Medical quality assurance by Dr. Albrecht Nonnenmacher, MD at December 16, 2015

Chills are a feeling of being cold, often from exposure to cold temperatures. As a symptom of illness, the term "chills" often refers to episodic shivering usually manifesting along with fever, paleness or other symptoms. Chills can be a clear sign of a bacterial infection or virus.


Definition & Facts

When the body is exposed to cold temperatures in the environment, chills may occur. As a symptom, chills are episodic trembling or shivering as the body's natural means of inducing fever. Paleness may also accompany this feeling. Chills and the feeling of coldness associated with the shivering can occur despite being wrapped in blankets or dressed in warm clothing.

"Goose bumps" are a different physical reaction than chills. Cold air, strong emotions, shock and fear can cause goose bumps to appear. Also known as "goose pimples," these bumps cause body hairs to stand up from the skin as a sort of insulation or defense mechanism. Chills generate deeper within the body and involve rapid waves of muscle contractions and relaxation.

Episodes of chills can present in short waves of only a few minutes or remain somewhat constant for up to an hour in duration.


Many patients tell their doctor that their illness presented both chills and fever. When starting to become sick, that patient may have feelings of cold alternating with warmth. Chills often do occur before or with fever, as the sudden coldness and associated trembling are actually how the body raises its temperature.

Fever is desirable during illness because it works to kill infectious pathogens which thrive at normal body temperature. So when the body detects presence of a bacterial or viral infection, chills manifest in order to generate fever and provide a means of fighting the illness.

A relatively harmless common cold or more serious illnesses like influenza, meningitis or malaria can cause chills, followed by fever. Children more commonly experience both chills and fever because their bodies react more aggressively to even minor illnesses than adult bodies.

When an actual infection is not the cause of chills, the symptom can be the result of exposure to low temperatures and a drop in body temperature. In the case of hypothermia, chills are the body's effort to use muscle contractions and relaxation to generate heat. Autoimmune diseases and inflammatory disorders are known to cause chills, as do some forms of cancer.

The most frequent causes of chills include:

When to see a doctor

Chills may occur and disappear without obvious cause. Or they may occur for several days along with other symptoms of illness. Because chills may be a sign of a more serious infection or hypothermia, it is best to contact a doctor if they persist or become concerning. When chills are accompanied by lethargy, breathing difficulties, neck stiffness or confusion, medical attention should be sought. Emergency medical treatment should follow any exposure to chill-inducing extreme cold temperatures or cold water.

Babies rarely develop chills. This can mean that fever is more difficult to detect in an infant, than in an older child. But fever can become very serious quickly in infants and young children. For a child younger than one year, medical care should be sought if a fever develops.

Medical attention should be sought if chills develop along with any of the following symptoms:

Treatment & Therapy

Chills are most often the body's effort to raise temperature and cause fever. This means that chills are possibly symptoms of inflammation, illness or infection. If a fever results from chills and remains mild without other side effects, medical attention may not be necessary. Drinking plenty of fluids and getting good rest will help treat the underlying cause of chills and fever.

For fever, sponging the body with lukewarm water can help bring temperature down. Using cold water will likely trigger chills and increase the fever.

A standard dose of acetaminophen can help reduce fever and chills.

When experiencing chills or fever, avoid extreme temperatures. Do not use air conditioners or fans, as chills may worsen and fever can rise. When a fever is already present, do not bundle in blankets or heavy clothing.

For children made uncomfortable by chills and fever, child-strength non-aspirin pain reliever can help reduce discomfort. Ibuprofen is also helpful as an alternative. Children under the age of 19 years should never be given aspirin during a fever, as this may cause Reye's syndrome.

Children experiencing chills and fever should be dressed in light clothing, not bundled in blankets. The room should be cool but not cold and plenty of liquids should be consumed. Ice water or alcohol baths are not recommended for reducing fever. These can cause the child to go into shock. When the child is sleeping, he or she should not be awakened for medicine dosing or to take their temperature. Sleep is more healing than waking for these purposes.

If medical attention is needed, there are some questions the doctor may ask. Those include:

  • Do you shake when experiencing chills, or do you only feel cold?
  • What is the maximum body temperature reached during your chills?
  • Do you repeatedly experience chills or did they only occur once?
  • How long do your episodes of chills last?
  • Were you exposed to an allergen before the chills began?
  • Are there other symptoms with your chills?

The doctor will likely perform an examination and may run some tests to diagnose possible bacterial or viral infection. Such tests may include:

After these test results return, antibiotics may be prescribed if a bacterial infection is present. Strep throat and pneumonia are two examples of common bacterial infections which often cause chills.

Prevention & Prophylaxis

Chills are a natural means for the body to start fighting infections. Fever resulting from chills can be treated as needed. However, neither fever nor chills associated with illness can be prevented as they are important means for the body to treat itself and effectively signal possible presence of infection, inflammation or illness.

Chills caused by exposure to cold environments may be prevented through wear of appropriate attire, such as layers of warm clothing.

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