We are used to associating colds with high temperature. But sometimes a person has all the signs of ARVI, and the body temperature remains normal. Because of this, it seems that the condition is not serious, and you can ignore it. Let’s talk about whether it is necessary to treat ARVI without fever, and when to go to the doctor.
We are used to associating colds with high temperature . But sometimes a person has all the signs of ARVI, and the body temperature remains normal. Because of this, it seems that the condition is not serious, and you can ignore it. Let’s talk about whether it is necessary to treat ARVI without fever, and when to go to the doctor.
Why is there no fever when you have a cold?
The temperature rises when special substances, pyrogens, accumulate in the body. Pyrogens can be infectious – these include viral toxins and metabolic products of microorganisms. There are also non-infectious pyrogens – these are substances that enter the body from the environment or arise during inflammation or allergies.
When pyrogens interact with immune system cells, they provoke the production of secondary pyrogens – cytokines. They act on the thermoregulation center in the brain and increase body temperature. The more pyrogens, the higher the temperature, and vice versa. The amount of these substances in the blood depends on the type of pathogen and the immune system’s response.
Symptoms of a viral infection usually appear 1–3 days after infection. ARI may occur with subfebrile fever — up to 37.2ºС — or without fever at all 1 . At the same time, other cold symptoms appear: headache , muscle pain, runny and stuffy nose, sore throat, cough and fatigue 2 . These symptoms usually pass in 4–10 days, although the cough may persist for 14 days or longer 3 .
The absence of temperature is usually associated with the immune system’s reaction. This happens if the pathogen is not aggressive, and the body fights it with milder methods. As a result, substances that control inflammation, including pyrogens, are produced in small quantities and do not affect body temperature.
The temperature will not rise if the person has already suffered from a similar disease and antibodies to the infectious agent remain in the body.
If the patient is already taking medications that can suppress the temperature, it may also not rise. These include nonsteroidal anti-inflammatory drugs, or NSAIDs.
How to recognize ARVI without fever
ARVI most often begins with a sore throat, a general feeling of weakness and exhaustion. Later, a runny nose and sneezing join in. About 40% of those who have respiratory infections are bothered by a cough 4 . All these cold symptoms without a fever can appear at the initial stage of ARVI.
Sometimes sick people think that they are simply overtired and ignore the signs of illness. However, if drowsiness and fatigue do not go away, the body aches more and more, there is a pain in the eyes, then with a high probability we can talk about the onset of ARVI even without a fever.
Many people wonder whether flu can pass without a rise in temperature. No, this disease manifests itself quickly and acutely: literally in one day a person develops fever, severe headaches, nasal congestion 5 . If the signs of ARVI are not accompanied by a rise in temperature, it is not flu without fever, but another respiratory infection.
The temperature may rise 1-3 days after the first symptoms are detected or remain at a normal level. With ARVI, there is a risk of damage to the larynx, sinuses, trachea, bronchi, so you should be more attentive to the manifestations of the disease and take care of your health.
Why is a cold without fever dangerous?
There is an opinion that ARVI without fever does not require treatment. This is not true, because dangerous complications develop not because of fever, but under the influence of the infectious agent on internal organs and systems. At the same time, it is easy to miss the deterioration of the condition, since many people are careless about the disease without fever – they endure it on their feet and do not take medications.
Possible complications 6 :
● vascular pathology: increased blood pressure, impaired renal function;
● exacerbation of bronchial asthma;
● otitis media;
● sinusitis 7 ;
● increased blood clotting;
● thrombosis – blockage of blood vessels by a thrombus;
● vasculitis – inflammation of blood vessels;
● gastroenterocolitis – inflammation of the stomach and intestines;
● encephalitis – inflammation of the brain;
● meningitis – inflammation of the membranes of the brain;
● myocarditis – inflammation of the heart muscle;
● cytokine storm – a sharp increase in the concentration of inflammatory substances in the blood, which leads to death, an extremely rare complication, almost never seen with a common acute respiratory viral infection or flu.
A cold without a fever can trigger an infectious process that has been in the body for a long time but has not manifested itself in any way – for example, when carrying Staphylococcus aureus 8 .
When to see a doctor
You need to go to the hospital if:
● Unusual symptoms for ARVI have appeared, such as a rash.
● Cold symptoms without fever persist for more than 10 days.
● The person has a high risk of developing complications. Such patients include pregnant women, people with diabetes, asthma and other chronic diseases, as well as people over 65 years of age 9 .
Uncomplicated colds can be treated at home.
How to treat a cold without fever
Cold treatment begins with replenishing fluid in the body. The patient needs to drink 20-40 ml/kg of body weight per day. 2 Not only water is considered, but also tea, unsweetened compote, and fruit drink. Drinks should be warm – this helps reduce intoxication and speed up recovery.
In 90% of cases, colds are caused by viruses, and only in 10% by bacteria 8 . Therefore, antiviral drugs and medications that relieve the symptoms of the disease are used for treatment 10 .
Despite the absence of fever, at the first signs of ARVI it is important to start taking antiviral drugs. They will help eliminate the cause of the disease and speed up recovery. One example of modern antiviral drugs is Nobazit® Forte with the active substance enisamium iodide 11 . Nobazit® Forte reduces acute manifestations of viral intoxication and helps reduce the duration of the disease 12 . A study based on the A. A. Smorodintsev Research Institute of Influenza showed that the use of enisamium iodide reduces the severity of ARVI manifestations (headache, sore throat, cough, nasal congestion, etc.), and also reduces the duration of the disease by 24 hours 11 .
Medicines with antiviral effect 8 :
● M2 channel blockers: These interfere with viral replication by damaging the viral protein in infected cells. However, these drugs are not always effective because most viruses have developed resistance to them.
● Neuraminidase inhibitors. They block one of the main enzymes of the virus, responsible for its replication (reproduction). The drug disrupts the ability of viruses to penetrate healthy cells and stops the release of virions from infected ones. They are suitable only for viruses that have such proteins – influenza viruses
● Hemagglutinin inhibitors. Hemagglutinin is a protein on the surface of the virus. Blocking it prevents the virus from penetrating the body’s cells, making infection impossible. They can also only affect viruses that contain hemagglutinin – influenza viruses
● Leukocyte interferons. These are ready-made proteins with antiviral action that work like natural immune substances, but lose effectiveness with prolonged use and can cause side effects.
● Interferon inducers. Stimulate the production of the body’s own interferon, thereby strengthening the human immune system.
Antibacterial therapy is only connected if the bacterial nature of the disease is proven or a bacterial infection has joined the viral infection. Antibacterial therapy is prescribed by a doctor.
Signs of a bacterial infection:
● procalcitonin level is higher than 0.5 ng/ml;
● leukocytes more than 10*10 9 U/l;
● pus in sputum or nasal mucus.
Broad-spectrum antibiotics are prescribed if tests have not been performed, but symptoms increase or persist on the 5th–7th day.
For a runny nose, local moisturizers are used. These include saline solutions – isotonic, if the nose is running, or hypertonic – more salty, when the nose is stuffy. You can also rinse the nose with a warm isotonic solution of sodium chloride. This helps to wash away pathogens from the nasal mucosa, moisturize the mucosa and remove discharge.
To relieve symptoms, you can use nonsteroidal anti-inflammatory drugs, or NSAIDs 13 . They are used for colds without fever as a drug for pain, inflammation, and swelling 14 .
Preventive measures
The best prevention is to prevent the pathogen from entering the body 15 :
● wash your hands with soap every time after using the toilet, traveling on public transport, or simply when returning home, and, of course, before eating;
● use disposable tissues when sneezing and coughing;
● use disposable medical masks and respirators in places where there are many people, changing the mask every 2 hours and wearing the mask correctly – covering your mouth and nose;
● irrigate the nasal mucosa with isotonic sodium chloride solution;
● clean objects and surfaces that have been used by a sick or potentially infectious person with disinfectants 16 .
Additional prevention of colds is taking special vitamin complexes during the period of increased incidence, that is, from October to March . Their effectiveness does not decrease with prolonged use, since they act as universal substances necessary for the vital functions of the body.
Briefly about the main thing
➢ A cold can occur without fever – it depends on the immune response. The temperature will not rise if the patient is already taking medications that reduce the temperature: antibiotics, NSAIDs, and others.
➢ A cold without a fever is dangerous because it is easy to miss the deterioration of the condition.
➢ It is better to consult a doctor if symptoms worsen or do not go away within 5-7 days, as well as if there is a high risk of complications.
➢ ARVI without fever is treated with symptomatic agents and antiviral drugs. Antibiotics are used only if the bacterial nature of the disease is clarified or a bacterial infection is added.
➢ To prevent the disease, you need to follow the rules of personal hygiene, use disposable masks and respirators, disinfect objects and surfaces that a potentially sick person has touched, and irrigate the nasal mucosa with an isotonic sodium chloride solution.
