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    Rigors; Shivering

    Chills refers to feeling cold after an exposure to a cold environment. The word can also refer to an episode of shiveringalong withpaleness and feeling cold.


    Chills (shivering)may occur at the beginning of an infection and are usually associated with a fever. Chills are caused by rapid muscle contraction and relaxation. They are the body's way ofproducing heat when it feels cold. Chills often predict the coming of a fever or an increase in the body's core temperature.

    Chills are an important symptom with certain diseases such as malaria.

    Chills are common in young children. Children tend to develop higher fevers than adults. Even minor illness canproduce high fevers in young children.

    Infants tend not to develop obvious chills, but any fever in an infant 6 months or younger should be reported to a health care provider. Fevers in infants 6 months to 1 year should also be reported unless the parent is certain of its cause.

    “Goose bumps" are not the same as chills. Goose bumps occur due to cold air. They can also be caused by strong emotions such as shock or fear. With goose bumps, the hairs on the body stick up from the skin to form a layer of insulation. When you have chills, you may or may not have goose bumps.


    • Exposure to a cold environment
    • Viral and bacterial infections
      • Bacterial gastroenteritis
      • Colds
      • Infectious mononucleosis
      • Influenza
      • Meningitis
      • Pneumonia
      • Strep throat
      • Viral gastroenteritis
      • Urinary tract infections such as pyelonephritis

    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°F 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°F) may help reduce a fever. Cold water, though, is uncomfortable and may increase the fever because it can trigger chills.

    Medicines such as acetaminophen are effective for fighting a fever and chills.

    Do not bundle up in blankets if you have a high temperature. Do not use fans or air conditioners either. These measureswill only make the chills worse and even cause the fever to rise.


    If the child's temperature iscausing the childto beuncomfortable, give pain-relieving tablets or liquid. Non-aspirin pain-relievers such as acetaminophen are preferred. Ibuprofen may also be used. Follow the recommended dosage on the package label.

    Note: Do not give aspirin to treat fever in a child younger than 19 years oldbecause of the risk of Reye syndrome.

    Other things to help the child feel more comfortable include:

    • Dress the child in light clothing, provide liquids, and keep the room cool but not uncomfortable.
    • Do notuse ice water or rubbing alcohol bathsto reduce a child's temperature. These can cause shivering and evenshock.
    • Do notbundle a feverish child in blankets.
    • Do notwake a sleeping child to give medicine or take a temperature. Sleep (rest)is more important.

    When to Contact a Medical Professional

    • There is stiffness of the neck, confusion, irritability, or sluggishness.
    • There is abad cough, shortness of breath, abdominal pain or burning, or frequent urination.
    • A child younger than 3 months has a temperature of 101°F or more.
    • A child between 3 months and 1 year has a fever that lasts more than 24 hours.
    • The fever remains above 103°F after 1-2 hours of home treatment.
    • The fever does not improve after 3 days, or has lasted more than 5 days.

    What to Expect at Your Office Visit

    The health care provider will take your medical history and perform a physical examination.

    Medical history questions may include:

    • Is it only a cold feeling?
    • Are you actually shaking ?
    • What has been the highest body temperature connected with the chills?
    • Did the chills happen only once, or are there many separate occurrences (episodic)?
    • How long does each attack last (for how many hours)?
    • Did chills occur within 4 - 6 hours after exposure to something that you or your child are allergic to?
    • Did they begin suddenly?
    • Do they occur repeatedly? How often (how many days between episodes of chills)?
    • What other symptoms are present?

    The physical examination may include emphasis on the skin, eyes, ears, nose, throat, neck, chest, and abdomen. Body temperature will likely be checked.

    Tests that may be ordered include:

    • Blood (such as CBC or blood differential) and urine tests (such as urinalysis)
    • Blood culture
    • Sputum culture
    • Urine culture
    • X-ray of the chest

    Treatment depends on how long the chills and accompanying symptoms (especially fever) have lasted.


    Leggett J. Approach to fever or suspected infection in the normal host. In: Goldman L, Schafer AI, eds. Goldman’s Cecil Medicine. 24th ed. Philadelphia, PA: Elsevier Saunders; 2011:chap 288.

    Nield LS, Kamat D. Fever. In: Kliegman RM, Stanton BF, St. Geme JW III, et al., eds. Nelson Textbook of Pediatrics. 19th ed. Philadelphia, PA: Elsevier Saunders; 2011:chap169.

    Sullivan JE, Farrar HC, Section on Clinical Pharmacology and Therapeutics, Committee on Drugs. Fever and antipyretic use in children. Pediatrics. 2011;127:580–587.


          Talking to your MD

            Self Care

              Tests for Chills

                Review Date: 1/22/2013

                Reviewed By: Linda J. Vorvick, MD, Medical Director and Director of Didactic Curriculum, MEDEX Northwest Division of Physician Assistant Studies, Department of Family Medicine, UW Medicine, School of Medicine, University of Washington. Also reviewed by A.D.A.M. Health Solutions, Ebix, Inc., Editorial Team: David Zieve, MD, MHA, David R. Eltz, Stephanie Slon, and Nissi Wang.

                The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.

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