Vicious Cycle of Fever Phobia and the One Health Nexus: A Review

Abstract

Fever is a biological phenomenon experienced by both humans and animals with environmental (like infectious agents), iatrogenic factors (like vaccines, drugs) as culprits. However, in spite of the availability of national and international clinical practice guidelines on childhood fever management, fever phobia or fever anxiety persists globally till date. This enduring phenomenon leads to non-evidence based behaviours that are practiced by parents/caregivers, healthcare providers, all races and countries globally. Presumptive use of antimicrobial drug products to manage fever is a type of non-evidence based behaviour that drives antimicrobial resistance (AMR), which is a leading global cause of mortality with data-driven, well-coordinated One Health programs capable of stemming its tide. This review clarifies the nexus between fever phobia, its vicious cycle and One Health concept. First, this review was to draw attention to the perpetuity of fever phobia by illustrating (and briefly explaining) four nexuses with the expectation that it may contribute to the global re-awakening efforts towards addressing this important topic of global public health importance. Second, it draws strength by attempting to illustrate the nexus that exists between infectious diseases and childhood fever and One Health concept. Third, since the beneficial roles of fever are poorly understood and lack of harmonization/standardization of clinical practice guidelines for fever management could be partly responsible; we hereby recommend the development of a universally accepted, culturally-sensitive, harmonized Clinical Practice Guideline on childhood fever management that clearly spells out what constitute “good” and “bad” fevers. We further recommend that childhood fever, pain, infectious (including zoonotic) disease management and application of One Health framework should be incorporated into the academic curricula of healthcare students and be taught to a multidisciplinary class with the possibility of conducting interdisciplinary research on the subject matters. Additionally, promoting fever literacy among parents as such parents will neither engage in inappropriate practice/behaviour nor transmit same to their children/wards; was also recommended.