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Heated coverage of fever in kids completely missed the point

Copperfield's temperature has only just subsided over research into controlling fever in children. Why did the so-called experts not state the bleedin' obvious during the ensuing media scrum? Because they're gutless tossers, he concludes.

Copperfield's temperature has only just subsided over research into controlling fever in children. Why did the so-called experts not state the bleedin' obvious during the ensuing media scrum? Because they're gutless tossers, he concludes.



Yes, I know the research was published about two weeks ago. But it's taken me that long to calm down sufficiently to put pen to paper. Or, rather, fist to laptop.

So, BMJ: 'Paracetamol plus ibuprofen for the treatment of fever in children (PITCH): randomised controlled trial'. As far as I recall, ibuprofen is better at controlling fever. Or maybe it was paracetamol.

Hang on, it was ibuprofen, then paracetamol, then alternating the two.

Or was it the other way round?

Or maybe you had to dunk the screaming hot toddler in ice? Or put him in stocks and lob tepid sponges at him?

Whatever. Cue huge media scrum, demands that NICE changes its guidance, and various worthies saying do this, that and the other, or don't do this that and the other because everyone will overdose their children with paracetamol, or ibuprofen, or both.

Confused? I was.

But none of the great and good who were wheeled out to comment on The Big Medical Story of the Day had the guts or common sense to state what was bleedin' obvious - and what would have done parents, their febrile offspring, and us GPs far more good than frothing at the mouth over which drug, when.

Which is this: fever is not a problem.

It really isn't. Fever is the way the body fights off infectious disease. It's there for a reason. It doesn't harm children*.

You don't have to fight fever. You can try to reduce it to make a child more comfortable, but that's it.

We're not worried about the fever itself. We're worried about what's causing the fever.

Far more important than the height of the fever** is whether the child is well or not. An ill child can have little or no fever. A well child can have a high fever.

So stop measuring the temperature. It just makes you anxious.

I know you know this. Because it's what we GPs say every day of our working lives to anxious mums clutching hot, cross kids. And that's the point.
Here was a glorious opportunity to put across a key public health message - one which, at a sound-bite, would have slashed the workload of our emergency surgeries.

So did any of our ‘experts' say it? No, because they're tossers who, in the glare of the media spotlight, lose sight of the bigger picture, or who have never had that perspective in the first place.

Just thinking about it again now, I'm getting hot under the collar. And I'm breaking out into a sweat. Time to reach for the ibuprofen. Or should it be paracetamol?

* And yes, I know about febrile convulsions, but no, using antipyretics doesn't make any difference to their likelihood. Look it up if you don't believe me.

** Yes, OK, except in kids under 6 months, we all know that. Just stop it, will you. We don't want your sort around here.

Copperfield blog

Here was a glorious opportunity to put across a key public health message - one which, at a sound-bite, would have slashed the workload of our emergency surgeries.

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