Letter: Don't fear the fever

From Heinz-Uwe Hobohm, University of Applied Sciences Giessen-Friedberg

I was extremely interested in your discussion of the effects of fever (31 July, p 42). In 1996, while working in Germany on a cancer project at the University of Bremen, I stumbled on a 1951 paper by Louis Diamond and Leonard Luhby on spontaneous remission in childhood leukaemia (Journal of American Medicine, vol 10, p 238). They noted that a feverish infection preceded remission in 21 out of 26 children they studied.

I remember jumping up from my chair thinking this cannot be happenstance. I investigated many publications on spontaneous regression from cancer. Many, if not a majority, of cases were preceded by a feverish infection – see my 2005 paper in the British Journal of Cancer (vol 92, p 421).

Today we know that bacterial and viral chemicals such as lipopolysaccharides, which are strong inducers of fever, are needed to activate innate immune system – the body’s initial immune response which defends against pathogens in a general way without conferring immunity – and that this activation is needed to trigger a full-blown T-cell response against cancer cells.

Yet whenever I present these findings in medical circles, the reaction is blunt mistrust. For example, at a recent conference on innate immunity I listened to a talk that revealed that many more patients survive sepsis, a whole-body inflammatory response, if they develop fever. I asked whether it might be worth considering inducing fever in high-risk patients. I received a brief response: “No”.

Giessen, Germany