Viral Fever

Introduction

Viral fever refers to a broad spectrum of conditions where viral infections are associated with elevations of body temperature. The term encompasses a wide variety of viral infections, some of which can be clearly identified by their symptoms and signs. These viral infections may show generalised symptoms, but may target specific organs.

Headaches, body aches and a skin rash characterise most of these viral fevers. They may affect any age group, and are seen world-wide. They require only symptomatic treatment. Some are highly contagious. Most of them are not dangerous and self-limited, but some can progress rapidly leading to death.

Symptoms and Signs

Once the virus enters the body, there is an incubation period when the virus multiplies to a level high enough to cause infection. This is followed by a prodromal phase of fatigue, malaise and body and muscle aches that may lead to the onset of fever. The fever may be low grade or high grade and remittent. Inflammation of the pharynx, a running nose, nasal congestion, headache, redness of the eyes, cough, muscle and joint pains and a skin rash could be present.

The fatigue and body pain could be disproportionate to the level of fever, and lymph glands may swell up. The illness is usually self-limited but the fatigue and cough may persist for a few weeks. Sometimes pneumonia, vomiting and diarrhoea, jaundice or arthritis (joint swelling) may complicate the initial viral fever. Some viral fevers are spread by insects, for example, arbovirus, can cause a bleeding tendency, which results in bleeding from the skin and several other internal organs and can be fatal.

Treatment and Prognosis

Treatment of viral fever is purely symptomatic with antipyretic and analgesic drugs. Bed rest and adequate fluid intake is advised. Nasal decongestants may be beneficial. Specific antiviral therapy is not routinely recommended. Steroids are not advised as it may lead to bacterial super-infection. Only in cases of super-infection do antibiotics need to be prescribed. It is important that antibiotics are NOT routinely used for prophylaxis.

Complications of viral infections like pneumonia (viral or super-infection by bacteria) need to be addressed specifically by clearance of respiratory secretions and utilising ventilator assistance if hypoxia is severe. Symptoms of gastroenteritis should be managed with anti-motility agents. Most viral fevers recover completely in a week although fatigue may persist for a few weeks.

Prevention

Viral fevers are difficult to prevent. They occur as epidemics of infection depending on their mode of spread. Vaccines have been tried targeting the respiratory and gastrointestinal viruses with little success due to several sub-groups of viruses with different forms of antigenicity, all of which cannot be covered with a single vaccine. Fortunately since most infections are mild and self-limited, we can be assured of a full recovery.



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