Sweating Out A Fever -WSJ

When a child's temperature begins to rise, worried parents often spring into action, marshaling ['mɑ:ʃəliŋ] cool washcloths and pain relievers, making frantic ['fræntɪk]adj.狂乱的calls to the doctor or even visiting an emergency room. Now, the American Academy of Pediatrics [,pi:di'ætriks]n.小儿科is telling parents that the number the thermometer [θə'mɒmɪtə]n.温度计,体温计displays显示 is just a number -- and that making a feverish ['fiːv(ə)rɪʃ]adj.发热的child comfortable is far more important than bringing his temperature to 98.6 on the dot准确地. 'The signs and symptoms体征,症状provide much more information than just the fever itself,' says Janice E. Sullivan ['sʌlivən], a professor of pediatric critical care重症护理 at the University of Louisville ['lu:ivil] School of Medicine in Kentucky [ken'tʌki] and co-author合著者 of an AAP report (the American Academy of Pediatrics美国儿科学会) on fevers, released Monday. The report, aimed at calming what it calls 'fever phobia ['fəʊbɪə]n.恐惧症,' also says there is no evidence that lowering a fever will help a child get well faster, or that leaving a fever untreated could cause seizures ['siːʒəz]n.痉挛或惊厥, brain damage or death, as some caregivers照料者 fear. Many pediatricians [,pidɪə'trɪʃən]n.儿科医师have given parents a similar message for decades, but it hasn't sunken ['sʌŋk(ə)n] in完全被理解. There's widespread confusion over what fevers in both children and adults signify, when to treat them -- even what constitutes ['kɔnstitju:ts]vt. 构成an official 'fever' (100 degrees Fahrenheit ['færən'haɪt]adj.华氏的? 100.4?) Many parents also rely on the thermometer to tell them how sick a child is when he's too young to talk. To some, it's an objective measure客观标准, which can't be faked捏造, of whether an older child should be packed off送走 to school or sent back送回 to bed. Fevers are the main reason for one-third of calls and visits to pediatricians, the report notes. Yet many beliefs about them are based more on culture, tradition and playground chatter ['tʃætə]n.闲聊 than scientific evidence. Ads showing parents fretting [fret] vt.焦急over thermometers confuse things further. 'There's a huge desire [di'zaiə]n.要求,心愿to do the right thing, but when we think we're healing ['hiːlɪŋ]v.治疗the child, we may be really treating ourselves [aʊə'selvz] by taking action, says Glen Stream, president-elect 刚刚当选的主席of the American Association of Family Physicians 美国家庭医师学会. Experts stress that a fever isn't an illness, it's a response [rɪ'spɒns]n.反应, probably an evolutionary [,iːvə'luːʃənərɪ]adj.进化的adaptation [ædəp'teɪʃən]n.适应to help fight infection [ɪn'fekʃən]n.感染. Setting the body's thermostat ['θɜːməstæt]n.恒温器 (the hypothalamus [,haɪpə(ʊ)'θæləməs] gland in the brain) a few degrees higher slows the reproduction繁殖 of bacteria [bæk'tɪərɪə] and viruses ['vaɪərəsɪz]n.病毒（virus的复数）and boosts促进 white blood cells. There's some evidence that illnesses may resolve缓解 faster when fevers are left untreated, the report notes. At the same time, elevated temperatures themselves can cause discomfort [dɪs'kʌmfət]n.不适in children by interfering [,intə'fiə]vi.打扰with sleep, appetite ['æpɪtaɪt]n.食欲and activities. 'If your child looks uncomfortable [ʌn'kʌmfətəbəl]adj.不舒服的, then treat the discomfort with acetaminophen [ə,siːtə'mɪnəfen] or ibuprofen [,aɪbjuː'prəʊf(ə)n],' says Dr. Sullivan. But she says a fever alone with no other symptoms doesn't need treating. 'The fever itself doesn't tell us how ill the child is. There isn't a good correlation [,kɒrə'leɪʃən]n.关联.' The report, which is aimed at pediatricians, not parents, doesn't specify列举,详细说明 other ways to make a sick child more comfortable. But Dr. Sullivan says parents should be on the lookout警惕着 for rashes皮疹, irritability [,ɪrɪtə'bɪlɪtɪ]n.躁动and altered ['ɔːltəd]adj.改变了的 mental status精神状态. 'Anytime you have a significant change in behavior, you need to talk to your doctor,' says Henry Farrar ['færə], who practices pediatric [,pi:dɪ'ætrɪk]adj.小儿科的emergency medicine at Arkansas ['ɑ:kənsɔ:] Children's Hospital and co-authored the report. It also stresses the need for rest and proper fluid intake液体摄入. If a fever-reducing [ri'dju:siŋ] medicine is warranted ['wɔrəntid]v.批准to make a sick child more comfortable, the report says there is no substantial [səb'stænʃəl]adj.实质的difference between acetaminophen [ə,siːtə'mɪnəfen] and ibuprofen [,aɪbjuː'prəʊfən] in safety or effectiveness. But it warns against combining them or alternating ['ɔːltəneɪtɪŋ]v.交替使用them -- which some doctors recommend -- because it compounds ['kɔmpaundz]增加 the risk of errors. The report also stresses the importance of checking package labels for the correct dosages ['dəusidʒ]n.剂量,用量, which are based on weight and age in children. As many as half of all U.S. parents give children incorrect [ɪnkə'rekt] doses, according to the report. And if a child is asleep, he shouldn't be awakened just for medication [medɪ'keɪʃən]n.药物治疗, the report notes. In one study, 85% of parents said they had done so. There are some cases where a fever alone can be worrisome ['wʌrɪsəm]adj.令人不安的. Parents should contact a doctor immediately if an infant under 3-months old has a fever of 100.4 or higher, which could signal a serious infection. Children with underlying [ʌndə'laɪɪŋ]adj.严重的conditions病症(身体状况), such as weak heart muscles, may not be able to tolerate ['tɒləreɪt]vt.忍受a fever and should get medical attention医疗护理 if one appears. Children and adults can spike迅速上升 fevers as high as 106 due to hyperthermia [,haipə'θə:miə]n.高烧, or 'heat stroke中暑,' a malfunction [mæl'fʌŋkʃən]n.故障in the body's ability to cool itself, often after physical exertion [iɡ'zə:ʃən]强体力活动 in hot weather. Drinking fluids and being immersed [i'mə:st]vt.浸泡in cool water can help; fever-reducing drugs don't. Fevers can occur in children and adults for many other reasons, including auto-immune diseases like lupus ['luːpəs]n.[医]狼疮, cancers like leukemia [lju'ki:miə]n.[肿瘤]白血病and lymphoma [lɪm'fəʊmə]n.[医]淋巴瘤and just normal teething ['tiːðɪŋ]n.出牙. Some people routinely [ru:'ti:nli]adv.常规地run fevers发烧 even with minor illnesses小病, and some people seldom get them. (Rare fevers that last for weeks with no apparent reason are known as FUOs -- fevers of undetermined [ʌndɪ'tɜːmɪnd]adj.未确定的origin.) Even the classic标准的98.6 isn't so much 'normal' as 'average,' experts note. A healthy person's temperature varies much as a full degree during the day, reaching highest in the evening and lowest between about 6 a.m. and 9 a.m. (just when tough school-or-bed decisions are being made.) Given假定all that variability [,veərɪə'bɪlətɪ]n.变化性, does it make sense讲得通 to check the thermometer at all? Yes, doctors say. Since most fevers accompany viral ['vairəl] infections病毒性感染, experts agree that children with temperatures above 100.4 should stay home until they are fever free, without medication, for at least 24 hours, whether they have symptoms or not. The same goes for adults -- and they shouldn't be under the illusion [ɪ'ljuːʒən]n.幻觉,错误的观念that lowering a fever with medication also lowers their chance of infecting coworkers, experts say. 'We really don't want people with fevers to be in the workplace,' says Robert Hopkins, a University of Arkansas ['ɑ:kənsɔ:] professor of internal medicine内科医学 who serves on担任 the American College of Physician's clinical ['klinikəl]adj.临床的,诊所的guidelines临床指导 committee. The illnesses with little or no fever pose [pəʊz]vt.引起,造成 more of a dilemma [di'lemə]n.困境. Some viruses are most contagious [kən'teɪdʒəs]adj.传染性的,会感染的in the early stages, before a fever has developed产生,出现. Others, like last year's H1N1 virus, made many people miserable ['mɪzərəbəl]adj.悲惨的;痛苦的but seldom caused fevers. That can make for tough calls艰难的判定 for parents and school nurses when it comes to deciding whether a child who complains of illness, but doesn't have a fever, should be in school. 'Sorting out挑选,区分 the difference between a math-anxiety headache and an illness that could be contagious or prevent a child from learning is a judgment call判断,' says Amy Garcia ['ga:ʃjə], executive director of the National Association of School Nurses. It helps to know the child very well, she says. 'I had three boys myself, so I know the drill训练,军事操练 pretty well.' Melinda Beck