What Defines My Life

What Defines My Life

I like to say pus is my life, mostly as it bugs my children. My license plate says ‘pus’ and he hates it when I pick him up at school. In reality pus is a theoretical construct that others collect and analyze and I decide what to do with the results.

Fevers are probably a more important aspect of my professional life, although I did not want ‘fever’ as a license plate. Too much like hot. But almost all my patients have a fever at one time or the another. Understanding fevers is part of my professional expertise.

I have a strong bias that fevers should not be treated in normal people. I can go on and on and on and on about how fevers are good. The fever response is millions of years old and every animal that can make a fever does make a fever. The immune system functions better at higher temperature, many organisms do not grow at higher temperatures, and virtually every study not only shows no clinical benefit from treating a fever but most show worse outcomes: a longer illness or more complications.

There are certainly people who do not have the physiological reserve or other problems (stroke or heart attack) in whom fevers are bad. But when my kids have a fever, I let them burn. It doesn’t hurt them (as long as it is less than 104) and they are quiet. I have a strong bias from the preponderance of the medical literature to leave fevers alone.

So when I saw Population-level effects of suppressing fever it certainly fed into my confirmation bias.

It is a mathematical model, not a true clinical trial, where they determine that treating fevers leads to increase in viral shedding and, since it makes people feel better, they are more likely to go out and spread the disease. Like all models there are suppositions that may or may not be true.

They estimate treating fever with influenza would increase cases by 1% and kill an extra 700 people. Works for me. Whether it is true or not, I do not know. Like a zombie outbreak, mathematical modeling is interesting and perhaps adds insight into disease spread.

I am going to add the article to my anti-anti-pyretic tirade.

Points of Interest: 1/31/2014
Points of Interest: 1/30/2014

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