The end of fever and the time after

When does a febrile illness end?

When is a child healthy again?

When can the child go back into the community?

A child is considered healthy when all symptoms have subsided and she or he is out of the recovery phase. With simple febrile infections this usually means one to two days with no fever. 

During recovery children are still fatiqued, pale, prone to sweating, and picky. In the morning they may be given warm lemon-honey liquid, mild sage tea during the day, linden tree tea, elder flower tea or chamomile tea in the evening. Warm clothing is important, so that the child does not get cold too early. Activities should be reintroduced gradually.

Usually, the end of the recovery phase can be recognized by the fact that the child is energetic again, active, with rosy cheeks, returing appetite, playful, and "has an urge to go."

In situations like this usually one extra day of rest is home is needed, and then the child can go back to the community (go back into the public). A child who is taking medication (e.g. antibiotics) should not go back to the community. A child who is sick enough to need antibiotics, also needs to be at home, resting. A child who is no longer febrile is no longer contagious. However, in the kindergarten a child may get infected by others in just a few days. This is normal in nursery, kindergarten, elementary school, or in cases where a child has several siblings.

From this point of view kindergarten can be considered an “immunological gym”. Kids practice going through things little by little, so by the time they get to grade school, life can go on with fewer fevers and fewer absences.

Nursery is, of course, a bit more difficult terrain, because children are even smaller, more responsive, and recover more slowly (and sometimes with more complications).

After a well-endured febrile illness, children sometimes develop new qualities or new skills. For example, they may become more talkative, less fearful, have better sleep or appetite, and appear to be better at something than before. This is a sign that the disease they endured made them more robust. In other words, the child came out of a crisis by gaining something from it.

 

How to prevent new febrile infections?

By allowing natural, seamless exposure to common infections. It is a common experience that after some (even high) febrile illnesses, there is a longer break; illnesses are less frequent, shorter and less severe.

Seek medical attention for recurrent fever if:​

  • within three weeks fever returns to over 38.5 degrees over 2-3-day interval,
  • if the child has traveled to a far country in the past year,
  • if she has had febrile infections more than 10-12 times a year and possibly with complications.

A toddler who moves about in the community, visits a swimming pool, or comes from a large family may have up to 8-10 feverish illnesses in an average year.

 

You can find the corresponding numbered references here: References

Version update: 29 November 2020