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Expert Q&A
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| By Michael F. Wasserman General Pediatrician | ||
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My child was running a temperature last night, but he really didn't have any other symptoms. After fever-reducing medicine before bed, his temperature is lower, but still not normal. Is there a way I can tell for sure that he is too sick for school?
First, when discussing fever in children, it is useful to accurately measure the temperature with a thermometer. Each method of temperature taking gives a slightly different correlation with internal body temperature. Rectal temperatures are the most accurate. Oral (mouth) temperatures are useful in the child who can hold the thermometer under the tongue for several minutes. Axillary (armpit) temperatures can be accurate, but the arm must be tightly pressed against the chest for about five minutes. The ear temperature seems to be the least accurate way to measure temperature, because the beam may only partly reflect down the ear canal, registering a lower temperature of the ear canal skin rather than the higher temperature of the eardrum.
Assuming an infection is the cause of a child's temperature, I generally tell parents that their child must be fever-free for 24 hours straight before we can consider the child to be non-contagious. Older children who have the sudden onset of temperature and no other specific symptoms most commonly have a viral illness. These illnesses usually last three to seven days, and the child's immunity will properly deal with this problem. In this situation, I would not send the child to school, as the most likely diagnosis is that of viral syndrome, which would be contagious to others.
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