According to Dr. Mohit Sharma, Senior Consultant, Department of Internal Medicine, Amrita Hospital, Faridabad, “Generally, body temperature between 98 degree Fahrenheit (36.6-degree Celsius) and 98.6 degree Fahrenheit (37-degree Celsius) is considered normal. However, increasing data from emerging research from wearable technology (which monitors normal people/subject’s participating in research studies) suggests this range may be much wider and it is the change from an individual’s baseline temperature that is more important than the absolute temperature. For instance, someone who has a baseline temperature of 97.5-degrees Fahrenheit may have fever at a temperature of 98.6-degrees but will be dismissed as normal traditionally.”
Dr Rajiv Dang, Senior Director and HOD – Internal Medicine and Medical Director, Max Super Speciality Hospital, Gurugram shares, “We have to understand that the body temperature varies between individuals and even during morning to evening hours. The temperature is minimum in morning hours and as the sun rises and therefore the whole of the earth and atmosphere gets heated, the human body also slowly gets warmed up and the maximum body temperature is noted in a normal individual between 6 pm to 10 pm after which the temperature slowly tries to settle down.
99.4 degrees Fahrenheit is the upper limit of normal temperature for late evening hours. That being said, this is the uppermost normal limit we may consider. Same temperature recorded in morning hours around 7 to 8 am is considered fever or is considered a record much above the normal susceptible age.”
When should you worry about fever?
When it comes to the rise in body temperature, a lot of people get confused regarding its seriousness. A lot of times people feel feverish and treat it with paracetamol/crocin but how do we know what fever is worrisome?
Fever signifies the body responding to some change from normal,” states Dr Sharma.
Dr Dang explains, “Many people have this concept of feeling feverish, it doesn’t mean anything. It could probably mean fatigue or weakness, exertion can certainly increase the body temperature but much below these are accepted normal ranges, it will always be below these. Somebody says I exercised and my temperature rose to 101 degrees. This is not accepted, this is not related to your fever, this is because of some other reason.
The point here is that there are a number of fevers which are short lasting self limiting and in those cases we don’t need to do anything. But the precise duration of 2 or 3 days cannot be fixed because even if we talk in terms of the simplest which mean viral fever, the fever can last for 7 days, which is the phase or life span of a viral fever. Most cases may look comfortable once the fever is settled but it cannot be taken as an ultimate proof of total recovery. The Dengue fever settles by day 4 or 5 but the actual phase of so called complications or problems is the platelet fall or fluid imbalance comes after that. So no fever or settled fever does not mean that the disease is settled in all cases.”
Fever is often under-estimated but it can either be caused by mild or self-limiting infections or potentially serious ones. It is not a matter of how many days one should be worried or not worried, as there are far too many factors in play for the layperson to risk their health to self-diagnosis. Infections are still one of the biggest killers, even though medical science has advanced significantly and most of them improve with correct investigations and treatment, Dr Sharma adds.
“Paracetamol is used to bring down fever, which also makes one feel a little better, and to buy time till they see the doctor. Also, if one feels unwell, in addition to the fever, then should seek urgent medical attention. Feeling unwell here can take different non-specific forms and refers to simply knowing that “it does not feel right” or dizziness or uncontrollable shivering, feeling too weak to stand or walk, confusion, irritability or passing less than normal amounts of urine.”
Is treatment of fever age specific?
In very young children less than 2-3 years old, very high fever should prompt bringing the temperature down quickly as it can cause febrile convulsions/ seizures. Also, fever in children is mostly due to self-limiting viral infections but occasionally can lead to severe illness. So, if the child is not eating, playing or behaving like his/her usual, even after fever comes down with paracetamol, then it suggests seeking urgent medical help from a child specialist / pediatrician. Also, one has to be careful with the dose of paracetamol which has to be calculated carefully using body weight.
In elderly, it is important to be aware that even with very serious infections an elderly person may not have fever. Having said that if they have fever, it has to be treated in the same way with paracetamol and if, like children, their behavior and look is different, they should seek medical help urgently, says Dr Sharma.