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This page is intended to provide you with general information about Reye's syndrome and Reye-like illnesses.
* What is Reye's SyndromeReye's syndrome is an acute disorder which affects children when they seem to be recovering from a viral illness like 'flu', chicken-pox or diarrhoea.The child has a change in his/her personality or becomes drowsy or unconscious and develops frequent or persistent vomiting.
Unless diagnosed and treated successfully, death or severe disability may result. Abnormal accumulations of fat develop in the liver and some other organs of the body. There is swelling of the brain which can cause it injury.The disease affects children from infancy onwards. Although it does occur in teenagers and adults, it is rarely recognised after 19 years of age. Children of both sexes and all races can be affected.
*What Causes Reye's Syndrome?The cause is unknown; but a number of studies suggest a link between the development of Reye's syndrome and the use of aspirin to treat the viral illness which precedes it. These studies do not prove that aspirin causes Reye's syndrome but may aggravate it. Other chemical substances including insecticides and emulsifiers have also been implicated but the evidence that these are involved is controversial. Because there are alternatives, there is no need to use aspirin for feverish illnesses in childhood. Since 1986, aspirin preparations have been labeled with differing warnings. The latest advice from the Medicines and Healthcare Products Regulatory Agency which came into force on 1st October 2003, requires all aspirin products to carry a warning that children under 16 should not take aspirin unless on the advice of a doctor. The warning, to appear on the Carton/Label and Patient Information Leaflet, is as follows: -
Carton/Label
DO NOT GIVE TO CHILDREN UNDER 16 YEARS, UNLESS ON THE ADVICE OF A DOCTOR |
Patient Information Leaflet
THERE IS A POSSIBLE ASSOCIATION BETWEEN ASPIRIN AND REYE'S
SYNDROME WHEN GIVEN TO CHILDREN. REYE'S SYNDROME IS A VERY RARE DISEASE WHICH CAN BE FATAL. FOR THIS REASON ASPIRIN SHOULD NOT BE GIVEN TO CHILDREN AGED UNDER 16 YEARS UNLESS ON THE ADVICE OF A DOCTOR |
*What are Reye-like illnesses?Many rare genetic (inherited) disorders of the body chemistry (metabolic disorders) are now known to cause an illness exactly like Reye's-syndrome. The early treatment of these "Reye-like illnesses" is similar to that of Reye's syndrome but some require special drugs or diets for treatment and to prevent recurrence of illness. Special laboratory tests are required to make certain that such disorders are excluded in all children with Reye's syndrome. Furthermore, other children in the family may also have the genetic disorder in a latent form. Reye Syndrome-like Disorders which can simulate RS.
*What are the early stages of Reye's syndrome?Persistent or continuous vomiting and/or
Signs of brain swelling:
- Listlessness
- Loss of energy
- Drowsiness
Personality changes:
- Irritability
- Aggressive behaviour
- Disorientation:
- Confusion
- Irrational behaviour
- Delirium, Convulsions
Reye's syndrome should be suspected if a child displays all or part of this pattern of symptoms a few days after the onset of viral illness such as 'flu' or chicken-pox. Fever is not usually present. Many diseases have similar features. Medical staff who do not have experience of Reye's syndrome may initially suspect encephalitis, meningitis, poisoning, mental illness or even drug abuse. In infants the symptoms of Reye's syndrome may not follow a typical pattern; for example vomiting is less common. However, it is in infants that the "Reye-like illnesses" are most likely to occur.
*What should be done if symptoms of Reye's Syndrome develop?Advice to parents:Consult your general practitioner immediately; a child's life may depend on obtaining emergency treatment in the nearest children's unit. Statistics indicate a better chance of survival when Reye's syndrome is diagnosed and treated in its earliest stages. The later the diagnosis, the more advanced the coma and the chances of survival and full recovery are greatly reduced. Reye's syndrome can successfully be managed with a good outcome if diagnosed early and meticulously treated.
*Are there lasting effects?Survival is related to the severity of the brain swelling. Some children recover completely. Others may sustain slight to severe permanent brain damage. All children surviving Reye's syndrome require follow up, with developmental assessment.After Reye's Syndrome
*What can I do if my child has a fever and I cannot use aspirin?Fever is a normal response to infection. It may actually help your child to fight off viral illness. If you feel you must do something, there are a number of non-drug actions which may be taken:
- Excess covering and clothes should be removed.
- Sponge or bathe the child (especially the head, neck and face) with cool water and allow this to evaporate.
- This will often induce sleep.
- Keep the room at a moderate temperature.
- Encourage the child to drink liquids such as water or non-fizzy soft drinks.
If the fever does not respond to these measures, obtain advice from your doctor.Children under 12 months of age who have fever should not be treated without medical advice.
*Is Reye's Syndrome a common disease?Reye's syndrome was first described in 1963 by an Australian pathologist, R. Douglas Reye, MD. Since then it has been recognised in many parts of the world. It used to occur in minor epidemics, which in some countries (most notably the USA) were associated with influenza epidemics. Although the exact incidence of the disease in the UK and Ireland is not known, reported cases have fallen dramatically from nearly a hundred in 1984 to only one in 2002. Information on surveillance of Reye's syndrome will shortly be made available on the Foundation's website. It is likely that there is some under-reporting and under-diagnosis, but this downward trend has also been seen in the USA and is attributed to reduction in use of aspirin in children since the public warnings in 1986. Nevertheless, there may be a resurgence, especially if there is a large 'flu' epidemic or the aspirin warning is ignored as time goes by. It is thus essential to retain high diagnostic awareness of Reye's syndrome and Reye-like illnesses among clinicians.
Remember
- Reye's syndrome can appear soon after a viral infection, especially a flu-like illness or chicken- pox.
- Early signs of Reye's syndrome are: continuous vomiting, listlessness, drowsiness, irritability, confusion, irrational behaviour or a convulsion.
- The GP should be phoned immediately.
- In patients with the signs and symptoms described above, abnormal liver function tests, including raised blood ammonia strongly suggest a diagnosis of Reye's syndrome or a "Reye-Iike" inherited metabolic disorder.
- Inherited metabolic disorders can be present with a "Reye-Iike" illness, especially in children under 4 years. It is essential to diagnose them because of implications for genetic counselling, specific treatment and investigation of other children in the family.
- Medicines can mask symptoms. Therefore, if a child develops any of the symptoms of Reye's syndrome, the child should not be given anti-nausea or fever-reducing medicine.
- Children and teenagers under 16 should not take or be given aspirin unless on the advice of a doctor.
- Reye's syndrome rarely occurs in adults.
- Early diagnosis and appropriate treatment is vital.
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