As Use of Kids' Aspirin Drops, So Do Cases of Reye Syndrome

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As Use of Kids' Aspirin Drops, So Do Cases of Reye Syndrome

Twenty-five years ago, when children got chicken pox or the flu, their mothers probably gave them aspirin for the aches and fever. No one knew any better because no one had heard of Reye syndrome--a disease associated with aspirin use and viral infections in children and teen-agers. It wasn't until 1963 that the rare but deadly syndrome was first described by a doctor in Australia, and it wasn't until the 1980s that the evidence of its association with aspirin began to appear.

The symptoms of the syndrome, described by the doctor, Ralph Douglas Reye, included severe tiredness, belligerence, and excessive vomiting. He found that they usually occurred just as the child or teen-ager appeared to be recovering from another illness--usually chicken pox or flu.

Twenty-four years later, many parents know that they shouldn't give their children aspirin if they have chicken pox, influenza, or other flu-like illnesses. While the cause of Reye syndrome is still not known, two recent studies add to the evidence of a link between the disease and the use of aspirin and other similar drugs known as salicylates.

In the first study, researchers from the U.S. Centers for Disease Control compared the histories of 27 children who developed Reye syndrome after a bout of flu or chicken pox from January 1985 through May 1986 with those of 140 controls. (Controls were children who did not get Reye syndrome even though they had the flu or chicken pox at the same time as the other children.) Out of the 27 children with Reye, 25 had taken aspirin and one had taken a non-aspirin salicylate (bismuth subsalicylate)--96 percent. Of the controls, only 53 had taken aspirin or other salicylates--38 percent.

The researchers noted that the fact that only 38 percent of the controls in this study took salicylates, down from rates ranging from 46 percent to 71 percent in previous studies, indicated a declining use of salicylates among children.

Confirming this observation, epidemiologists with the Food and Drug Administration reported in the June 1987 issue of Pediatrics that, since 1979, sales of children's aspirin have been declining each year. Janet B. Arrowsmith, M.D., and her colleagues also found that physicians "mentioned' aspirin less frequently in 1985 than in 1980 for treating flu or chicken pox. The trend among doctors was found for patients of all ages, but was most pronounced in the youngest (9 and under) age group. Although a "drug mention,' which includes prescriptions, recommendations, and direct administration, is not directly equivalent to patient use, the researchers said that they assumed "that trends in drug mentions by physicians will reflect trends in actual drug use by patients.'

In place of aspirin, doctors recommended acetaminophen to relieve pain and reduce fever. …