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Chills
Definition:
The sensation of cold from exposure to a cold environment, or an episode of shivering with paleness and a feeling of coldness.

Alternative Names:
Rigors; Shivering

Considerations:
"Goose bumps" are associated with a feeling of chilliness but are not necessarily associated with chills or fevers. "Goose bumps" raise the hairs on the body to form a layer of insulation.

Chills may occur at the beginning of an infection and are usually associated with a fever. Chills are caused by rapid muscular contractions and relaxation and are the body's way of generating heat when it perceives that it is cold. Chills often herald the onset of a fever or increase in the body's core temperature.

Chills may also represent a very significant and consistent finding in certain diseases such as malaria.

When dealing with young children:
Chills are common in young children. Children tend, in general, to develop higher fevers than adults. Even minor illness may produce high fevers in younger children. Infants tend not to develop obvious chills, but any fever in an infant of 6 months or less should be reported to a health care provider. Fevers in infants 6 months to 1 year should also be reported unless the parent is absolutely certain of its cause.
Common Causes:
Home Care:

Fever (which can accompany chills) is the body's natural response to a variety of conditions, such as infection. If the fever is mild (102 degrees Fahrenheit or less) with no side effects, no professional treatment is required. Drink lots of fluids and get plenty of rest.

Evaporation cools the skin and thereby reduces body temperature. Sponging with comfortably warm water (about 70 degrees Fahrenheit) may help in reducing a fever. Cold water, however, is uncomfortable, and may increase the fever because it can trigger chills.

Medications such as acetaminophen are effective in fighting a fever and chills. Children who have symptoms of a viral infection should not be given aspirin because of the risk of Reye's syndrome.

Do not bundle up in blankets if there is a high temperature; this will only cause a fever to rise.

Child home care:
If the child's temperature is over 102 degrees Fahrenheit, or if the child is uncomfortable, give pain-relieving tablets or liquid (non-aspirin containing analgesics such as acetaminophen are preferred). Follow the recommended dosage on the package label.

If the child's temperature is over 103.5 degrees Fahrenheit 1 to 2 hours after giving medication for fever, place the child in a tub of lukewarm water up to the navel. Rub a wet washcloth or towel over the child's body for 20 minutes or for as long as can be tolerated. Add warm water as needed to maintain the water temperature and keep the child from shivering. Pat (don't rub) the child dry with a towel.

  • Dress the child in light clothing, give them liquids, and keep the room cool but not uncomfortable.
  • Don't use ice water or rubbing alcohol to reduce a child's temperature. These can cause shock.
  • Don't bundle a feverish child in blankets.
  • Don't wake a sleeping child to give medication or take a temperature; sleep is more important.
Medication precautions:
Don't give aspirin to children who may have a viral infection because of the possibility of Reye's syndrome. Acetaminophen (Tylenol) is effective in fever reduction but note that acetaminophen in high dosages causes liver damage.
Call your health care provider if:
  • there is stiffness of the neck, confusion, significant irritability, or sluggishness.
  • there is a significant cough, shortness of breath, abdominal pain or burning and/or frequency of urination.
  • there is a temperature of 101 degrees Fahrenheit or more in a child younger than 3 months of age.
  • a child between 3 months and 1 year old has a fever that lasts more than 24 hours.
  • the fever remains above 103 degrees Fahrenheit after an hour or 2 of home treatment.
  • the fever does not improve after 3 days or has lasted more than 5 days.
What to expect at your health care provider's office:
A medical history and a physical examination will be performed.

Medical history questions documenting chills in detail may include:
  • quality
    • Is it a cold feeling only?
    • Is the person actually shaking ?
    • What has been the highest temperature associated with the chills
  • time pattern
    • Did the chills happen only once or are there multiple separate occurrences (episodic)?
    • How long does each attack last (for how many hours)?
    • Did chills occur within 4 to 6 hours after exposure to something that you or your child are allergic to (an antigen)?
    • Did they begin suddenly?
    • Do they occur repeatedly (recurrent)?
      • How often (how many days between episodes of chills)?
  • What other associated symptoms are present?
The physical examination may include emphasis on the skin, eyes, ears, nose, throat, neck, chest, and abdomen. Usually the temperature will be taken.

Diagnostic tests that may be performed include: Treatment depends on the duration of the chills, and accompanying symptoms, especially fever.

After seeing your health care provider:
You may want to add a diagnosis related to chills to your personal medical record.
Review Date: 11/30/2001
Reviewed By: Steven Angelo, M.D. Department of Internal Medicine, Yale School of Medicine, Hospital of Saint Raphael, New Haven, CT. Review provided by VeriMed Healthcare Network.
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