Fever In State Research Articles

An Outbreak of Dengue in Patna, Bihar: A study of 60 cases and review of literature

Background : Dengue virus belongs to family Flaviviridae , having four serotypes that spread by the bite of infected Aedes mosquitoes. Materials and methods : Dengue positive cases from June to December of two constitutive years, 2015-2016 were obtained, total number of cases were 60. Result: Male and female were 36(60%) and 24(40%) respectively. It denotes almost all cases were primary dengue infection. They were negative for IgM and IgG. Out of total cases 28(46.6%) patients had initial presentation with thrombocytopenia, below 150,000/ul, minimum 20,000/. In first weak leucopenia with relative lymphocytosis, neutropenia, raised ALT and AST are important laboratory findings. From first weak onwards, petechial rashes due thrombocytopenia and erythematous skin patches due to increased vascular permeability are important features. The erythematous patches due to vasculopathy give a hot touch feeling. Rapid ELISA for NS1, IgM, and IgG could be false negative in 10% cases. For those dengue suspected cases ELISA, hemagglutination or PCR based investigations are warranted for diagnosis. Conclusion: The study results are relevant in the characterization of biological markers in the evolution of the disease and can be used as markers for the most severe forms thereby enabling health professionals in taking early help with the adaption of therapeutic conduct for specific patients. It could be useful for making policy regarding control and prevention of dengue fever in state like Bihar where such type study is not till now published.

How do child care center personnel define fever?

ABSTRACTBackground Children with ‘fever’ are routinely excluded from child care centers, resulting in disruption of parental work schedules. Little is known about how child care centers define fever in states that do not provide guidelines.Objective To determine the frequency of temperature thresholds for the definition of fever used by child care centers that are either lower or higher than thresholds commonly used and to identify factors associated with their use.Methods We interviewed a random sample of 1632 child care program directors in Connecticut. Child care centers were classified into three groups based on their temperature threshold for definitions of fever by oral temperature: (1) group with lower fever threshold (<99.5°F); (2) group with mid‐range fever threshold (99.5–100°F); or (3) group with higher fever threshold (>100°F).Results Of the 115 directors randomly selected and then contacted, 100 (87%) agreed to be interviewed. Of the 100, one center did not have a numerical definition of fever. Eight centers used a lower temperature threshold, 60 centers used a standard or mid‐range temperature threshold, and 31 centers used a higher temperature threshold. The multinomial logistic regression model indicated that directors without a college degree were more likely to use higher or lower temperature threshold for the definition of fever compared to those with a degree (p < 0.05).Conclusions There is substantial variation in the definition of fever used by child care centers. Directors without a college degree may be target groups for continuing education of what constitutes fever in child care settings. In addition, implementation of state‐wide standards for definition of fever in child care programs should be advocated.

Release of endogenous pyrogen-activating factor from concanavalin A-stimulated human lymphocytes.

Evidence is presented that the mitogen concanavalin A stimulates human lymphocytes to produce a nonpyrogenic lymphokine (LK) that is capable of activating human monocytes but not granulocytes to produce endogenous pyrogen (EP) in vitro. The potency of this preparation should facilitate further studies to purify and characterize this agent and determine its relation to other know LK. It seems likely that this factor, which we have called EP-activating factor (EPAF), plays a significant role in the development of fever in states of delayed hypersensitivity in man.

Pathogenesis of fever in delayed hypersensitivity: factors influencing release of pyrogen-inducing lymphokines.

In continuing studies on the pathogenesis of fever in states of delayed hypersensitivity, we have investigated the conditions for the release of an endogenous pyrogen (EP)-inducing lymphokine from draining-lymph-node lymphocytes of rabbits with delayed hypersensitivity to bovine gamma globulin. Using doses of 4 X 10(7) to 5 X 10(7) blood leukocytes (BL) as a source of EP, we found that ratios of about 5:1 of viable lymphocytes to BL were required to stimulate the BL to produce detectable amounts of EP in vitro. Both irradiated lymphocytes (1,700 R) as well as those from steroid-treated donors retained their ability to activate BL when incubated with antigen, properties consistent with activated "T" lymphocytes. In experiments to determine effects of temperature and duration of incubation on lymphokine release, the maximum EP-releasing activity was found to be present in supernatants of sensitized lymphocytes incubated with antigen for 18 h at 37 degrees C. These studies have confirmed that sensitized lymphocytes release a soluble, pyrogen-inducing lymphokine when incubated with antigen and further demonstrate that tissue macrophages (Kupffer cells) as well as BL can be activated to produce EP in vitro by this agent.

Influence of the duration of experimental fever on salicylate antipyresis in the rabbit.

1. Steady state fever has been produced in rabbits with a priming injection followed by a sustaining infusion of homologous plasma containing endogenous pyrogen (EP). This fever appears to last as long as the infusion continues.2. Intravenous salicylate given 1 h after the start of the EP infusion produced only a small antipyretic effect. The same dose of salicylate given 4 h after the start of an EP infusion resulted in rapid and progressive defervescence. Intermediate antipyretic responses were obtained when salicylate was administered intravenously 2 and 3 h after the start of an EP infusion.3. Less than 1% of the systemic dose, when injected into a lateral cerebral ventricle, produced a significantly smaller response at 1 h than at 4 h after the start of an EP infusion. At both these times the fall in temperature following the intraventricular salicylate injection was dose dependent, but the slope of the dose-response line was significantly steeper at 4 h than at 1 hour.4. It is suggested that salicylates produce their antipyretic effects by antagonizing the action of EP within the nervous system, and that the hypothalamic EP concentration falls during the course of an EP infusion.