OR PROVIDED HERE IS FOR GENERAL INFORMATION PURPOSES ONLY AND IS NOT TO BE CONSTRUED AS REFLECTING THE KNOWLEDGE OR OPINIONS OF THE PUBLISHER, AND IS NOT TO BE CONSTRUED OR INTENDED AS PROVIDING MEDICAL OR LEGAL ADVICE.  THE DECISION WHETHER OR NOT TO VACCINATE IS AN IMPORTANT AND COMPLEX ISSUE AND SHOULD BE MADE BY YOU, AND YOU ALONE, IN CONSULTATION WITH YOUR HEALTH CARE PROVIDER.