Chills before a fever: what to know

During some infections, the brain signals the body to conserve and produce heat. Muscles contract rapidly, causing shivering, while the measured temperature may still be normal or only beginning to rise. Influenza, pneumonia, urinary tract infection and kidney infection can present with chills. Dengue fever and malaria require particular attention when there has been relevant travel or mosquito exposure. Chills can also follow cold exposure, exertion, stress or dehydration, so the timing of a fever is only one part of the picture.

Rest, use light comfortable layers and measure your temperature with a working thermometer. Drink fluids unless a clinician has told you to restrict them. Note when the chills began, whether fever follows, and any cough, sore throat, pain, rash, vomiting, diarrhoea or urinary change. Follow label directions for any symptom medicine and avoid combining products with the same ingredient.

Seek urgent help for confusion, fainting, severe breathing difficulty, blue or clammy skin, a seizure, severe weakness or rapidly worsening illness. Contact a clinician promptly for repeated shaking, persistent fever, severe localised pain, inability to drink, or chills after travel where malaria is present. A urinary infection with back or side pain and chills also deserves prompt review.

Ask what pattern of temperature and symptoms should prompt testing, whether travel or exposure changes the assessment, and which medicines are appropriate for your age, pregnancy status and health conditions.