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Fever: Suppress or Let It Ride?

2 点作者 haltingproblem大约 2 年前

1 comment

haltingproblem大约 2 年前
<i>&quot;Is fever good or bad? Scientifically, we just do not know. However, if we take the evolutionary perspective, then blunting of the adaptive febrile response must be maladaptive. Fever is estimated to be more than 4 million years old and has been documented in the phyla Vertebrata, Arthropoda, and Annelida (7). Despite its long history of study, the exact mechanism of fever and its potentially protective effect is not fully delineated. One could hypothesize that treatment of fever compromises immune competence and renders patients more susceptible to infection. Take, for example, the classic experiment by Kluger et al. in 1981 (21,22). Here, Kluger et al. infected cold-blooded iguanas with bacteria. He gave them the opportunity to seek heat via sunlamps and all but one sought the warmth to raise their temperature. The one who did not was the only one who died. Next, he injected the iguanas with bacteria and gave them antipyretics. The iguanas that were able to mount a fever despite the antipyretic were the only ones that survived.&quot;</i><p>There seems to be significant evidence as outlined in the article that letting fever ride (i.e. leave it untreated) can save lives. Given the pervasiveness of fever and its treatment, the public health benefits of letting it tide can be quite large - both in deaths and reduced transmissions.<p>This can have an outsize impact something akin to hand washing before surgery. I wonder why this does not get more airtime from health professionals!