title: Fever and sickness behavior: Friend or foe?
abstract: Fever has been recognized as an important symptom of disease since ancient times. For many years, fever was treated as a putative life-threatening phenomenon. More recently, it has been recognized as an important part of the body's defense mechanisms; indeed at times it has even been used as a therapeutic agent. The knowledge of the functional role of the central nervous system in the genesis of fever has greatly improved over the last decade. It is clear that the febrile process, which develops in the sick individual, is just one of many brain-controlled sickness symptoms. Not only will the sick individual appear "feverish" but they may also display a range of behavioral changes, such as anorexia, fatigue, loss of interest in usual daily activities, social withdrawal, listlessness or malaise, hyperalgesia, sleep disturbances and cognitive dysfunction, collectively termed "sickness behavior". In this review we consider the issue of whether fever and sickness behaviors are friend or foe during: a critical illness, the common cold or influenza, in pregnancy and in the newborn. Deciding whether these sickness responses are beneficial or harmful will very much shape our approach to the use of antipyretics during illness.
authors.affiliation: Brain Function Research Group, School of Physiology, Faculty of Health Sciences, University of the Witwatersrand, 7 York Road, Parktown, Johannesburg, South Africa. Electronic address: lois.harden@wits.ac.za.
authors.forename: L M
authors.initials: LM
authors.lastname: Harden
authors.affiliation: School of Psychology and Public Health, La Trobe University, Melbourne, VIC, Australia. Electronic address: s.kent@latrobe.edu.au.
authors.forename: S
authors.initials: S
authors.lastname: Kent
authors.affiliation: Hotchkiss Brain Institute, Department of Physiology and Pharmacology, University of Calgary, Calgary, Alberta, Canada. Electronic address: pittman@ucalgary.ca.
authors.forename: Q J
authors.initials: QJ
authors.lastname: Pittman
authors.affiliation: Institute of Veterinary-Physiology and -Biochemistry, Justus-Liebig-University of Giessen, Frankfurter Strasse 100, D-35392 Giessen, Germany. Electronic address: Joachim.Roth@vetmed.uni-giessen.de.
authors.forename: J
authors.initials: J
authors.lastname: Roth
mesh_terms: D000293:Adolescent; D000328:Adult; D000818:Animals; D058633:Antipyretics / Q000627:therapeutic use; D001921:Brain / Q000503:physiopathology; D002648:Child; D003139:Common Cold / Q000150:complications / Q000188:drug therapy; D005260:Female; D005334:Fever / Q000150:complications / Q000188:drug therapy / Q000503:physiopathology*; D006801:Humans; D055809:Illness Behavior / Q000502:physiology*; D007223:Infant; D007231:Infant, Newborn; D007249:Inflammation / Q000150:complications / Q000503:physiopathology; D007251:Influenza, Human / Q000150:complications / Q000188:drug therapy; D008875:Middle Aged; D011247:Pregnancy; D012307:Risk Factors; D055815:Young Adult
chemical_list: D058633:Antipyretics
keywords: Anorexia; Antipyretics; Critical illness; Cytokines; Hyperalgesia; Immune-to-brain communication; Infancy; Inflammation; Influenza; Lethargy; Lipopolysaccharide; Non-steroidal anti-inflammatory drugs; Pregnancy; Prostaglandins