Fever in Children

Fever in Children

Fever in Children | Johns Hopkins Medicine

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A fever is defined by most healthcare provider as a temperature of 100.4°F (38°C) and higher when taken rectally.

The body has several ways to maintain normal body temperature. The organs involved in helping with temperature regulation include the brain, skin, muscle, and blood vessels. The body responds to changes in temperature by:

  • Increasing or decreasing sweat production.
  • Moving blood away from, or closer to, the surface of the skin.
  • Getting rid of, or holding on to, water in the body.
  • Seeking a cooler or warmer environment.

When your child has a fever, the body works the same way to control the temperature, but it has temporarily reset its thermostat at a higher temperature. The temperature increases for a number of reasons:

  • Chemicals, called cytokines and mediators, are made in the body in response to an invasion from a microorganism, malignancy, or other intruder.
  • The body is making more macrophages, which are cells that go to combat when intruders are present in the body. These cells actually “eat-up” the invading organism.
  • The body is busily trying to make natural antibodies, which fight infection. These antibodies will recognize the infection next time it tries to invade.
  • Many bacteria are enclosed in an overcoat- membrane. When this membrane is disrupted or broken, the contents that escape can be toxic to the body and stimulate the brain to raise the temperature.

What conditions can cause a fever?

The following conditions can cause a fever:

  • Infectious diseases
  • Certain medicines
  • Heat stroke
  • Blood transfusion
  • Disorders in the brain
  • Some kinds of cancer
  • Some autoimmune diseases

What are the benefits of a fever?

Fever is not an illness. It is a symptom, or sign that your body is fighting an illness or infection. Fever stimulates the body's defenses, sending white blood cells and other “fighter” cells to fight and destroy the cause of the infection.

What are the symptoms that my child may have a fever?

Children with fevers may become more uncomfortable as the temperature rises. In addition to a body temperature greater than 100.4°F (38°C), symptoms may include:

  • Your child may not be as active or talkative as usual.
  • He or she may seem fussier, less hungry, and thirstier.
  • Your child may feel warm or hot. Remember that even if your child feels he or she is “burning up,” the measured temperature may not be that high.

The symptoms of a fever may look other medical conditions. According to the American Academy of Pediatrics, if your child is younger than 3 months of age and has a temperature of 100.4°F (38°C) or higher, you should call your child's healthcare provider immediately. If you are unsure, always check with your child's healthcare provider for a diagnosis.

When should a fever be treated?

In children, a fever that is making them uncomfortable should be treated. Treating your child's fever will not help the body get rid of the infection any faster; it simply will relieve discomfort associated with fever.

 Children between the ages of 6 months and 5 years can develop seizures from fever (called febrile seizures). If your child does have a febrile seizure, there is a chance that the seizure may occur again, but, usually, children outgrow the febrile seizures. A febrile seizure does not mean your child has epilepsy.

There is no evidence that treating the fever will reduce the risk of having a febrile seizure.

What can I do to decrease my child's fever?

Give your child an antifever medicine, such as acetaminophen or ibuprofen. DO NOT give your child aspirin, as it has been linked to a serious, potentially fatal disease, called Reye syndrome.

Other ways to reduce a fever:

  • Dress your child lightly. Excess clothing will trap body heat and cause the temperature to rise.
  • Encourage your child to drink plenty of fluids, such as juices, soda, punch, or popsicles.
  • Give your child a lukewarm bath. Do not allow your child to shiver from cold water, as this can raise the body temperature. NEVER leave your child unattended in the bathtub. 
  • DO NOT use alcohol baths.

When should I call my child's healthcare provider?

Unless advised otherwise by your child’s healthcare provider, call the provider right away if:

  • Your child is 3 months old or younger and has a fever of 100.4°F (38°C) or higher. Get medical care right away. Fever in a young baby can be a sign of a dangerous infection.
  • Your child is of any age and has repeated fevers above 104°F (40°C).
  • Your child is younger than 2 years of age and a fever of 100.4°F (38°C) continues for more than 1 day.
  • Your child is 2 years old or older and a fever of 100.4°F (38°C) continues for more than 3 days.
  • Your baby is fussy or cries and cannot be soothed.

Source: https://www.hopkinsmedicine.org/health/conditions-and-diseases/fever-in-children

Hopkins Researchers Find Postoperative Fevers Common Following Hemispherectomy

Fever in Children | Johns Hopkins Medicine

There is reassuring news for families and medical staff who care for children who spike fevers following hemispherectomy, a surgery in which half the brain is removed to relieve frequent severe seizures that medications cannot control.

Researchers from the Johns Hopkins Children's Center report in the November issue of Pediatric Neurosurgery that these postoperative fevers are usually harmless. As a result, most of these children can probably be spared painful spinal taps or other invasive treatments.

In one of the largest studies of its kind, Hopkins researchers reviewed the charts from 106 consecutive hemispherectomies performed at the Children's Center from January 1975 to December 2001.

The review included 102 hemidecortications, a less radical form of hemispherectomy that removes the overlaying gray matter of the brain, preserving the white matter around the ventricle.

Medical records were examined for information regarding immediate postoperative problems and care.

Researchers found that few postoperative fevers were caused by serious postoperative complications, such as bacterial meningitis, which is commonly diagnosed by a spinal tap.

“As hemispherectomies become increasingly used in the treatment of unilateral and severe childhood epilepsy, it's important to study and understand the incidence of complications such as meningitis, and other issues in the immediate postoperative period so that we can provide the highest quality care,” said lead researcher Eric Kossoff, M.D., a pediatric neurologist at the Children's Center.

The surgery, which leaves intact the deep structures of the brain (the thalamus, brain stem and basal ganglia) is performed at Hopkins on children with Rasmussen's syndrome, a variety of developmental abnormalities on one side of the brain, and on those who have had disabling strokes. First attempted by Johns Hopkins surgeon Walter Dandy, M.D. in the late 1920s, the operation was reintroduced at Hopkins in 1968 and refined in the mid-1980s by Benjamin S. Carson, M.D., director of pediatric neurosurgery and a co-author of this study.

Researchers found that more than 80 percent of patients had postoperative fevers. Of the patients with fever, 62 percent were given lumbar punctures, or spinal taps, to diagnose suspected bacterial meningitis.

Only six of these patients were diagnosed with meningitis, and these children had also complained of headache, lethargy and wound discharge, which the majority of children with low-grade fever alone did not experience.

“This study has already been helpful to the physicians and nurses providing postoperative care for these children because it helps them anticipate which patients truly require spinal taps,” said Kossoff.

“A child with a low-grade fever who is active and does not exhibit other symptoms is unly to be infected, while a child with a high fever, headache, lethargy and actually appears ill is at perhaps higher risk.

Other factors that indicated infections included elevated white blood cell counts in the cerebrospinal fluid (CSF), very high temperatures, and prolonged use of steroids, commonly used in these patients.

As a result of this study, Children's Center doctors and nurses may allow fevers without other symptoms to persist for as long as two weeks if the child is active and playful. Of the 10 patients undergoing hemispherectomy since 2001, only one has required the insertion of a shunt to drain CSF, and none have been diagnosed with bacterial meningitis.

Researchers from the Department of Neurology and Pediatrics, Department of Pediatric Neurosurgery, and the Pediatric Epilepsy Center also contributed to this report. The study was supported in part by funds from the Roxanne Fellowship.

Story Source:

Materials provided by Johns Hopkins Medical Institutions. Note: Content may be edited for style and length.

Source: https://www.sciencedaily.com/releases/2002/11/021111070718.htm

Johns Hopkins team launches temperature-tracking study and app to map and monitor potential COVID-19 cases

Fever in Children | Johns Hopkins Medicine

A team of engineers, epidemiologists, and physicians from Johns Hopkins' Whiting School of Engineering, Bloomberg School of Public Health, and School of Medicine today launched a new smartphone app that analyzes users' body temperatures in a study to predict geographical areas at risk for outbreaks of the novel coronavirus, giving public health experts and government officials critical information to inform decisions on mitigation, resource allocation, and deconfinement.

The study relies on users recording their body temperatures, as well as other symptoms, daily. The free app is available under the name “COVID Control” on Google Play and in the Apple App Store.

Image : Courtesy of Ralph Etienne-Cummings

“Recording and mapping daily temporal fluctuations in temperature and symptoms could be critical in identifying trends that could signal emerging disease flares,” said team member Robert D.

Stevens, an associate professor of anesthesiology and critical care medicine and neurology and associate director of the Precision Medicine Center of Excellence for Neurocritical Care at the Johns Hopkins School of Medicine.

“Because we will be getting this information before people will be seeking health care, this can aid the deployment of resources in a time-sensitive manner.”

The team created COVID Control using advanced spatial analytics and machine learning to compare national body temperature records during previous flu trends—provided by health care facilities and regional governments—to identify atypical spikes in regional body temperatures. The group is particularly focused on body temperatures because fever is one of the common symptoms displayed by individuals who show symptoms of the virus. It is estimated that fevers can occur in one-half to two-thirds of people with symptomatic COVID-19.

“Data from this app will allow us to map and identify hot spots of fevers across the United States, potentially indicating emerging outbreaks of COVID-19 before health care or testing is sought,” said team member Frank C.

Curriero, a professor in the Department of Epidemiology and director of Spatial Science for Public Health Center at the Bloomberg School of Public Health.

“That information can be key in our efforts to control and mitigate the spread of the virus.”

The group's goal is to reach a large sample of the population nationwide. Anyone older than age 13 who has access to a thermometer and a smartphone can contribute. Importantly, with the group aggregating data across regions for analysis, a participant's individual data will never be shared.

One aim of the group was to make the app as easy to use as possible. After participants take their temperature with a thermometer, developers believe it will take fewer than 10 seconds to submit their data to the app.

“Our hope is that the app's user friendliness will set it apart from others that have been developed in response to COVID-19, which require a long questionnaire, typically many pages, to be answered by users,” said Ralph Etienne-Cummings, chair of the Department of Electrical and Computer Engineering and director of the Computational Sensory-Motor Systems Laboratory. “Our view is the longer the questionnaire, the less ly the individual will finish it. Also, the less ly the individual will want to participate every day. We need a large cohort to remain engaged with the study for it to be most effective at tracking and predicting emerging COVID clusters, hence the simpler information submission system.”

Another noteworthy feature of the app is that it allows users to view results via a dashboard of analytical maps, which are updated daily and reveal not only the number of users contributing information but also how many are reporting fevers and other symptoms in a given county. The maps also show results from the group's cluster detection analysis with identified hot spots of symptoms.

The maps generated by this data are available to the public on both the mobile app and its website, allowing people who are not participating to also have access to the system's daily findings.

“As an intensive care physician, I believe that one of the most important contributions we can make in the fight against this pandemic is to go upstream and create measures that will prevent people from developing the critical illness in the first place,” said Stevens. “One way to achieve this is to leverage the power of high-resolution data that are captured via sensors and portable devices such as smartphones.”

For Curriero, this app is a combination of Johns Hopkins' many strengths, and highlights why it is one of the organizations leading the fight against COVID-19.

“Johns Hopkins is populated with so many talented faculty, students, staff, and medical professionals,” Curriero said. “Being able to tap into that pool of expertise can lead to unique collaborative efforts, and that perspective is our 'Hopkins advantage' in facing public health challenges.”

Stevens and Curriero lead the project with Etienne-Cummings.

The system's development was completed by Amparo Güemes, Soumyajit Ray, Khaled Aboumerhi, and John Rattray—PhD candidates from Etienne-Cummings' lab—while spatial epidemiologists from the Spatial Science for Public Health Center—Timothy Shields, Anton Kvit, Brendan Fries, Anne Corrigan and Michael R. Desjardins—provide the data analytics.

Source: https://hub.jhu.edu/2020/04/30/johns-hopkins-covid-temperature-tracking-app/

COVID-19 Treatment, Recovery And Immunity: What You Need To Know

Fever in Children | Johns Hopkins Medicine

As global health organizations track the death toll of COVID-19, scientists are also learning more about treatment for the illness, and what happens to people who recover.

We’ve gotten lots of questions about what living through COVID-19 might look .

Note: At this point, health officials are recommending that people experiencing mild symptoms such as cough and fever stay home to avoid exposing others in hospitals and clinics. But if your symptoms become serious, call your doctor. 

Here’s information for taking care of yourself if you get sick, and what scientists currently know about recovery:

How do I treat COVID-19 at home?

The World Health Organization estimates about 80% of COVID-19 cases are mild and will not require hospitalization. The most commonly reported symptoms are fever, dry cough and shortness of breath. If you come down with the illness, you can treat it much you would a cold or the flu: rest, hydration and non-prescription medication.

Here is a list of recommendations compiled from the Mayo Clinic, the U.S. Centers for Disease Control and Prevention and Johns Hopkins Medicine about what to do if you are experiencing COVID-19 symptoms.

  • Stay home. Do not go to work, do not go to the store, do not go to the hospital. Call your doctor to discuss your symptoms and whether testing or formal treatment is needed.
  • Try to stay in one room of the house to avoid exposing others. If you must touch other surfaces and household items, sanitize them after use. 
  • Drink fluids
  • Rest
  • Take cough medicine or pain relievers as needed.
  • Restrict contact with your pets. Although there have not been reports of pets becoming sick with COVID-19, it is still recommended that symptomatic people limit contact with animals until more is known about the virus.

Find a booklet on how to prevent and treat COVID-19 created by and for people with intellectual and developmental disabilities here.

When should I go to the hospital for treatment?

Seek immediate care in a professional health setting if you are experience following emergency warning symptoms: 

  • Trouble breathing
  • Persistent pain or pressure in the chest
  • New confusion or inability to arouse
  • Bluish lips or face

The CDC notes that this list is not all inclusive, and that people should consult a medical provider about other symptoms that are severe or concerning.

Can I take ibuprofen for COVID-19?

Yes.

Last week, French health minister Olivier Véran suggested that people who believe they have COVID-19 should avoid ibuprofen and take Tylenol instead. Véran said ibuprofen could possibly worsen a coronavirus infection. The journal Lancet also published a letter in which doctors theorized whether there might be a harmful link between the drug and the virus. 

Since then, leaders from the European Medicines Agency, the World Health Organization and U.S. Food and Drug Administration have all said that there is no evidence to support the idea that ibuprofen could worsen COVID-19 symptoms, and that sick people should feel free to take any pain reliever they choose. 

What is the estimated recovery time for COVID-19?

One to two weeks, for mild cases.

There is no specific medicine to treat COVID-19. People who go to the hospital with severe cases may receive supportive care such as a ventilator to help them breathe and IV bags or feeding tubes to deliver nutrition.

Symptoms can appear anywhere between two and 14 days after infection, though some experts say they usually show up about five days in. If it’s going to progress to a severe case, the symptoms usually get worse after about a week of being sick.  

Those with mild cases of COVID-19 appear to recover within one to two weeks, according to Johns Hopkins Medicine. For severe cases, recovery may take six weeks or more.

After I become sick with COVID-19 and get better, will I become immune?

Scientists do not have enough research at this point to say for certain whether people become immune to COVID-19 after catching it once, but many researchers say it’s ly that humans who get the illness will have immunity for at least a short period of time.

A preliminary study in monkeys showed subjects who were exposed to the virus developed antibodies to it shortly after infection, and that those antibodies were still present four weeks later. Attempts to infect the monkeys a second time failed. 

“The latest evidence suggests that If you get infected, you will become immune to this strain of the virus,” said Juris Grasis, a molecular cell biologist at UC Merced. “People are developing immune response, they’re developing antibodies against the virus, and that’s indicative of a ‘memory response’, as we call it in immunology.”

How long after becoming sick with COVID-19 do people remain contagious? 

In general, people can return to normal activities after at least seven days have passed since symptoms began and 72 hours after fever is gone and other symptoms are improving, according to Johns Hopkins Medicine.

But the virus shedding period may extend beyond that window. One study in The Lancet looked at 137 COVID-19 survivors and found that the virus stayed in their bodies for a median duration of 20 days after symptoms began, with the longest duration being 37 days. 

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Source: http://www.capradio.org/articles/2020/03/23/covid-19-treatment-recovery-and-immunity-what-you-need-to-know/

Ruth Bader Ginsburg admitted to hospital after chills and a fever

Fever in Children | Johns Hopkins Medicine

Washington (CNN)Justice Ruth Bader Ginsburg was admitted to Johns Hopkins Hospital in Baltimore Friday night after experiencing chills and a fever earlier in the day, the Supreme Court said in a statement Saturday.

Ginsburg, 86, was initially evaluated at Sibley Memorial Hospital in Washington, DC, before being transferred to Hopkins for further evaluation and treatment.

With IV antibiotics and fluids, the court said Ginsburg's symptoms have abated, and she expects to be released from the hospital as early as Sunday morning.

A four-time cancer survivor, Ginsburg has had a lengthy history of medical issues. In August, she was treated for pancreatic cancer, and last fall, nearly two months before she underwent surgery to remove the cancerous nodules, the liberal justice received treatment for three ribs she fractured during a fall in her office.

Ginsburg's health has become a recurring issue as the court grapples with wide-reaching cases that can transform American law. Since coming to office, President Donald Trump has made two appointments, Neil Gorsuch in 2017 and Brett Kavanaugh in 2018, deepening the conservative tilt.

News of the hospital trip comes just days after Ginsburg returned to the bench after missing a day in court due to a stomach bug.

On Friday, Ginsburg had participated in the regular closed-door conference with other justices, according to a court spokeswoman.

The justices discussed petitions for the court to take up cases, including possibly Trump's request to block a subpoena for his financial records. Ginsburg then stayed at the court until midday, the spokeswoman said, before she went to a meeting outside the court where she started feeling ill.

The liberal icon is best known for her opinions related to civil rights issues, including the landmark case opening up the Virginia Military Institute to women.

Her dissents in recent years have continued to energize Democrats at a time when Republicans control the White House and Senate, and the Supreme Court moves rightward.

In 2013, Ginsburg was dubbed the “Notorious RBG,” a play on the late rapper Notorious B.I.G., as a response to a dissent Ginsburg wrote when the court majority issued a milestone decision rolling back voting-rights protections.

Ginsburg said earlier this year she'll “stay on the job” as long as she can “do it full steam.”

“I was OK this last term. I expect to be OK next term,” she said. “And after that we'll just have to see.”

This story has been updated.

CNN's Joan Biskupic, Dan Berman and Veronica Stracqualursi contributed to this report.

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Source: https://www.cnn.com/2019/11/23/politics/ruth-bader-ginsburg-supreme-court-hospital/index.html

Fever

Fever in Children | Johns Hopkins Medicine

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A fever is a body temperature that is higher than normal. It usually means there is an abnormal process occurring in the body. Exercise, hot weather, and common childhood immunizations can also make body temperature rise.

What causes a fever?

A fever is not an illness by itself. Rather it is a symptom that something is not right within the body. A fever does not tell you what is causing it, or even that a disease is present. It may be a bacterial or viral infection. Or, it could be a reaction from an allergy to food or medicine. Becoming overheated at play or in the sun can also result in fever.

What are the symptoms of a fever?

Normal body temperature ranges from 97.5°F to 98.9°F (36.4°C to 37.2°C). It tends to be lower in the morning and higher in the evening. Most healthcare providers consider a fever to be 100.4°F (38°C) or higher. High fevers may bring on seizures or confusion in children. It's not how high the temperature is, but how fast the temperature goes up that causes a seizure.

A fever has other symptoms besides a higher-than-normal temperature. These are especially important when caring for babies, young children, and disabled people. These groups may not be able to express how they feel. Signs that mean fever include:

  • Flushed face
  • Hot, dry skin
  • Low output of urine, or dark urine
  • Not interested in eating
  • Constipation or diarrhea
  • Vomiting
  • Headache
  • Aching all over
  • Nausea

How is a fever diagnosed?

The best way to diagnose a fever is to take a temperature with a thermometer.

There are several types of thermometers, including the following:

  • Digital thermometer (oral, rectal, or under the armpit)
  • Tympanic (ear) thermometer (not recommended in babies younger than 6 months of age)
  • Temporal artery (temperature taken across the forehead area)

Taking a temperature rectally is the most accurate method in children under 3 years of age. In older children and adults, take the temperature under the armpit or in the mouth. Talk with your healthcare provider about the best way to take your temperature.

Most thermometers today are digital, but there are some glass thermometers containing mercury still in use. Mercury is toxic substance and is dangerous to humans and the environment.

Because glass thermometers can break, they should be disposed of properly in accordance with local, state, and federal laws.

For information on how to safely dispose of a mercury thermometer, contact your local health department, waste disposal authority, or fire department.

How is a fever treated?

You can treat a fever with acetaminophen or ibuprofen in dosages advised by your healthcare provider. Switching between giving acetaminophen and ibuprofen can cause medicine errors and may lead to side effects. Never give aspirin to a child or young adult who has a fever.

A lukewarm bath may reduce the fever. Alcohol rubdowns are no longer recommended.

Call your healthcare provider for guidance anytime you are uncomfortable with the conditions of the fever, and remember to contact your healthcare provider any time a temperature spikes quickly or persists despite treatment.

When should I call my healthcare provider?

Call your healthcare provider right away for a fever in a baby younger than 3 months old.

Call right away or seek immediate medical attention if any of the following occur with a fever:

  • Seizure
  • Feeling dull or sleepy
  • Irregular breathing
  • Stiff neck
  • Confusion
  • Purple spotted rash
  • Ear pain (a child tugging on his or her ear)
  • Sore throat that persists
  • Vomiting
  • Diarrhea
  • Painful, burning, or frequent urination

Key points about fevers

  • A fever is not an illness by itself, but, rather, a sign that something is not right within the body.
  • Illness, exercise, hot weather, and common childhood immunizations can make body temperature rise.
  • In addition to an elevated temperature, look for other signs, such as: flushed face, hot skin, low urine output, loss of appetite, headache, or other symptoms of an infection or illness.
  • Once you have determined that the person has a fever, you may treat it by giving acetaminophen or ibuprofen in dosages advised by your healthcare provider.
  • Call your healthcare provider if a baby under 3 months has a fever, or seek immediate medical attention if a fever is accompanied by a seizure, lethargy, irregular breathing, stiff neck, confusion, or other signs of a serious illness.

Next steps

Tips to help you get the most from a visit to your healthcare provider:

  • Know the reason for your visit and what you want to happen.
  • Before your visit, write down questions you want answered.
  • Bring someone with you to help you ask questions and remember what your provider tells you.
  • At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you.
  • Know why a new medicine or treatment is prescribed, and how it will help you. Also know what the side effects are.
  • Ask if your condition can be treated in other ways.
  • Know why a test or procedure is recommended and what the results could mean.
  • Know what to expect if you do not take the medicine or have the test or procedure.
  • If you have a follow-up appointment, write down the date, time, and purpose for that visit.
  • Know how you can contact your provider if you have questions.

Source: https://www.hopkinsmedicine.org/health/conditions-and-diseases/fever