- The ARC - California Edition -

The Reye Syndrome Story

WARNING: Children and teenagers should not use aspirin for chicken pox or flu symptoms before a doctor is consulted about Reye Syndrome, a rare but serious illness reported to be associated with aspirin.

They call it a rare disease - Reye Syndrome. It is a neurological disorder that may result in brain damage and even death. And it is clearly a preventable disease.

There is a medical warning marked on the containers for aspirin and as the warning infers, Reye Syndrome disease usually occurs just as a child or teen-ager appears to be recovering from flu, chicken pox, or other viral infection.

To prevent Reye Syndrome, people must be aware of the need to avoid ASPIRIN.

Because doctors are not contacted every time a child gets sick, parents themselves need to be aware of the association between aspirin and Reye Syndrome. The message also has to reach teenagers, who may take medications without talking to either their parents or a doctor.

Reye Syndrome was formally defined about 35 years ago for the first time. The medical profession usually starts by describing common symptoms that they are observing within a group of people.

It is often much later when it is established and proven that this group of people is linked to a common cause or causes for generating the symptoms. This happened with Reye Syndrome. It was in 1963 that Dr. Ralph Reye defined a group of children as having common abnormalities that included severe tiredness, belligerence, and excessive vomiting.

Today, Reye symptoms are described as including the following:

- Nausea
- Severe vomiting
- Fever
- Lethargy
- Stupor, or coma, often followed by convulsions
- Wild delirium and restlessness often is noted

In hindsight these types of symptoms were actually described in a 1929 paper.

Unique to the Reye technical description of the symptoms was his including the correlation that most of the kids with the syndrome also appeared to be recovering from another illness - usually chicken pox or flu.

Since then, many other viruses have been linked to Reye Syndrome — Chicken pox, Influenza, Mumps, Rubella (3-day measles), Rubeola (10-day measles), Polio, Epstein-Barr, Herpes simplex, Cytomegalovirus, Coxsackie, and Anenovirus.

Toxic substances, (such as carbon tetrachloride, phosphorus and alcohol) and diseases (such as acute hepatitis and viral encephalitis) can also produce similar symptoms to those which Dr. Reye had described.

Most physicians during the 1960’s were completely unfamiliar with the syndrome at the time, and they needed to know what constituted a positive diagnosis.

It was less than 20 years ago that another part of the research community finally linked the use of aspirin (and other similar drugs known as salicylates) as being the cause of these symptoms.

As soon as this was formally recognized, accepted, and communicated to other professionals (and to the general public), the numbers of Reye Syndrome cases plummeted. From 1979 to 1985, purchases of children’s aspirin decreased from 560 million tablets to 173 million. The number of Reye Syndrome cases decreased from a high of nearly 700 in 1980, to less than 100 cases reported by 1985.

There are many people involved before a prevention strategy becomes identified and implemented as a true prevention strategy. Without having someone meticulously describing the specific outcomes that are observed within a group of people, nothing will happen.

Once you recognize a common group of conditions are causing the conditions to happen, what do you do? Yes, you know what might be causing the syndrome, but, just what can you do to reduce the possibility of the damage from occurring.

Let me tell you about another person besides Dr. Reye that was very important in bringing about the prevention of the damage defined as Reye Syndrome . This person’s name is Karen Starko. During the 1970’s, she was working for the Centers for Disease Control and Prevention (CDC) as an epidemiologist.

By the year 1978 many people knew that there was a problem, but they had no idea as to what actually was causing the problem. What Karen did was to develop a simple tool — a questionnaire — that resulted in aspirin being spotted as a common denominator. Yes, 100 percent of the Reye’s cases in her survey were linked to the use of aspirin.

It was a year later that the CDC recommended that aspirin labels include a warning relating cause and effect. Not until the warning became mandatory did the number of Reye’s cases plummet.