{"id":1490,"date":"2015-01-30T10:17:23","date_gmt":"2015-01-30T10:17:23","guid":{"rendered":"https:\/\/inmedblogs.us\/nicholascomninellis\/?p=1490"},"modified":"2016-01-04T01:22:40","modified_gmt":"2016-01-04T01:22:40","slug":"what-is-causing-my-fever-here-in-china","status":"publish","type":"post","link":"https:\/\/inmedblogs.us\/nicholascomninellis\/2015\/01\/30\/what-is-causing-my-fever-here-in-china\/","title":{"rendered":"What Is Causing My Fever Here In China?"},"content":{"rendered":"<p><a href=\"https:\/\/inmedblogs.us\/nicholascomninellis\/wp-content\/uploads\/sites\/2\/2015\/01\/light-residents-2011-e1422698696842.jpg\"><img fetchpriority=\"high\" decoding=\"async\" class=\"alignleft size-full wp-image-1496\" src=\"https:\/\/inmedblogs.us\/nicholascomninellis\/wp-content\/uploads\/sites\/2\/2015\/01\/light-residents-2011-e1422698696842.jpg\" alt=\"light-residents-2011\" width=\"530\" height=\"284\" \/><\/a><\/p>\n<p>&nbsp;<\/p>\n<p>Yesterday I was mentoring these Chinese family medicine resident physicians. During my presentation I suddenly sensed a shaking chill. The weather is extremely cold here in Shenyang, far NE China &#8211; about -10 degrees. So I attributed my chill to the walk outside. But then I was struck once more by that bone-rattling sensation, followed by extreme fatigue. Not wanting to miss this teachable moment before I departed, I quizzed the residents about causes of acute fever in China. These are similar to the US: upper respiratory viral infection, strep throat, influenza. But China also has some unique causes: dengue, Japanese encephalitis, epidemic meningitis &#8211; uncommon but everyone here is vaccinated, except me.<\/p>\n<p>&nbsp;<\/p>\n<p><a href=\"https:\/\/inmedblogs.us\/nicholascomninellis\/wp-content\/uploads\/sites\/2\/2015\/01\/malaria-rate-world-map-e1422698624794.jpg\"><img decoding=\"async\" class=\"alignleft size-full wp-image-1494\" src=\"https:\/\/inmedblogs.us\/nicholascomninellis\/wp-content\/uploads\/sites\/2\/2015\/01\/malaria-rate-world-map-e1422698624794.jpg\" alt=\"malaria-rate-world-map\" width=\"530\" height=\"269\" \/><\/a><\/p>\n<p>&nbsp;<\/p>\n<p>What would you teach these healthcare people about evaluation of people with acute fever? I emphasized to them, as I do to all <a href=\"https:\/\/www.inmed.us\/courses-info\/hybrid-courses\/international-medicine-public-health\/\" target=\"_blank\">INMED International Medicine &amp; Public Health students<\/a>, the prime importance of first considering the local fever etiologies wherever you may be serving. I related how last July I suffered a similar febrile illness with identical chills and fatigue. But at that time I was working in Angola, southern Africa. Observe the map above. Malaria is rare in China, and very common in central and southern Africa. My malaria test was indeed positive. I was treated and recovered quickly. Tonight in Shenyang I\u2019m nurturing my fever, confident that at the very least my residents benefited from a very teachable moment.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>&nbsp; Yesterday I was mentoring these Chinese family medicine resident physicians. During my presentation I suddenly sensed a shaking chill. The weather is extremely cold here in Shenyang, far NE China &#8211; about -10 degrees. So I attributed my chill to the walk outside. But then I was struck once more by that bone-rattling sensation, [&hellip;]<\/p>\n","protected":false},"author":3,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"site-sidebar-layout":"default","site-content-layout":"","ast-site-content-layout":"default","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"","footer-sml-layout":"","ast-disable-related-posts":"","theme-transparent-header-meta":"","adv-header-id-meta":"","stick-header-meta":"","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"default","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"var(--ast-global-color-4)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"ast-content-background-meta":{"desktop":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"footnotes":""},"categories":[37],"tags":[],"class_list":["post-1490","post","type-post","status-publish","format-standard","hentry","category-low-resource-healthcare-pearls"],"_links":{"self":[{"href":"https:\/\/inmedblogs.us\/nicholascomninellis\/wp-json\/wp\/v2\/posts\/1490","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/inmedblogs.us\/nicholascomninellis\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/inmedblogs.us\/nicholascomninellis\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/inmedblogs.us\/nicholascomninellis\/wp-json\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/inmedblogs.us\/nicholascomninellis\/wp-json\/wp\/v2\/comments?post=1490"}],"version-history":[{"count":0,"href":"https:\/\/inmedblogs.us\/nicholascomninellis\/wp-json\/wp\/v2\/posts\/1490\/revisions"}],"wp:attachment":[{"href":"https:\/\/inmedblogs.us\/nicholascomninellis\/wp-json\/wp\/v2\/media?parent=1490"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/inmedblogs.us\/nicholascomninellis\/wp-json\/wp\/v2\/categories?post=1490"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/inmedblogs.us\/nicholascomninellis\/wp-json\/wp\/v2\/tags?post=1490"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}