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[Roger]

I always thought that body temperature higher than 36.5 degrees celsius is considered "fever".
Today I read in the SCMP that foreign journalists and consular staff had been gathering at a Guangzhou five-star hotel where the authorities took the temperature of every participant. The temperature was measured at the forehead of everyone, and when it read 33 degrees the participant was regarded as symptom-free.
Strangely enough, someone else told me body temperature in excess of "35 degrees" was fever. Now I am confused. How do CHINESE medical staff know what is normal body temperature and what is not normal?
And, what is the most accurate way of gauging the temperature? Some put a hand on my forehead, others stuff something that looks like an earphone into my ear; still others put a meter undermy tongue or elsewhere in my body...

[Irish]

You'd think that a simple question like this would have a simple answer, wouldn't you? But, from my short stint in nursing school, I learned that simple answers are rare.

The short answer is that normal body temperature is about 37C/98.6F, but body temp varies throughout the day and with level of activity. Textbooks vary, but what I learned was that an oral reading at or above 37.5/100.4F or a rectal reading at or above 38C/101F is "officially" considered fever. (I was too lazy to dig out my old nursing notes but pulled this from a reliable site that I used back in the day.)

As for where to take readings, my professors told me that the most reliable site was--brace yourself--rectal. (Ouch!) Obviously some patients will object to this method and it requires extra sterilization procedures, so oral is more common. Besides, it's almost as accurate (within about .2C/.4F, I believe). The accuracy of ear readings depends on the instrument--some brands are just as good as oral thermometers. Also, they're easier to read, breakage isn't a big deal, and patients seem to prefer them. I'm not as famliar with forehead readings but I've heard that they're not as good as oral ones and can be significantly off. Perhaps there's a hygenic advantage. If you're worried about a contaigious disease, maybe you don't want to even risk dealing with a patient's saliva. Then there are armpit readings but they're not very reliable either.

As for why the Chinese staff are doing it that way, I don't know. My guess is that they use the method that they're most familiar with and feel is most reliable. Equipment availability may also be a factor. What surprises me is that the "normal" temp is set so low. I'd think that a 33C reading would be cause for concern because it's significantly subnormal. However, I am not a nurse, only someone who changed her mind about becoming one. It could be that this number takes into account other factors that would result in a number that's too low by textbook standards but perfectly normal for the situation. And, to venture out further on the creaky limb I've put myself on, I'm wondering if the Chinese are so concerned about SARS that they're purposely setting "normal" low in the hopes of catching cases as early as possible.

There--you should be sufficiently bored now.

[Glenski]

Irish,

Since oral and rectal temps are measured at points inside the body, it's reasonable to assume that their values would be higher than temps measured at the skin (forehead). I am guessing that 33 degrees is normal for such an external measurement, so anything higher would indicate that a fever is present. Perhaps they are using this type of method because it's traditional, or perhaps it may have something to do with the high incidence of AIDS\HIV over there, and some fear of taking oral/rectal measurements. I really don't know either.

[Irish]

Glenski:

You're right. I missed the key point that 33C was just for forehead readings. (Note to self: coffee first, then post.) If it's standard practice over there, they must have set ranges that they're comfortable with and feel that they can get accurate readings. Aural readings would probably be best for their situation but I'm guessing they don't have enough equipment to go around.