Unexplained fever in children – new quality standard

  • Date: 29 July 2014

NICE has published a new quality standard to help healthcare professionals quickly identify and treat under-5s seriously ill with fever and reduce their chances of death or disability.

The new quality standard sets out clear priorities to help doctors, nurses, pharmacists and other healthcare professionals pick up high-risk symptoms that indicate a child needs urgent medical attention.

Unexplained fever is a common concern for many parents with almost half (40 per cent) of young children with the symptom being taken to the doctor. Fever is the second most common reason that a child will be admitted to hospital.

The new standard includes four statements aimed at healthcare professionals, particularly those working in general practice and emergency departments, highlighting where improvements are most needed. It states that all under-5s with suspected fever who are seen face to face by a healthcare professional must have their vital signs checked, including temperature, heart rate and breathing. All reports of fever from parents or carers must be acted upon.

Under-5s who present with unexplained fever over 38°C should have their urine tested within 24 hours as they may have a urinary tract infection which can be managed with antibiotics.

The standard also states that physicians should use the traffic light system for identifying the risk of serious illness. This system groups signs and symptoms of serious illness into high (red), medium (amber) and low (green) to help determine how to manage fever.

Christopher Head, Chief Executive at Meningitis Research Foundation said: "Meningitis and septicaemia become life-threatening within hours of the onset of fever, so identification and treatment are time critical. Our charity shares NICE’s commitment to identifying seriously ill children from amongst those with milder feverish illnesses. We believe the new NICE quality standard to identify and treat under-5s seriously ill with fever will ensure that commissioners and health professionals have the information they need to deliver the best care for these children."


Feverish illness in children under 5 years

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