In 1917, doctors came up with a rather unusual treatment for syphilis, a bacterial infection that had plagued Europe for centuries. This treatment involved three main steps:
Although this method resulted in the death of about 15% of patients, it was surprisingly effective for those who survived. This approach remained the standard treatment for syphilis until penicillin became widely available. The key element in this treatment was fever.
Fever is a fascinating phenomenon that still holds many mysteries. It is a response seen in all mammals, some birds, and even a few invertebrates and plants. This response has been around for over 600 million years of evolution, despite its high energy cost. For every 1 degree Celsius increase in body temperature, energy expenditure rises by about 12.5%, which is similar to the energy used during 20 minutes of jogging for some people.
The body maintains its core temperature through a process called thermoregulation, which usually keeps it around 37 degrees Celsius. This process is controlled by the hypothalamus, a part of the brain that detects small changes in temperature and sends signals to the body. If the body gets too hot, the hypothalamus triggers sweat glands and dilates blood vessels to release heat. If the body is too cold, blood vessels constrict, and shivering generates heat.
When the body needs to induce a fever, it disrupts this balance, raising the temperature above 38 degrees Celsius. Mechanisms are in place to prevent temperatures from exceeding 41 degrees Celsius, which could cause organ damage. Immune cells fighting an infection can trigger a fever by initiating a biochemical cascade that instructs the hypothalamus to raise the baseline temperature. Until the body reaches this new temperature, individuals may feel cold, leading to chills.
The exact reasons for fever are still being studied. While the effects of higher temperatures on pathogens are not fully understood, fever seems to trigger a rapid, whole-body immune response. At elevated temperatures, some cells release heat shock proteins (HSPs), which are produced in response to stress. These proteins help lymphocytes, a type of white blood cell, move more quickly to infection sites. HSPs increase the “stickiness” of lymphocytes, allowing them to adhere to and pass through blood vessel walls to reach areas of infection.
In viral infections, HSPs help instruct nearby cells to reduce their protein production, limiting the virus’s ability to replicate. This slows the virus’s spread, as it relies on the host’s cellular machinery to reproduce. Additionally, HSPs protect surrounding cells from damage, as some viruses can cause destruction by rupturing host cells, leading to significant tissue damage.
Despite the known benefits of fever in activating the immune system, some clinical trials have shown that fever-reducing medications do not worsen symptoms or recovery rates. Therefore, there is no definitive guideline on whether to suppress a fever or let it run its course. Doctors make decisions based on individual cases, considering factors such as the fever’s duration and intensity, the patient’s immune status, comfort level, and age. If they choose to let a fever persist, they typically recommend rest and adequate fluid intake to prevent dehydration while the body fights the infection.
Engage in a seminar where you will explore the historical context of fever treatments, such as the malaria-induced fever therapy for syphilis. Discuss the ethical implications and effectiveness of past medical practices compared to modern treatments.
Conduct a lab experiment to understand thermoregulation. Measure your body’s response to temperature changes by monitoring heart rate and skin temperature while exposed to different environmental conditions. Analyze how the hypothalamus regulates body temperature.
Participate in a role-playing activity where you simulate the immune response during a fever. Assume roles of different immune cells and heat shock proteins, and demonstrate how they interact to fight infections. This will help you visualize the complex processes involved.
Analyze various case studies that involve fever management. Discuss in groups the decision-making process for treating fevers, considering factors such as patient age, immune status, and fever duration. Present your findings and recommendations to the class.
Engage in a debate on whether fevers should be suppressed or allowed to run their course. Research and present arguments for both sides, considering scientific evidence and clinical trial outcomes. This will enhance your critical thinking and understanding of fever management.
In 1917, doctors proposed a controversial treatment for syphilis, an incurable bacterial infection that had affected Europe for centuries. The treatment involved three steps:
1. Infect patients suffering from the later stages of syphilis with the parasite that causes malaria, a serious but treatable mosquito-borne disease.
2. Rely on malarial fevers to help clear the syphilis.
3. Administer quinine to manage the malaria.
While this method resulted in the death of about 15% of patients, it appeared to be effective for those who survived. It became the standard treatment for syphilis until the widespread use of penicillin decades later. The key factor in this treatment was fever.
Fever remains a subject of many mysteries, but it is known that all mammals, some birds, and a few invertebrate and plant species experience fever. This response has persisted for over 600 million years of evolution, but it comes with a significant energy cost. For every 1 degree Celsius increase in body temperature, there is a 12.5% increase in energy expenditure, comparable to about 20 minutes of jogging for some individuals.
So, how does the body produce a fever? Core temperature is regulated through thermoregulation, a set of processes that typically maintain a temperature around 37 degrees Celsius. These processes are controlled by the hypothalamus in the brain, which detects small temperature changes and sends signals throughout the body. If the body becomes too hot, the hypothalamus activates sweat glands and dilates blood vessels, bringing blood closer to the skin’s surface to release heat. Conversely, if the body is too cold, blood vessels constrict, and shivering occurs to generate heat.
When the body needs to induce a fever, it disrupts its usual temperature balance, setting in above 38 degrees Celsius. Mechanisms are in place to prevent temperatures from exceeding 41 degrees Celsius, which could lead to organ damage. Immune cells fighting an infection can trigger a fever by initiating a biochemical cascade that instructs the hypothalamus to raise the baseline temperature. Until the body reaches this new temperature, individuals may feel cool, which can result in chills.
The reason for this fever response is still being studied. While the exact effects of higher temperatures on pathogens are not fully understood, it appears that fever primarily induces a rapid whole-body immune response. When exposed to elevated internal temperatures, some cells release heat shock proteins (HSPs), which are produced in response to stress. These proteins assist lymphocytes, a type of white blood cell that combats pathogens, in traveling more quickly to infection sites. HSPs enhance the “stickiness” of lymphocytes, allowing them to adhere to and pass through blood vessel walls to reach areas of infection.
In the case of viral infections, HSPs help instruct nearby cells to reduce their protein production, limiting the virus’s ability to replicate. This slows the virus’s spread, as it relies on the host’s cellular machinery to reproduce. Additionally, HSPs protect surrounding cells from damage, as some viruses can cause destruction by rupturing host cells, leading to significant tissue damage.
Despite the known benefits of fever in immune activation, some clinical trials have indicated that fever-reducing medications do not worsen symptoms or recovery rates. As a result, there is no definitive guideline on whether to suppress a fever or allow it to run its course. Doctors make decisions based on individual cases, considering factors such as the fever’s duration and intensity, the patient’s immune status, comfort level, and age. If they choose to let a fever persist, they typically recommend rest and adequate fluid intake to prevent dehydration while the body fights the infection.
Fever – An elevated body temperature, often due to an immune response to infection. – During the study of infectious diseases, it was noted that fever is a common symptom indicating the body’s attempt to fight off pathogens.
Immune – Resistant to a particular infection or toxin owing to the presence of specific antibodies or sensitized white blood cells. – The research focused on how vaccines help the body become immune to certain viruses.
Temperature – The degree of heat present in a substance or object, often measured in degrees Celsius or Fahrenheit, crucial for maintaining homeostasis in biological systems. – The experiment demonstrated how enzyme activity is affected by changes in temperature.
Hypothalamus – A region of the brain that controls body temperature, hunger, and other homeostatic systems, and is involved in sleep and emotional activity. – The study highlighted the role of the hypothalamus in regulating the body’s response to stress.
Infection – The invasion and multiplication of microorganisms such as bacteria, viruses, and parasites that are not normally present within the body. – The course covered various mechanisms by which the body defends itself against infection.
Lymphocytes – A type of white blood cell that is part of the immune system, including B cells and T cells, which are crucial for adaptive immunity. – The lab session focused on how lymphocytes recognize and respond to antigens.
Malaria – A disease caused by a plasmodium parasite, transmitted by the bite of infected mosquitoes, characterized by fever, chills, and anemia. – The lecture discussed the life cycle of the malaria parasite and its impact on human health.
Syphilis – A bacterial infection usually spread by sexual contact that starts as a painless sore and can progress to more serious symptoms if untreated. – The seminar addressed the historical and modern challenges in diagnosing and treating syphilis.
Thermoregulation – The process that allows the human body to maintain its core internal temperature, involving physiological and behavioral responses. – The research paper explored the mechanisms of thermoregulation in mammals exposed to extreme environments.
Proteins – Large, complex molecules that play many critical roles in the body, made up of one or more chains of amino acids. – The biochemistry class emphasized the importance of proteins in cellular structure and function.
