FeverChildren Booklet

BAG68471_FeverChildren_Booklet 22.08.
2003 15:24 Uhr Seite 1 BAG68471_FeverChi
Contents
Foreword
Page 2
Body temperature
Page 3
Measuring body
temperature
Page 5
Common childhood
illnesses associated
with fever
Page 18
1
BAG68471_FeverChildren_Booklet 22.08.2003 15:24 Uhr Seite 2 BAG68471_FeverChi
Foreword
This is a small guide on body temperature, measuring body
temperature and common childhood illnesses that may be
associated with fever. I have helped to develop this booklet
by providing the medical information on these subjects.
However, this booklet is not intended as a substitute for
consultation with your doctor. Always consult your doctor if
your child shows symptoms or behavior that are not
consistent with their normal behavior or if you are ever in
doubt of your child’s health.
When your child is ill, they will need you even more than
usual. Your love and affection combined with the proper
medical care will help to ease the time of illness and will
positively influence the recovery.
Dr. med. Helmut Keudel

Pediatrician
2
Body temperature
What is normal body temperature?
Body temperature is regulated by the temperature control
center in the brain, which affects all internal organs. Normal
body temperature ranges from 34,7°C to 38,0°C, depending
on the body site where the temperature is taken. This normal
range is influenced by many factors such as physical activity.
Everyone has their own normal temperature range, and this
range also varies throughout the day. The normal temperature
range tends to decrease with age.
Normal temperature ranges of different sites
Axillary: 34.7 - 37.3ºC

Oral: 35.5 - 37.5ºC
Rectal: 36.6 - 38.0ºC
Ear: 35.8 - 38.0ºC
3
What is fever?
Fever is a defense mechanism the body uses to fight
infections, and it is therefore frequently associated with
childhood illnesses. A body temperature that is consistently
above the normal temperature range is called a fever. Fever
alone is not an illness, it is only a symptom. Therefore a fever
should never be taken as the only indication for the severity
of an illness. Always take other symptoms into consideration.
What happens in
the body
during fever?
An elevated body tempera-
ture increases the body's
metabolic rate. This helps to
slow down the multiplication
of germs. The elevated tem-
perature causes the blood
vessels to widen so that
heat can be lost via the skin.
4
Measuring body temperature

When and how often should
a temperature be taken?
If your child seems to be unwell, take his/her temperature to
see if he/she has a fever. To find out if it is a fever or just a
temporary increase in body temperature, repeated measure-
ments can be taken, for example every hour. Recording your
child’s temperature will give an indication of how your child’s
temperature is changing. It can provide useful information for
your doctor.
What is the ideal body temperature

measurement?
Measuring "core" body temperature would be the ideal. Core
body temperature is the temperature of the vital organs such
as heart and brain. Since these sites are not easily accessible
other sites for temperature measurement at home or in a doc-
tor’s office have been identified.
5
Taking temperatures at home:

choosing the site
Several body sites can be used to measure body
temperature at home.
Rectum
Taking temperatures in the rectum has been common prac-
tice for decades. However, rectal temperatures may lag
behind changes in core body temperature, and may therefore
be slow to reveal important changes in body temperature.
This method can take several minutes, and thus requires
your child’s cooperation. It bears risk of causing local injury,
as well as cross-contamination.
6
Mouth
Temperatures taken in the
mouth can reflect core body
temperature if proper techni-
que is used. However, rea-
dings can be affected by
external factors, such as
eating, drinking, or brea-
thing. Measuring temperatu-
re in the mouth requires
your child’s cooperation and
is not suitable for young
infants, It may take several
minutes to take a reading.
7
Skin (under the arm, forehead)

Skin temperatures, measured under the arm or at the
forehead, are convenient. In fact, you probably feel your
child's forehead to quickly check whether your child's tempe-
rature may be elevated, and if you are worried, follow-up by
taking your child's temperature with a thermometer.
However, skin temperatures are not always reliable indicators
of core body temperature, especially during those critical
times when core body temperature is increasing or decreasing.
This is because the skin is a tool the body uses to control
core body temperature. For example, when fever is increa-
sing your child is likely to react by shivering and drawing in
heat from the increase core body temperature. Skin tempera-
tures are further influenced by factors such as fever lowering
medication and external temperature.
8
Ear
As the eardrum shares blood supply with the temperature
control center in the brain, the hypothalamus, ear temperatu-
res accurately reflect changes in core body temperature with-
out a significant time lag. The ear is an easily accessible site
for temperature measurement.
9
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Taking body temperature at home:

choosing the thermometer
Mercury-glass thermometers
Mercury-glass thermometers have been used for years to
measure temperatures in the rectum, the mouth, or under the
arm. They can take several minutes to reach a constant tem-
perature, and the result can sometimes be difficult to read.
When used on children, the risk of breakage is a major safety
concern. There is also a potential risk of cross-infection when
the thermometer is used by more than one family member.
Electronic digital
thermometers
Electronic digital thermo-
meters offer certain
advantages over mercury-
glass thermometers.
They obtain temperature
readings faster, and their
digital display is easy to
read. There is also no risk
of injury from broken glass
or mercury.
10
Infrared thermometers
The key advantage of infrared thermometers is their speed.
They measure quickly, usually in just seconds.
Infrared thermometers measure thermal heat generated by
surfaces and cavities. Infrared sensors cannot measure the
heat or temperature below the surface.
Infrared ear thermometers - Ear thermometers measure

the infrared heat generated by the eardrum and surrounding
tissue, giving an accurate temperature on an easy-to-read
digital display in just a few seconds. In addition, due to the fast
measurement time and the easily accessible site, only minimal
cooperation is needed from your child. However, as with any
temperature taking method, proper positioning and technique
are necessary to obtain accurate measurements.
Skin thermometers - Infrared skin thermometers measure

temperatures at other sites, such as on the forehead temple or
under the arm. They measure the infrared heat produced by
the skin at these sites. Skin temperatures may not accurately
reflect core body temperature.
11
How does Braun

ThermoScan
4520/4020 work?
Braun ThermoScan
measures the infrared heat
generated by the eardrum
and surrounding tissue.
The unique ExacTemp

technology with the
Feedback System secu-
res professional accuracy
every time.
12
Fast/Easy/Gentle:
Within seconds it measures the
temperature in the ear with minimum
disturbance to your child.
It has a soft, flexible tip

for added gentleness.
13
Accurate:
Because the eardrum shares blood
supply with the temperature control
center in the brain, measurements with
Braun ThermoScan accurately reflect
changes in core body temperature.
Unique ExacTemp technology

with Feedback System confirms
with a light and a beep when you have
taken an accurate measurement. It
signals you if the thermometer is not
securely placed.
Safe:
The risk of transferring germs
from one user to another is virtually
eliminated through the use of
disposable lens filters.
14
Key Operating Points

for Braun ThermoScan
1
▼
1 To achieve accurate
readings, make sure a
new, clean lens filter is
in place before each
measurement.
▼
2 2 Push the Start but-

ton and then wait for the
ready signal.
15
▼
3 Fit the probe snuggly into
the ear canal, then push the
Start button again.
4 Feedback System signals you

4 ▼
with a light and a beep a secure place-
ment of the thermometer and confirms
an accurate measurement.
▼
5 5 If the probe has not been con-

stantly placed in a stable position in
the ear canal, the display will show an
error message («POS» = position error).
16
▼
6 6 Normal ThermoScan
0 - 2 years: temperature ranges by age
36.4ºC - 38.0ºC
3 - 10 years:
36.1ºC - 37.8ºC
11 - 65 years:
35.9ºC - 37.6ºC
> 65 years:
35.8ºC - 37.5ºC
Practice taking
your child’s tempe-
rature when your
child is well in
order to become
familiar with their
normal temperatu-
re range. This can
then be compared
to readings when
they are unwell.
17
Common childhood
illnesses associated with fever
What to do if your child is ill
1• Remain calm.
2• Give your child additional love and care.
3• In case of doubt always consult your doctor.
When your child is ill, they will need you even more than
usual. However, your love, tenderness and affection need to
be combined with the proper care. Have sympathy for your
child and try to understand their needs.
If there are symptoms that you are unfamiliar with, or if your
child’s symptoms do not improve within a short time period
as a result of your care, always consult your doctor.
18
Febrile
convulsions What can you do?
Febrile convulsions can •Remain calm.
occur in young children
usually under 6 years of •Lay your child on one side
age. Febrile convulsions in a stable position.
tend to occur if the body
temperature is rising very •Loosen any tight clothing.
quickly at the beginning of
an illness. During a febrile •Do not hold your child
convulsion the child may during a convulsion.
lose consciousness. The
body becomes either flabby •If a febrile convulsion
or stiff, and the muscles occurs, always consult
may twitch. The child will your doctor.
appear pale, their eyes may
roll and they may salivate.
After about 60 seconds, the
convulsion ends and the
child will fall asleep.
19
The common cold

The most common illnesses during childhood are respiratory
infections, otherwise known as the common cold. Infection is
spread by droplets, formed as an infected person coughs or
sneezes. It usually takes 1 - 3 days from catching a cold to
the first sign of symptoms.
20
The most frequent

symptoms Important!
With the onset of a cold, If your child's cold lasts for
your child will feel generally more than one week, you
unwell, which may include a should consult your doctor.
sore throat, a runny nose Newborns and babies
and a slight headache. The should always be taken to
start of a cold is also often the doctor. As most
accompanied by a cough. common childhood illnesses
During childhood, especially start with the symptoms of
in very young children, a cold, you should carefully
colds are commonly observe your child for any
accompanied by a fever. other symptoms, and in
A common cold will usually case of doubt, consult your
last for about 4 - 7 days. doctor at an early stage.
What can you do?

Consider keeping your child in bed, especially while there is
a fever. Use the methods recommended by your doctor to
reduce the fever. Give your child plenty of fluids and food
that is easy to swallow.
21
Influenza
Influenza is a worldwide viral illness which occurs mainly in
the winter. As for colds, infection is spread by droplets during
talking and coughing. The symptoms of influenza begin about
1 - 7 days after infection.
The most frequent

symptoms What can you do?
High fever, coughing,
Make sure your child stays
headaches and general
in bed and give plenty of
aching pain in the limbs and
fluids. Use the methods
abdomen occur at the
recommended by your
beginning of the illness.
doctor to reduce the fever.
Usually, the fever will
If in doubt, consult your
disappear after 2-3 days.
doctor.
If the illness is severe, the
fever may last 4 - 5 days.
22
Bronchitis
Infectious bronchitis is an inflammation of the lining of the
lungs. Bronchitis is often a result of a common cold and is
most common in the winter.
The most frequent symptoms

The first signs of bronchitis are similar to those of a cold. For
the first 2 days there is a hard dry cough, accompanied by a
backache. The cough then develops into a thick mucous,
which can be coughed-up. A fever occurs during the first few
days. A recovery from bronchitis should occur within about 2
weeks.
What can you do?

If there is a fever, your child should rest and be given plenty
of fluids. Once the fever has passed, you can take your child
out in the fresh air. Always consult your doctor.
23
Diarrhea
Diarrhea is not an illness, but a common symptom of a
number of illnesses involving the stomach and intestine. If
your child develops diarrhea, always consult your doctor.
The most frequent

symptoms
Diarrhea occurs very
suddenly, with griping pains
in the stomach (colic) and
watery feces. The feces
may be associated with
mucous and/or some
blood. Sometimes diarrhea
is accompanied by
vomiting. A slight or high
fever can also occur.
24
What can you do?

Take special care of your
child. Make sure that your
child is drinking enough to
compensate for the fluid
loss associated with the
diarrhea. Consult your
doctor on what food to give.
As the acute symptoms
diminish, slowly increase
your child's food intake.
25
Measles
Measles is a worldwide highly infectious illness that is caused
by a virus. Ninety percent of all children who have not been
vaccinated get measles. It takes 10 - 12 days from the day of
infection until the first symptoms appear. Having measles
leads to a life-long immunity from re-infection.
26
The most frequent

symptoms What can you do?
During the first 2 - 3 days, For the first few days your
the symptoms are similar to child should stay in bed.
those of a common cold, The room should be
but initially accompanied by darkened to protect your
a high fever. Your child will child's eyes. Keep the room
be sensitive to light and cool and moisten the air
have a dry cough. The fever using wet towels. Use the
will then decrease slightly methods recommended by
and small white spots will your doctor to reduce the
appear on the lining of the fever. Give your child plenty
mouth. On days 3 - 4, the of fluids.
fever will increase again,
and a light red rash will
develop on the skin,
beginning behind the ears
and on the face. The rash
will then spread all over the
body and develop a reddish- Important!
purple appearance. It will Because of the risk of
take another 3 - 4 days for complications, always
the fever and the rash to consult your doctor.
disappear.
27
Mumps
Mumps is a highly infectious viral illness that affects the
salivary glands. Infection is spread via droplets when
sneezing, coughing or talking. It takes 2 - 3 weeks from
infection to the first signs of the illness. A child with mumps
will be infectious for about one week before and up to two
weeks after symptoms appear. Children do not usually catch
mumps before they are two years old. Having mumps leads
to a life-long immunity from re-infection.

Mumps begin with a painful swelling of the parotid salivary
glands which are located over the angle of the jaw. Chewing,
swallowing and head movements will cause pain. At first only
one side is affected but a few days later the glands on the
opposite side will start to swell. Mumps is accompanied by a
mild to severe fever. About 20% of children will develop a
stomach ache because their pancreas becomes affected.
28
What can you do?

Consult your doctor.
Depending on what your
child prefers, apply warm or
cold compresses to the
affected area. Give a light
fluid diet. Use the methods
recommended by your
doctor to reduce the fever.
29
German measles
German measles is a harmless viral infection which is
transmitted via droplets when sneezing, coughing or talking.
The incubation period is 2 - 3 weeks. German measles is
infectious from about 1 week after the initial infection until
about 10 days after the rash has appeared. Infection with
German measles leads to a life-long immunity from
re-infection.

After brief symptoms of a cold, a light red patchy rash
appears behind the ears and on the face. The rash spreads
over the neck, trunk, arms and legs, and will disappear in the
same way after about 10 days. A typical symptom of German
measles is a swelling under the skin on the back of the neck,
which feels like a string of pearls.
30
What can you do?

If in doubt, consult your
doctor. If necessary, use the
methods recommended by
your doctor to reduce fever.
Important!
If your child catches
German measles, ensure
that they do not come into
contact with any pregnant
women who do not have
immunity. German measles
caught during pregnancy
can lead to malformations
of the unborn child.
31
Scarlet fever
Scarlet fever is one of the
most contagious childhood
illness. It is caused by
streptococcus bacteria
which lead to a severe
throat infection. The bacteria
are transmitted in droplets.
The incubation period for
scarlet fever is 2 - 4 days.
32

Fever accompanied by a severe sore throat. Vomiting and
stomach aches may also occur. The uvula and the roof of the
mouth turn bright red and become swollen. A white coating
appears on the tongue. After 2 - 3 days, a red rash develops
in the region of the armpits and the groin. An area around the
mouth always remains free from the rash. The white coating
on the tongue then disappears and the tongue develops a
raspberry-like appearance. About 1 - 2 weeks after the first
symptoms, the skin on the palm of the hands and the sole of
the feet begins to peel.
What can you do?

Consult your doctor immediately if you suspect symptoms of
scarlet fever. Ensure that your child receives plenty of fluids.
Give only liquid food because of the sore throat. Use the
methods recommended by your doctor to reduce fever.
33
Chickenpox
The chickenpox virus is
highly infectious and can be
transmitted over distances
of up to 10 meters. A risk of
infection is already present
2 days before the first
symptoms appear and
persists until the blisters dry
up after about 10 days. The
incubation period is about
12 - 21 days.
34

Chickenpox start like a cold with a sore throat, headache and
fever. Then, all over the body red spots the size of lentils
appear. These quickly fill up with fluid and develop into
blisters, which burst and become scabs. In particular, these
blisters will appear on the scalp and the mucous membranes.
This rash is very itchy and it develops in phases within 4 - 5
days. It takes 2 - 3 weeks to recover from chickenpox.
What you can do?

Try to ease the itching and if necessary, use the methods
recommended by your doctor to reduce the fever. Encourage
your child not to scratch. Blisters that are exposed by
scratching easily become infected and can leave unsightly
scars. Once the blisters have scabbed over, your child can
have a warm shower. This will help to ease the itching. If in
doubt, consult your doctor.
35
Meningitis
Meningitis is not a common childhood illness.
However, similar symptoms may occur.

The child seems indifferent. A headache and high fever are
accompanied by vomiting. The child may not be able to bend
the head forward. Convulsions may occur.
Important!
If you suspect your child to
show symptoms of
meningitis, immediately
consult your doctor.
36

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BAG68471_FeverChildren_Booklet 22.08.

2003 15:24 Uhr Seite 1 BAG68471_FeverChi

Dr. med. Helmut Keudel

Normal temperature ranges of different sites

Axillary: 34.7 - 37.3ºC

Measuring body temperature

What is the ideal body temperature

Taking temperatures at home:

Skin (under the arm, forehead)

Taking body temperature at home:

Infrared ear thermometers - Ear thermometers measure

Skin thermometers - Infrared skin thermometers measure

How does Braun

The unique ExacTemp

It has a soft, flexible tip

Unique ExacTemp technology

Key Operating Points

2 2 Push the Start but-

4 Feedback System signals you

5 5 If the probe has not been con-

The common cold

The most frequent

What can you do?

The most frequent

The most frequent symptoms

What can you do?

The most frequent

What can you do?

The most frequent

The most frequent symptoms

What can you do?

The most frequent symptoms

What can you do?

The most frequent symptoms

What can you do?

The most frequent symptoms

What you can do?

The most frequent symptoms

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