Reye’s syndrome
To describe the epidemiological and clinical features of Reye syndrome in the British Isles, to monitor long term trends and to provide a database for detailed clinical, laboratory, and aetiological studies.
Lead investigator
Dr S M Hall
About the study
Surveillance of Reye syndrome (RS) in the British Isles began in August 1981. The original BPA-CDSC “passive” reporting scheme was taken over by the BPSU in June 1986. In the early years the surveillance findings showed that, while the incidence of RS in the British Isles was similar to that in the USA (the only other country with a national reporting scheme), other epidemiological features were different – notably a younger mean age; no clear seasonal (winter) peak; no striking association with influenza and chickenpox; a higher case fatality rate.
In 1984-5 an epidemiological risk factor study mounted on to the surveillance database demonstrated an association between RS and aspirin. Based on this and on similar findings in the US, the Committee on Safety of Medicines in 1986 issued public and professional warnings about the use of aspirin in children under 12 and required product warning labelling. Annual totals of reports of “confirmed cases” peaked at 81 in 1983/4 but have since declined (11 in 1994/95) in spite of a better method (BPSU) of case ascertainment; the mean age has also fallen. The surveillance scheme findings have also highlighted the importance of certain inborn errors of metabolism such as fatty acid oxidation and urea cycle defects, in the differential diagnosis of “Reye-like” illnesses. These are particularly likely to present in patients under two years old, but can manifest in older children.
Surveillance of RS continued, mainly in order to monitor long term trends; it was particularly important to determine the effects of possible large influenza epidemics in the future on the current declining incidence of RS.
Duration
June 1986 – April 2001
Published papers
The changing clinical pattern of Reye’s syndrome 1982-1990 – PMC
Advice/Support Group
National Reye’s Syndrome Foundation UK
Web: http://www.reyessyndrome.co.uk