Teething does not cause actual symptoms of illness

Q My one-year-old daughter has been having frequent fevers and she is also teething.

Does teething cause fever and can it lead to brain damage?

What symptoms should I look out for and what is the cut-off temperature at which I should take her to the doctor?

I'm also concerned about the many vaccinations that she has to undergo. Are they necessary and do they cause autism?

A Many parents have a misconception that fever can damage the brain.

There is no cut-off temperature above which the brain will sustain brain damage.

In any episode of illness with or without fever, what is more important for the parent to observe would be the child's overall levels of activity, appetite, frequency of urination and whether he has any breathing difficulties.

The severity of fever does not necessarily correlate with the severity of the illness either.

Fever is a natural response of the body's immunity system to fight off infections. Some infections have a higher propensity to cause fever than others.

While high fever itself does not usually cause brain damage, fever caused by meningitis or encephalitis (infection of the brain lining or brain matter) or, in the rare instance of hyperthermia or heat stroke, fever may cause brain damage.

High fever may cause "fever fits", or febrile seizures, although these usually do not result in long-term complications unless the seizure is prolonged and lasts for more than 20 minutes.

In any episode of illness with or without fever, what is more important for the parent to observe would be the child's overall levels of activity, appetite, frequency of urination and whether he has any breathing difficulties.

Parents often attribute many symptoms to the process of teething. Teething may give rise to the child having a low-grade temperature, biting or drooling frequently, eating less and being more irritable.

However, the process does not cause actual symptoms of illnesses like fever, diarrhoea, cough or runny nose. In most instances, teething causes minimal symptoms.

The controversy over whether vaccinations can cause autism stems largely from a 1998 publication of an article by Andrew Wakefield and his colleagues in the Lancet, a prominent medical journal.

It was posited that there was a possible link between autism/ pervasive developmental disorder and the combined measles, mumps and rubella (MMR) vaccine.

Subsequently, multiple large epidemiological studies were done and all of them refuted the link between the MMR vaccine and autism.

Wakefield's research was discredited as being improperly conducted and has even been described as being fraudulent.

In 2010, the Lancet went on to completely retract the Wakefield article, admitting that several elements in the article were incorrect.

Even so, this saga has caused damage to public health vaccination policies internationally as parents have withheld vaccinations from their children for fear of the child developing autism.

This, despite there being clear evidence against the Wakefield article and well-documented complications of the diseases of measles, mumps and rubella.

Through the years, pockets of disease outbreaks across the world continue to occur in unvaccinated children.

Notably, there was an outbreak of measles last year when more than 100 children were infected with measles after visiting Disneyland in California.

In short, vaccinations can save a child's life. Vaccines are safe and effective in preventing the diseases that could otherwise cause severe illness in a child who is not vaccinated.

Protecting the child against these diseases also protects his family members and the community from contracting the illness.

Such vaccine-preventable diseases are generally also costlier in terms of medical bills and missed school- or work-days, in comparison to the cost of the vaccine itself.

Dr Kenneth Chua

Paediatrician at Thomson Paediatric Centre

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A version of this article appeared in the print edition of The Straits Times on July 19, 2016, with the headline 'Teething does not cause actual symptoms of illness'. Print Edition | Subscribe