Fluid intake is very important and parents should be advised that fluids containing sugar are preferable to plain water as the child’s calorie intake is likely to be reduced and hypoglycaemia can occur in infants, especially if there are ongoing losses such as vomiting or diarrhoea. If a child is breastfeeding, breast milk is best for them to continue taking. Parents should be informed of signs of dehydration to look out for, including: sunken fontanel, dry mouth, sunken eyes, absence of tears and poor overall appearance.
The average duration of febrile illness in children is three days,but anything from 10 minutes to 14 days can occur with a simple viral illness. Duration of fever is not a specific indicator for significant illness. In fact, a long duration of fever in a child not on antibiotics and who has not rapidly deteriorated makes a severe bacterial infection very unlikely; however, there are other conditions which are characterised by persistent fever such as Kawasaki, and hence a reassessment after five days if the illness has failed to dissipate is not an unreasonable approach, and again is likely to give parents more confidence managing at home.
The appearance of a non-blanching rash is something all parents should be made aware of and be shown how to look for this important sign.