This has to be one of the commonest presenting symptoms in a general medical practice. It also seems to be a mother’s common source of anxiety. There is not a day that goes by where I don’t have to educate a mother of a small child when is a high temperature worrisome. This is also relevant all year round, regardless of whether it is summer or winter.
Body temperature is regulated by the part of the brain known as the HYPOTHALAMUS. This is the body’s inner thermostat. We require a regulated body temperature which is not too cold or too hot, for optimal functioning of our cells which make up our organs and ultimately our systems which are always in constant communication with one another. Imagine an orchestral band with many different instruments which all play together synchronised. All individual instrument players give their best performance but all put together and under the guidance of a conductor they make a wonderful symphony. The hypothalamus of the brain has the same function as the conductor.
Nothing in the body is a flat, constant value. Human are similar in their makeup but different in how we relate to the environment. A normal body temperature if measured peripherally (under the arm, under the tongue) ranges between 35.5 to 37.4 degrees Celsius, and it fluctuates throughout the day being lowest early hours of the morning and highest late in the afternoon. The average is 37 degrees. You have a fever when the body temperature is any value from 37.5degrees and above.
Many different conditions can cause a fever. Some are potentially serious while some are quite mild and self limiting. Infections (bacteria, viruses, fungi) or inflammatory conditions (like gout) commonly cause the body temperature to rise. Other illnesses include insect bites such as spider bites, which release toxins that cause the body temperature to rise. Certain medications may also cause a fever when taken and need to be administered under supervision of a doctor or a nurse. Lastly, overheating from too much environmental heat must not be mistaken for a fever, as this is treated differently.
In my almost 13 years as a medical doctor, there has been no study to show that the hand can be used as a tool or parameter to measure body temperature. There are various thermometers which can be used; the hand is not one of them. Earlier I referred to peripheral temperature, which is as the word means, it is outer body temperature. This is one of the common ways in which temperature is measured in medical practice. For this we use the armpit, forehead skin, or oral thermometers. Another way of determining the body temperature is to examine what we call the CORE part of the body. Core thermometers measure temperature from the inner ear (common) or the rectum (where it is indicated or appropriate). The rectal temperature probes are most commonly used in the emergency rooms situation where someone was perhaps found out in the cold or in water etc. and the most accurate core temperature needs to be ascertained. In these circumstances the periphery is too cold to give a near accurate estimate of the body temperature. (Please do not insert thermometers into babies’ bums at home; there is risk of perforating the anus if wrong thermometers and technique are used).
Of all methods mentioned above, the most practical and my preference is the middle ear thermometer. It is quick and has no hygiene concerns as disposable covers are used per patient.
When in doubt about whether or not there is a higher than normal temperature or whether it is something to be concerned about then I advise that you seek medical attention. This is generally if a mild fever (37.5 to 37.9) lasts more than 3days with or without taking treatment, and is accompanied by general feeling of being unwell, fatigue and other symptoms that are concerning or cannot be tolerated. Or if a moderate fever (38.0 to 38.5) persists despite medication for fever and any underlying infection. A temperature rises above 38.5 degrees needs to be closely monitored, especially in young children under age of 6 years as it can cause seizures in some children. Please note that these are guidelines and there are no cast in stone rules about this as people will react and cope differently to any disease process. However, I cannot stress enough that fever in children needs close monitoring; hence it is necessary to have a thermometer. I advise that one seeks medical help sooner rather than later if a baby or child is not eating food or drinking fluids, if the child generally looks ill and/ or if they have convulsions. The younger the child, the sooner action must be taken as they can deteriorate very quickly.
So now you know what to do the next time you are feeling hot and bothered. Until next time, stay cool.
Dr Lerato Masemola