Report: Dramatic drop in Reye's syndrome
May 5, 1999
(WebMD) -- There has been a sharp drop in the incidence of Reye's syndrome, an often fatal disease that affects children and teens, according to a report in the May 6 edition of the New England Journal of Medicine. This dramatic decline is a public health success story.
Reye's syndrome, also known as Reye syndrome, is a dangerous, acute illness characterized by encephalopathy (brain swelling) and liver degeneration. It is found almost exclusively in children, and nearly a third of these patients die. Many more are left with significant neurological damage.
In the early 1960s, researchers began to notice that more cases of Reye's syndrome occurred during influenza outbreaks than at other times. The U.S. Centers for Disease Control and Prevention (CDC) began to monitor the disease in the mid-1970s. By 1980, from these and other observations, they had deduced that Reye's syndrome occurred primarily in children who had recently suffered a viral illness such as influenza or chickenpox and had taken aspirin to relieve the symptoms of that disease.
In the current study, doctors at the CDC found a consistent, dramatic decline in Reye's syndrome cases since 1980, when the first public health warning was issued about the association between aspirin and Reye's syndrome.
The 1980 announcement prompted the steepest decline during the entire study period of 1980 to 1997. Reye's syndrome cases further declined in 1982, when the U.S. Surgeon General issued an advisory about the relationship. Another drop was observed after 1986, when pharmaceutical companies were required to place warnings on the containers of medications containing aspirin, indicating the danger it poses to young people. By 1997, cases of Reye's syndrome in the United States had dwindled to almost none (see table).
There is some evidence that children who have juvenile rheumatoid arthritis or Kawasaki disease are at greater risk for Reye's syndrome. Aspirin is a primary and long-term medication for these children, so they should be monitored especially closely for early symptoms of Reye's syndrome. They should also be immunized against chickenpox and influenza.
The widespread publicity about the association between the disease and aspirin undoubtedly saved many lives. It is still unknown, however, what causes Reye's syndrome.
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