Learn about symptoms and causes of fever, self help treatment options, medication and when to seek medical help.

What is a Fever?

A fever is having a body temperature which is higher than normal. It is usually a symptom of an illness, which may or may not be an infection.

What are the possible causes of Fever? 

Fevers are often associated with an infection of the body. Some common infections include:

• Cold
• Flu
• Food poisoning
• Dengue (a viral infection which is passed to humans through the bite of an infected Aedes mosquito)
• Malaria (a disease caused by a parasite which is passed to humans through the bite of an infected female Anopheles mosquito)

Fevers may also be caused by:

• Heat exhaustion
• Diseases which cause pain and swelling such as rheumatoid arthritis (a condition where your immune system attacks your body’s tissues by mistake)
• Medications e.g.  to treat epilepsy, and certain antibiotics 
• Vaccines
• Cancer
•      Hormonal disorders e.g. hyperthyroidism (a condition where your body makes too much thyroid hormone)
• Illegal drug use
• Teething (in babies)

What are the symptoms of a Fever?

The normal body temperature varies from each person. Temperature taking at the mouth, forehead or under the arm may give a slightly lower temperature than measuring through the ear or through the rectum.

Rectal temperature taking  is considered the most accurate form of measurement and is recommended for infants 6 months old and below. 

For most adults and children, a temperature of 37.5 °C (taken at the mouth or ear) and above is considered a fever. Any temperature above 38.5 °C (taken at the mouth or ear) is considered a high fever.

When you have a fever, you may also experience a hot or flushed face, body aches, headache, loss of appetite, shivering, sweating and feel light-headed.

What can I do to treat a Fever?

Fever can be treated using the following medications which are available over the counter. You can ask your pharmacist to recommend a suitable medication.

• Paracetamol

It is used to lower the body temperature during a mild fever. Do take note to check the ingredient list of the product as Paracetamol is frequently combined with other medications. You may risk giving or taking  more medication than needed. For infants and children, it is recommended to calculate a Paracetamol dose using the child’s weight, rather than by age.

• Ibuprofen

Ibuprofen can be used to lower the body temperature in patients who cannot take Paracetamol or have high fever. It should only be given to children and infants more than 6 months old. For children and infants, it is also recommended to calculate an Ibuprofen dose using the child’s  weight, rather than by age. Ibuprofen should usually be taken after meals as it may cause irritation to the stomach. It should also be avoided in pregnant women and in fever caused by chicken pox or dengue.

For people who are unable to take medications by mouth, Paracetamol suppositories can also be given through the rectum. For high fever, your doctor may prescribe Diclofenac suppositories.

When do I need to see a doctor?

For adults, most mild fever can be self-treated. However, you should see a doctor if:

• You have a high fever
• Your fever lasts for more than 5 days
• You are pregnant
• You are taking medications which suppress the immune system 
• There are other concerning symptoms such as:
• Severe headaches
• Severe sore throat
• Nausea
• Vomiting
• Diarrhoea
• Rash
• Extreme thirst
• Cough with thick green or yellow phlegm or frothy pink mucus
• Earache
• Irritability
• Confusion
• Abdominal pain
• Pain when urinating
• Severe back pain
• Severe neck pain
• Fits

For children and infants, bring them to see a doctor if:

• Their fever is above 41°C, or above 38°C for those younger than 3 months old
• Their fever last for more than 3 days
• They appear overly drowsy and difficult to awaken
• They are very tired
• They seem confused
• They are very irritable or cry constantly and cannot be soothed
• They have difficulty in breathing, or have hard and fast breathing
• Their skin appears pale or grey
• They start developing rashes or unexplained bruise-like spots
• They have a fit
• They have abdominal pain      
• They are drinking less fluids or have lower urine output than usual
• They have unstoppable vomiting with a stiff neck or severe headache

What else can I do to manage this condition?

If you cannot take both Paracetamol and Ibuprofen, or if you would like to use some other methods to keep yourself or your child comfortable, fever can also be managed by the following methods:

• Stay hydrated with plenty of water (unless your doctor has advised you to limit your fluid intake)
• Sponge yourself or your child with lukewarm water. Do not use ice water or cold water, or sponge for more than 30 minutes at a time as this may cause shivering which will raise the body temperature.
• Rest whenever possible in a cool and airy room
• Dress yourself or your child in light and comfortable clothing
• Apply a cool compress to forehead, neck, armpits and groin

Disclaimers

This article is jointly developed by members of the National Medication Information workgroup. The workgroup consists of cluster partners (National Healthcare Group, National University Health System and SingHealth), community pharmacies (Guardian, Unity and Watsons) and Pharmaceutical Society of Singapore. The content does not reflect drug availability and supply information in pharmacies and healthcare institutions. You are advised to check with the respective institutions for such information.

The content above is solely for informational purposes only and is not intended as a substitute for the advice provided by your physician, pharmacist or other healthcare professional. You should not use the information for diagnosing or treating a health problem or disease, or prescribing any medication or other treatment. Always speak with your physician, pharmacist or other healthcare professional before taking any medication or supplement, or adopting any treatment for a health problem.