My wife currently has a cold. She has always been leery of drugs, especially ones that do nothing more than alleviate symptoms. We had a discussion about whether reducing one’s fever could prolong the course of infectious disease. The general description I was taught years ago was that a fever is one way the human body combats infection, as elevated temperatures make replication more difficult for an invader that’s been optimized for 98.6 degrees.
As I thought about it, this kind of makes sense for bacteria, which bring along their own copy machines. However, viruses hijack the cells of your body, so I wondered whether a fever really makes a difference for them. Afterall, your own body seems to get along OK at elevated temps (“OK” here means your cells don’t seem to suffer from mass extinction, even though you may feel like shit).
My wife then tracked down this article, which claimed that a fever is indeed helpful in fighting viral infections, as it stops viral replication, giving your immune system a chance to wipe out the existing viral load. That article referenced this one, The Tamiflu Myth, which explained viral replication in more detail. However, the websites hosting these articles appear to be heavy on woo and an anti-establishment bias, and in fact the author of the latter article admits he does not hold a medical degree.
So what’s the deal? Is a fever in fact helpful for fighting bacterial or viral infections? If so, what exactly is the mechanism? Do I prolong the course of my cold or flu or bacterial infection if I take anti-pyretic drugs?
It’s still under investigation, but the last recommendations I’ve read are to leave a fever unmedicated unless the patient is uncomfortable or it goes over 102.
It’s important, especially with children, to *keep *medicating for fever once you start. It’s now believed that “febrile seizures” are not caused by high temps per se, but by a *sudden *elevation in temperature of more than a couple of degrees. So if you start giving a fever reducer and then stop and the temp zooms back up, that’s when seizures may happen. Keep medicating according to the time table the pharmacist gives you until the kid is feeling better, and then keep a cautious eye on it when you stop, so you can give it again if the temp creeps upward.
I don’t know how relevant this is, but I’m willing to bet that it has some relevance since even virii rely on properly folded proteins in order to function. And proteins are notoriously sensitive to being denatured by heat exposure. In fact we have whole classes of proteins such as heat-shock proteins that exist in part to protect against denaturing due to excessive heat.
Viruses, being the simple, barely alive critters that they are, don’t have any such protective mechanisms, or to the extent they do, they are, of necessity, quite primitive.
Lacking more controlled studies, it’s best said that, based on what is known, a fever *probably *slows many infections… but like all things, the infection could be so bad that it causes a fever that is too damaging, and we can opt to treat the infection directly and manage the fever… both with meds.