If this is your first visit, be sure to check out the FAQ by clicking the link above. You may have to register before you can post: click the register link above to proceed. To start viewing messages, select the forum that you want to visit from the selection below. |
|
|
Thread Tools | Display Modes |
#1
|
|||
|
|||
Advice on Paracetamol is Unscientific and Unsafe
Same as Tylenol in the US
http://www.scoop.co.nz/mason/stories/GE0409/S00084.htm Advice on Paracetamol is Unscientific and Unsafe Monday, 20 September 2004, 4:22 pm Press Release: Ron Law Press Release: Ministry's Advice on Paracetamol is Unscientific and Unsafe Ron Law Beyond Alternative Solutions "The Ministry of Health's advice regarding the use of paracetamol in children is unscientific and unsafe," says Ron Law, a risk and policy analyst. There is no scientific evidence supporting the routine use of paracetamol to reduce fevers in children, and certainly not in fevers up to 39°C as recommended by the Ministry of Health. It has been known for over a decade that routine administration of antipyretics such as paracetamol may interfere with the clinical evaluation of patients with infections, such as meningitis, that their use may prolong infection and reduce the antibody response in mild disease [and presumably following vaccination], and increase morbidity and mortality in severe infection. There is also no scientific evidence that antipyretics prevent febrile convulsions... it's all part of medical folklore that the Ministry advice is based on. So why is the Ministry of Health advising parents to give children paracetamol for "slight fevers" up to 39°C following vaccination with meningococcal B vaccination... [even fevers as low as 37.5°C] when there is no evidence to support such use -- and it can do harm? Surely social responsibility requires the Ministry of Health to apply the cornerstone of the Hippocratic Oath; First Do No Harm? "If similar advice was given by a dietary supplement company they would be prosecuted under the Fair Trading Act for fraud,"says Ron Law [09-832 4773] Even the World Health Organisation advises against such use. They say that routine use of antipyretics such as paracetamol does no significant good, and may be harmful. The WHO says that fever represents a universal and usually beneficial response to infection, and its suppression under most circumstances has few, if any, demonstrable benefits. On the other hand, some harmful effects have been shown to occur as a result of suppressing fever... they may result in an increase in morbidity and perhaps the occurrence of occasional mortality. The World Health Organisation states categorically that antipyretics, such as paracetamol, should not be encouraged either in developing countries or in industrial societies. So why is the Ministry of Health encouraging paracetamol use when there is no scientific evidence of benefits, but scientific evidence of harm? The Ministry of Health states that fevers greater than 39°C are "very rare." Using internationally agreed definitions, as used by the Ministry of Health itself, that means that less than 1 per 10,000 vaccinations would warrant the use of paracetamol; In other words, less than 10 children since the commencement of the Meningococcal B vaccination programme. Besides the medical reasons for recommending against routine Paracetamol use for treating fevers, Paracetamol medications are by far the leading cause of poisoning in New Zealand children. Interestingly, a leading brand of paediatric paracetamol provides no product safety information sheet in their product packaging, but offers a website. The website is parked and provides no information. Even Medsafe's website has no datasheet for that brand -- What's the point of companies having to compile product information sheets if they are not available to consumers? "Based on the scientific evidence available to the Ministry of Health, why is it putting young New Zealanders at greater risk from harm due to recommended paracetamol use than are harmed by meningococcal B itself?" asks Ron Law. The Ministry of Heath's advice makes a mockery of its belief that it policies are evidence-based. The Ministry's advice is so unsound that the precautionary principle as applied to risk management practice requires that the Ministry advice to parents and healthcare professionals be retracted forthwith. Note to editors: Ron Law is risk and policy analyst who has lectured widely in medical science and business management. He was an invited member of the Ministry of Health expert working group that advised the Ministry on the management of medical injury within the New Zealand health system. ] |
#2
|
|||
|
|||
"john" wrote in message ... Same as Tylenol in the US http://www.scoop.co.nz/mason/stories/GE0409/S00084.htm Illegally copied material deleted. I basically agree with the article. Unless the fever is going to harm your child (like if you child gets febrile seizures or have a real high fever), then there is no need to give medicine to lower his fever. Jeff |
#3
|
|||
|
|||
"Jeff" wrote in message ...
"john" wrote in message ... Same as Tylenol in the US http://www.scoop.co.nz/mason/stories/GE0409/S00084.htm Illegally copied material deleted. I basically agree with the article. Unless the fever is going to harm your child (like if you child gets febrile seizures or have a real high fever), then there is no need to give medicine to lower his fever. Jeff Actually, true simple febrile seizures aren't dangerous unless the child is mechanically harmed by the thrashing that occurs during the seizure. Simple febrile seizures do not mean the child will develop epilepsy, they do not cause brain damage, etc. As to "a real high fever", fever by itself is not a disease state, it is a symptom. The only time a fever actually causes thermal damage to body tissues is when it climbs over 106-107 degrees F. I've only ever heard of this happening due to heat stroke or malignant hyperthermia. I tell the parents of my patients that if you have a febrile toddler, the only reason to treat the fever is to make the child comfortable. If he has a temp of 103 but is running around, playful and happy, leave it alone. In any case, if someone has a sick child, febrile or not, consulting a bunch of strangers on Usenet is foolish. Go to your child's doctor for advice. Mark, MD |
#4
|
|||
|
|||
"Jeff" wrote in message ...
"john" wrote in message ... Same as Tylenol in the US http://www.scoop.co.nz/mason/stories/GE0409/S00084.htm Illegally copied material deleted. I basically agree with the article. Unless the fever is going to harm your child (like if you child gets febrile seizures or have a real high fever), then there is no need to give medicine to lower his fever. Jeff COMMENT: Jeff: Yes, but you missed the subtext of the article, which is a deliberate blurring of the dangers of treating the fever in a live infection, and treating the fever from a non-live vaccine (like meningococcus B). The article says: It has been known for over a decade that routine administration of antipyretics such as paracetamol may interfere with the clinical evaluation of patients with infections, such as meningitis, that their use may prolong infection and reduce the antibody response in mild disease [and presumably following vaccination], and increase morbidity and mortality in severe infection. COMMENT: That phrase "presumably following vaccination" is the bull**** part. Not proven. Makes sense as a good hypothesis for live vaccines such as MMR, but a pretty long inference and may very well not be true when it comes to an antigen vaccine like meningococcal B vaccines. The article continues: So why is the Ministry of Health advising parents to give children paracetamol for "slight fevers" up to 39°C following vaccination with meningococcal B vaccination... [even fevers as low as 37.5°C] when there is no evidence to support such use -- and it can do harm? Comment: What harm would it do? The unwary reader might assume that the meningococcal B vaccine might cause meningitis (so lack of fever might interfere with clinical evaluation). But the vaccine cannot cause meningitis, so the point is irrelevent. As is also the point about "morbidity and mortality in severe infection." The meningococcal vaccine can't cause any kind of infection, severe or otherwise. In sort, there's no particular reason to think the advice to use Tylenol/paraceamol when they get vaccinated with meningococcal vaccine, is bad advice. Probably it will make children with high fevers from meningococcal vaccine, more comfortable. The question of whether or not to use antifebrile drugs in vaccinations with live viruses which DO causes (mild) infections, is another matter worthy of debate and further clinical study. But this article contributes nothing to that debate because it's too ignorant to even draw any distinctions between types of vaccines. And it's chosen the wrong type here, as a fulcrum issue. The acticle continues: There is also no scientific evidence that antipyretics prevent febrile convulsions... it's all part of medical folklore that the Ministry advice is based on. Comment: Indeed, the preponderance of evidence probably supports a lack of effectiveness of antipyretics in preventing febrile seizures. Recent reviews of available good randomized studies (of which there are only about 4) suggest no effect. This is counterintuitive, and deserves to be more widely known. But presenting it in the context of how to treat kids with fevers after a vaccination in which they have no infection, is not the way to do it. Such treatment may be confort based, and while it might not prevent convusions, there's no reason to think it does any harm, either. On the other hand, when an active infection with a live organism is going on, whether from a vaccination or natural disease, the role of antipyretics should be re-evaluated. It's indeed very possible they do more harm than good, overall. It's just a shame this question wasn't raised by the article in a relevent context, such as vaccination by MMR, or in children suffering natural viral or bacterial illnesses. Meningococcal B vaccination is the wrong place to even bring the subject up. SBH |
Thread Tools | |
Display Modes | |
|
|