Influenza burden of illness, diagnosis, treatment, and prevention: what is the evidence in children and where are the gaps? | Archives of Disease in Childhood

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Acute paediatrics

Influenza burden of illness, diagnosis, treatment, and prevention: what is the evidence in children and where are the gaps?

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Influenza burden of illness and Reye's syndrome: lest we forget
Susan M Hall
Published on: 22 March 2016

Published on: 22 March 2016
Influenza burden of illness and Reye's syndrome: lest we forget
- Susan M Hall, Honorary lecturer
Dear Editor,
It is disappointing that Teo et al., in describing the burden of illness caused by influenza in children, did not mention Reye’s syndrome. [1]
In the 20 or so years since warnings about the use of aspirin in children were introduced in the USA and UK, the incidence of this serious disorder has declined dramatically in both countries. However, it must not be forgotten that the other risk fa...
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Dear Editor,
It is disappointing that Teo et al., in describing the burden of illness caused by influenza in children, did not mention Reye’s syndrome. [1]
In the 20 or so years since warnings about the use of aspirin in children were introduced in the USA and UK, the incidence of this serious disorder has declined dramatically in both countries. However, it must not be forgotten that the other risk factor for developing Reye’s syndrome is a viral infection - most commonly influenza.[2]
The danger of complacency about infectious diseases which have declined because of preventive measures is well known and the same applies to Reye’s syndrome. It has not been eradicated and could well re-emerge in the event of an influenza pandemic if the warning labels on aspirin- containing medications are not heeded by teenagers or the parents of younger children. Neither group will have been exposed to the publicity of the mid 1980s. Moreover, young consultants and juniors in paediatrics and accident and emergency medicine are unlikely to have seen Reye’s syndrome and the “bad old days” of poor outcome associated with delayed diagnosis will return.
In the USA the continuing importance of Reye’s syndrome as a complication of influenza is underlined by the current Advisory Committee on Immunisation Practice recommendation that all children up to age 18 years who are taking long term aspirin should be offered annual vaccination.[3] It is important that Reye’s syndrome is not forgotten by clinicians, public health physicians and policy makers in the UK – although rare, it is a preventable cause of morbidity and mortality in childhood and it may become an important differential diagnosis from flu encephalitis in a pandemic.
References
(1) Teo SSS, Nguyen-Van-Tam JS, Booy R. Influenza burden of illness, diagnosis, treatment, and prevention: what is the evidence in children and where are the gaps? Arch Dis Child 2005; 90: 532-536
(2) Glasgow JFT, Hall SM. Reye’s syndrome and aspirin. In Rainsford KD (ed) Aspirin and related Drugs, Taylor and Francis, London 2004; 555- 585
(3) Harper SA, Fukuda K, Uyeki TM et al. Prevention and control of influenza: recommendations of the Advisory Committee on Immunisation Practices (ACIP). MMWR Recomm Rep 2004; 53: 1-40
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Conflict of Interest:
None declared.
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