Host: Fever in children, first of all it's not a disease, is that correct?
Vito Sessa: Fever, no, it's a sign, it's a symptom.
Host: Many reasons for it. So bringing it down doesn't make the kid cured of anything. All is to make the kid little bit more comfortable. I think one of the problems we have today people think if a kid had a 104 and I got the fever down to normal the kid is now cured and that isn't true, is it?
Vito Sessa: No.
Host: So you really have to look at the cause of the fever and if you saw a kid in a room that had a high temperature. What would make you from the glimpse, this kid may not have a big problem or kid that maybe has something serious. What would you be looking at the kid? What would be the observations you would make at first?
Vito Sessa: Well, often you can decide whether a kid is really sick from the door I think, actually tell the residents that a lot. If you relate it is he looking at his parent, is he looking at you. If he is a young kid under 18 months or two years if he fearful when you are walk in the room or anxious. If he is not relating, if he doesn't notice you come in the room, if he is not attached to his parents he maybe sicker than you'd like to have him be. The other thing is, whether he is active, playful, happy. Kids with sometimes 103, 104 would be that way and that's certainly a good sign that there is a plus point, that something serious has happened.
Host: Actually the fever is not a terrible thing it's your immune system.
Vito Sessa: Doing its job and I think there is some evidence and some studies a few years ago where fever under 101.5 is actually found to be beneficial in terms of illumining the virus or the bacterial process that's causing that.
Host: So again, while the nature is doing its job, it's over 102 most doctors want to get it done and make the kid little bit more comfortable, but if the kids is playful it's 101, you don't have to reach for that Tylenol or that Motrin or Advil bottle.
Vito Sessa: Exactly and that's what we do. If a child is 101 but uncomfortable, we can give him something but if he is happy then we don't treat fever until it's approaching 102.
Host: I mean Advil, Motrin and Tylenol are probably safe used correctly but there were some indications and it's really starting it by using Motrin and Advil, it decreases the kid's white blood cells in that starting. Significant number of patients were affected and it's just the white blood cells not evenly enterobacterial, we are just killing and the enterobacterial white blood cells in position to do the final kill, is that correct?
Vito Sessa: Yeah, right, it's not the end, it's just preparing the bacteria to be killed by the white cells so those are worth. And I think Tylenol implicated in some elevated function tests so too much Tylenol can --
Host: So if you use things appropriately minimize overuse would be probably okay. If you do use any medicine you have to realize something. You still don't know what's wrong with the kid and if you think the kid is seriously ill, that must be assist right away. What would you make you think this kid is sicker than another kid that came into your office. What would decide that kid had a fever, they say, oh, we've got to see the doctor right away. What are the things you would be looking for?
Vito Sessa: Coughing and kind of distress. Again, that lack of attachment, lack of relativeness.
Host: Photophobia, irritability.
Vito Sessa: Irritability can stand a room with bright lights.
Host: And also the young children under 2-3 months fevers are red flag to almost every kid, is that correct?
Vito Sessa: That is because you can have subtle infections that may be not be evident like a cold or a cough such as urinary tract infection or even meningitis.
Host: And you really shouldn't treat fever with antibiotics. You treat at that total infection not viral illnesses, is that correct?
Vito Sessa: Yeah, bacteria response to antibiotics but viruses don't. In fact giving antibiotics where you clearly or you presume to have a viral infection really won't help at all and might make you more susceptible to a resistant bacterial infection later on.
Host: Also make the chance of antibiotics to come more resistant inappropriately, is that correct?
Vito Sessa: Yeah.
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