• Fever is associated with systemic symptoms such as headache, myalgia and arthralgia

• The body will be dehydrated – due to sweating and decreased ADH production [17]

• Protein catabolism (amino acids for immune system components), decreased glucose availability and increased peripheral vascular resistance lead to nutritional deficiency and decreased muscle strength. Acute infectious disease may result in 5–15% decrease in isometric muscle strength, compared to bed rest [48]

• Fever reduces stroke volume and cardiac output to an extent depending on the severity of the fever [5]. It also increases oxygen consumption and heart rate: for every 1°C body temperature rise above 37°C, there is a 13% increase in oxygen consumption, and for every 1.5°C increase in body temperature, the heart rate may increase by 2.44 beats per minute [5]. A febrile illness may also decrease the blood volume and total haemoglobin. Together, these changes can lead to as much as a 25% reduction in endurance capacity. Maximal aerobic performance and endurance capacity decreased by 13–18% as a result of illness [49]