Letters: Reducing fever does harm immune response

Thank you for your review and the balanced advice on the management of this common, difficult problem (Management of fever in children, GP, 6 March).

Could you kindly clarify the following point. As presented by the authors, there is evidence that fever may enhance the immune response. Other evidence indicates that if fever is reduced by drugs (paracetamol in malaria and chickenpox) the immune response is impaired.

Is there any evidence to suggest that if fever is reduced by physical means only, any possible benefit to the immune system is retained?

Dr John Brand, Gosport, Hampshire

The author replies:

A good question. There is no evidence that I am aware of that physical measures only allow retention of normal immune function.

Dr Alastair Hay, a GP and consultant senior lecturer, University of Bristol

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