Fever and Anti-pyretics
Posted: Thu Oct 14, 2004 2:51 pm
From Hilary Butler, one of my colleagues in working with vaccine dangers
PARACETAMOL. (USA TYLENOL,IBUPROFEN etc)
Your child is scratchy, your child has a temperature, your child is
irritable, and you ring the doctor's surgery, and the voice on the other end
says what it always says" "Just give Pamol, dear, and come back tomorrow if
you are still worried.
What is the purpose of fever? What do parents believe about fever? Should it
be treated with antipyretics? Why do doctors prescribe antipyretics? What
does the medical literature say about the biological impact of paracetamol?
Antipyretics are also recommended prior to vaccination, though in this
country, this advice is given hesitantly, since there is debate that
antipyretics could "conceal" medically significant symptoms, and confuse
diagnosis.
EXTRACTS FROM MEDICAL LITERATURE:
"Not all fevers need to be treated but many physicians do so to relieve
parental concern." (Eur J Ped 1994 Jun; 153 (6): 394-402)
"An elevation in temperature following bacterial infection results in a
significant increase in host survival" (Science 1975 Apr 11; 188 (4184): 166-
"Many components of the nonspecific host defence response to infection such
as leukocyte mobility, lymphocyte transformation, and the effects of
interferon, appear to be enhanced by elevations in temperature that simulate
moderate fevers. In addition, some evidence indicates that a fever in
conjunction with the changes in plasma iron levels known to occur during
infections is a synergistic host defence response." (Pediatrics 1980, No: 66
(5) : 720 - 723)
"Parental fever phobia and its correlates...surprising, higher socioeconomic
status was not associated with a lesser degree of fever phobia...undue fear
and overly aggressive treatment of fever are epidemic among parents of
infants and young children, even among the highly educated and well-to-do.
considerable effort will be required on the part of pediatricians and other
child health workers to reeducate that parents about the definition,
consequences and appropriate treatment of fever." (Pediatrics 1985 June;75
(6) 1110-1113)
"There is no convincing evidence that naturally occuring fevers are harmful.
In contrast, animal studies have shown that fever helps animals to survive
and infection whereas antipyretic increases mortality. Moreover there is
considerable in vitro evidence that a variety of human immunological defences
function better at febrile temperatures than at normal one." (The Lancet,
Volume 337, March 9, 1991)
"Many cytokines are endogenous mediators of fever including interleukin (IL)
-, 1 beta, IL-6 and others. Tumor necrosis factor-alpha may be both an
endogenous pyrogen and an endogenous antipyretic or cryogen."
(Neuroimmunomodulation 1995 Jul-Aug; 2 (4):216-223)
"There is overwhelming evidence in favor of fever being an adaptive host
response to infection... as such, it is probable that the use of
antipyretic/anti-inflammatory/analgesic drugs, when they lead to suppression
of the fever, result in increased morbidity and mortality during most
infections; this morbidity and mortality may not be apparent to most health
care workers..." Infect Dis Clin North Am 1996 Mar;10(1) : 1-20.)
Acetaminophen can induce pneumonia...'These finding suggest that allergic
mechanism was involved in the pathogenesis of the pneumonitis. Underlying
immunological disorders may have enhanced the occurrence." Nihon Kyobu
Shikkan Gakkai Sasshi 1997 Sep; 35 (9) 974-9) There are other reports of this
as well...
"The results suggest that lung disease (rheumatoid lung) associated with
collagen vascular diseases may be exacerbated by drug-induced (acetaminophen)
pneumonitis." Nihon Kyobu Shikkan Gakkai Sasshi 1997 Oct; 35 (10) 1113-111
"Despite our lack of knowledge about its therapeutic mechanism, it has been
claimed to be a safe drug, especially for children... paracetamol syrup
(presumably for children) is extensively prescribed in large volumes...There
is mounting evidence that paracetamol is not the benign drug that it was
formally thought to be... We would question the whole rationale of
prescribing the drug in near epidemic proportions. If it is to be used as a
placebo, then it is a very dangerous placebo... The whole place of
paracetamol prescribing for children has been questioned. While there is
little concern about its use in the short term as an analgesic, there is
considerable controversy over its use as an antipyretic....there is little
evidence to support the use of paracetamol to treat fever in patients without
heart or lung disease. Paracetamol may decreast antibody response to
infection and increase morbidity and mortality in severe infections...too
many parents and health workers think that fever is bad and needs to be
suppressed by paracetamol when, indeed, moderate fever may improve the immune
response...the use of paracetamol in children with acute infection did not
result in an improvement in mood, comfort, appetite or fluid intake." (Family
Practice, Volume 13, No 2, 1996 pgs 179 - 181)
"Fever is rarely harmful. Only extremely high fevers of 42.2C or 108 F or
higher have been known to cause brain damage. Only fevers of 40.5C or 105F
and higher need immediate attention, mainly because they are a clue that a
serious infection could be present "(such as meningitis) (Sunday Star Times,
May 3, 1998, C3) doctor's column.
"Paracetamol has no antipyretic benefits over mechanical antipyreses alone in
..malaria. Moreover, paracetamol prolongs parasite clearance time, possible
by decreased production of TNF and oxygen radicals. " (Lancet
1997;350:704-709)
"The data suggest that frequent administration of antipyretics to children
with infectious disease may lead to a worsening of their illness." (Acta
Paed. Jpn 1994 Aug;36 (4) 375-37
"Fever is an important indicator of disease and should not be routinely
suppressed by antipyretics...fever may actually benefit the host defense
mechanism...fever is short-lived and causes only minor discomfort...routine
antipyretic therapy should be avoided byt may be necessary in individual
patients with cardiovascular or neurologic disorders."(Infect Dis Clin North
Am 1996 Mar;10 (1) 211-216)
"Studies of bacterial and viral-infected animals have shown that moderate
fevers decrease morbidity and increase survival rate" (Yale J Biol Med 1986
Mar-April; 59 (2) : 89-95)
"Antipyretic drugs are effective in diminishing fever, but have significant
side effects and may suppress signs of ongoing infections" (Arch Intern Med
1990, Aug; 150 ( : 1589-1597)
Meningococcal Disease: "use of analgesics were associated with
disease...analgesic use was defined as analgesics taken in the past 2 weeks,
excluding, for cases, those taken for identified early symptoms of
meningococcal disease. These analgesics were predominantly acetaminophen
products......because analgesics showed a stronger relationship with
meningococcal disease, the use of analgesics may be a better measure of more
severe illness than reported individual symptoms....we cannot exclude the
possibility that acetaminophen use itself is a risk factor for meningococcal
disease" (Ped Infec Dis, Oct 2000, Vol 19, No 10, 983-990)
"Antipyretics prolong illness in patients with Influenza A.... The duration
of illness was significantly prolonged from 5 days(without) to 8 1/2 days
(with). Pharmacotherapy 2000, 20: 417-422)
Take two aspirin, prolong the flu - 2 January 2001 Anne Burke, HealthScout
Reporter (also reported by Reuters medical news...) "Taking aspirin or
Tylenol for the flu actually prolongs the illness by up to 3 1/2 days, say
researchers at the University of Maryland. That is because fever may be the
body's natural way of fighting an infection and taking aspirin or
acetaminophen - the generic name for products such as Tylenol - may
interefere with the process. "You are messing with Mother Nature," Says Dr
Leland Rickman, an associate clinical professor of medicine at the University
of California San Diego. "An elevated temperature may actually help the body
fight the infection quicker or better than if you don't have a fever."
"Whatever you do, don't give aspirin or Tylenol to children who have the flu
or any other viral illness", Rickman said
"These results suggest that the systematic suppression of fever may not be
useful in patients without severe cranial trauma or significant hypoxemia.
Letting fever take its natural course does not seem to harm patients with
systemic inflammatory response syndrome, or influence the discomfort level
AND MAY SAVE COSTS." (wow!!!) (Arch Intern Med 2001, Jan 8; 161 (1) 121-123)
Chickenpox treated with Tylenol/Ibuprofen provokes bacterial skin infections
into fulminant necrotising fasciitis (Pediatr I(Pediatrics Vol 103, No 4,
April 1999, 783-784 and 785-790) (Infect Med1999 16 (5):307) Just two of many
references for antipyretic induced complications of chickenpox.
(In MMWR - May 15, 1998, Vol 47 No 18. All cases of Varicella related deaths
were treated with antipyretics. No causal association was investigated or
ascribed. The "solution" to the problem was considered to be mandatory
vaccination.)
What you do as a parent, is your choice. Make sure that it is an "informed"
choice. Get the articles referenced, do a med-line search - retrieve any
others. REad the whole articles. Give them to your doctor to read, and
discuss them with him/her. Most importantly, if you feel your child has an
immunodeficiency, get your child tested so that you know what you are dealing
with.
How a child handles any infectious disease is dependant upon the immune
system inherited, nutritional status, life-style, environment and resultant
stresses and how the child reacts to them.
The choice is yours.
PARACETAMOL. (USA TYLENOL,IBUPROFEN etc)
Your child is scratchy, your child has a temperature, your child is
irritable, and you ring the doctor's surgery, and the voice on the other end
says what it always says" "Just give Pamol, dear, and come back tomorrow if
you are still worried.
What is the purpose of fever? What do parents believe about fever? Should it
be treated with antipyretics? Why do doctors prescribe antipyretics? What
does the medical literature say about the biological impact of paracetamol?
Antipyretics are also recommended prior to vaccination, though in this
country, this advice is given hesitantly, since there is debate that
antipyretics could "conceal" medically significant symptoms, and confuse
diagnosis.
EXTRACTS FROM MEDICAL LITERATURE:
"Not all fevers need to be treated but many physicians do so to relieve
parental concern." (Eur J Ped 1994 Jun; 153 (6): 394-402)
"An elevation in temperature following bacterial infection results in a
significant increase in host survival" (Science 1975 Apr 11; 188 (4184): 166-
"Many components of the nonspecific host defence response to infection such
as leukocyte mobility, lymphocyte transformation, and the effects of
interferon, appear to be enhanced by elevations in temperature that simulate
moderate fevers. In addition, some evidence indicates that a fever in
conjunction with the changes in plasma iron levels known to occur during
infections is a synergistic host defence response." (Pediatrics 1980, No: 66
(5) : 720 - 723)
"Parental fever phobia and its correlates...surprising, higher socioeconomic
status was not associated with a lesser degree of fever phobia...undue fear
and overly aggressive treatment of fever are epidemic among parents of
infants and young children, even among the highly educated and well-to-do.
considerable effort will be required on the part of pediatricians and other
child health workers to reeducate that parents about the definition,
consequences and appropriate treatment of fever." (Pediatrics 1985 June;75
(6) 1110-1113)
"There is no convincing evidence that naturally occuring fevers are harmful.
In contrast, animal studies have shown that fever helps animals to survive
and infection whereas antipyretic increases mortality. Moreover there is
considerable in vitro evidence that a variety of human immunological defences
function better at febrile temperatures than at normal one." (The Lancet,
Volume 337, March 9, 1991)
"Many cytokines are endogenous mediators of fever including interleukin (IL)
-, 1 beta, IL-6 and others. Tumor necrosis factor-alpha may be both an
endogenous pyrogen and an endogenous antipyretic or cryogen."
(Neuroimmunomodulation 1995 Jul-Aug; 2 (4):216-223)
"There is overwhelming evidence in favor of fever being an adaptive host
response to infection... as such, it is probable that the use of
antipyretic/anti-inflammatory/analgesic drugs, when they lead to suppression
of the fever, result in increased morbidity and mortality during most
infections; this morbidity and mortality may not be apparent to most health
care workers..." Infect Dis Clin North Am 1996 Mar;10(1) : 1-20.)
Acetaminophen can induce pneumonia...'These finding suggest that allergic
mechanism was involved in the pathogenesis of the pneumonitis. Underlying
immunological disorders may have enhanced the occurrence." Nihon Kyobu
Shikkan Gakkai Sasshi 1997 Sep; 35 (9) 974-9) There are other reports of this
as well...
"The results suggest that lung disease (rheumatoid lung) associated with
collagen vascular diseases may be exacerbated by drug-induced (acetaminophen)
pneumonitis." Nihon Kyobu Shikkan Gakkai Sasshi 1997 Oct; 35 (10) 1113-111
"Despite our lack of knowledge about its therapeutic mechanism, it has been
claimed to be a safe drug, especially for children... paracetamol syrup
(presumably for children) is extensively prescribed in large volumes...There
is mounting evidence that paracetamol is not the benign drug that it was
formally thought to be... We would question the whole rationale of
prescribing the drug in near epidemic proportions. If it is to be used as a
placebo, then it is a very dangerous placebo... The whole place of
paracetamol prescribing for children has been questioned. While there is
little concern about its use in the short term as an analgesic, there is
considerable controversy over its use as an antipyretic....there is little
evidence to support the use of paracetamol to treat fever in patients without
heart or lung disease. Paracetamol may decreast antibody response to
infection and increase morbidity and mortality in severe infections...too
many parents and health workers think that fever is bad and needs to be
suppressed by paracetamol when, indeed, moderate fever may improve the immune
response...the use of paracetamol in children with acute infection did not
result in an improvement in mood, comfort, appetite or fluid intake." (Family
Practice, Volume 13, No 2, 1996 pgs 179 - 181)
"Fever is rarely harmful. Only extremely high fevers of 42.2C or 108 F or
higher have been known to cause brain damage. Only fevers of 40.5C or 105F
and higher need immediate attention, mainly because they are a clue that a
serious infection could be present "(such as meningitis) (Sunday Star Times,
May 3, 1998, C3) doctor's column.
"Paracetamol has no antipyretic benefits over mechanical antipyreses alone in
..malaria. Moreover, paracetamol prolongs parasite clearance time, possible
by decreased production of TNF and oxygen radicals. " (Lancet
1997;350:704-709)
"The data suggest that frequent administration of antipyretics to children
with infectious disease may lead to a worsening of their illness." (Acta
Paed. Jpn 1994 Aug;36 (4) 375-37
"Fever is an important indicator of disease and should not be routinely
suppressed by antipyretics...fever may actually benefit the host defense
mechanism...fever is short-lived and causes only minor discomfort...routine
antipyretic therapy should be avoided byt may be necessary in individual
patients with cardiovascular or neurologic disorders."(Infect Dis Clin North
Am 1996 Mar;10 (1) 211-216)
"Studies of bacterial and viral-infected animals have shown that moderate
fevers decrease morbidity and increase survival rate" (Yale J Biol Med 1986
Mar-April; 59 (2) : 89-95)
"Antipyretic drugs are effective in diminishing fever, but have significant
side effects and may suppress signs of ongoing infections" (Arch Intern Med
1990, Aug; 150 ( : 1589-1597)
Meningococcal Disease: "use of analgesics were associated with
disease...analgesic use was defined as analgesics taken in the past 2 weeks,
excluding, for cases, those taken for identified early symptoms of
meningococcal disease. These analgesics were predominantly acetaminophen
products......because analgesics showed a stronger relationship with
meningococcal disease, the use of analgesics may be a better measure of more
severe illness than reported individual symptoms....we cannot exclude the
possibility that acetaminophen use itself is a risk factor for meningococcal
disease" (Ped Infec Dis, Oct 2000, Vol 19, No 10, 983-990)
"Antipyretics prolong illness in patients with Influenza A.... The duration
of illness was significantly prolonged from 5 days(without) to 8 1/2 days
(with). Pharmacotherapy 2000, 20: 417-422)
Take two aspirin, prolong the flu - 2 January 2001 Anne Burke, HealthScout
Reporter (also reported by Reuters medical news...) "Taking aspirin or
Tylenol for the flu actually prolongs the illness by up to 3 1/2 days, say
researchers at the University of Maryland. That is because fever may be the
body's natural way of fighting an infection and taking aspirin or
acetaminophen - the generic name for products such as Tylenol - may
interefere with the process. "You are messing with Mother Nature," Says Dr
Leland Rickman, an associate clinical professor of medicine at the University
of California San Diego. "An elevated temperature may actually help the body
fight the infection quicker or better than if you don't have a fever."
"Whatever you do, don't give aspirin or Tylenol to children who have the flu
or any other viral illness", Rickman said
"These results suggest that the systematic suppression of fever may not be
useful in patients without severe cranial trauma or significant hypoxemia.
Letting fever take its natural course does not seem to harm patients with
systemic inflammatory response syndrome, or influence the discomfort level
AND MAY SAVE COSTS." (wow!!!) (Arch Intern Med 2001, Jan 8; 161 (1) 121-123)
Chickenpox treated with Tylenol/Ibuprofen provokes bacterial skin infections
into fulminant necrotising fasciitis (Pediatr I(Pediatrics Vol 103, No 4,
April 1999, 783-784 and 785-790) (Infect Med1999 16 (5):307) Just two of many
references for antipyretic induced complications of chickenpox.
(In MMWR - May 15, 1998, Vol 47 No 18. All cases of Varicella related deaths
were treated with antipyretics. No causal association was investigated or
ascribed. The "solution" to the problem was considered to be mandatory
vaccination.)
What you do as a parent, is your choice. Make sure that it is an "informed"
choice. Get the articles referenced, do a med-line search - retrieve any
others. REad the whole articles. Give them to your doctor to read, and
discuss them with him/her. Most importantly, if you feel your child has an
immunodeficiency, get your child tested so that you know what you are dealing
with.
How a child handles any infectious disease is dependant upon the immune
system inherited, nutritional status, life-style, environment and resultant
stresses and how the child reacts to them.
The choice is yours.