Monday, May 02, 2011

It Gives You Fever

 

 

# 5534

 

 

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Photo Credit – PHIL

 

An interesting study is about to get underway in New Zealand which will look at the potential downside to taking antipyreticsfever reducers – when you have influenza.

 

When we take antipyretics, we lower the body’s temperature to provide symptomatic relief – but we also create a more favorable environment for the virus to replicate.

 

Last year, in A Hot Topic For Further Research I wrote:

 

Today we have some new research that suggests (but falls far short of proving) that we may be better off carrying a bit of a fever – rather than reaching for the pill bottle -  when we have the flu.

 

And while that isn’t exactly a new idea, the evidence to support it has been limited.

 

It makes sense, of course.

 

A fever is the body’s way of combating an infection.  And we know human adapted flu viruses replicate in a narrow temperature range, and that replication is inhibited by fever.

 

If we reduce the fever, we are (theoretically, anyway) undermining our body’s own protective immune response.

 

And that in turn could increase the amount of time we remain ill, and shed the flu virus.

 

First the study in the Journal of the Royal Society of Medicine (registration required for access) – which is a retrospective analysis of previous animal (not human) studies on the outcomes of the treatment of bacterial and viral infections with antipyretics.

 

The effect on mortality of antipyretics in the treatment of influenza infection: systematic review and meta-analysis

Sally Eyers, Mark Weatherall, Philippa Shirtcliffe, Kyle Perrin, and Richard Beasley

v.103(10); Oct 1, 2010

In a review of the existing literature, researchers at the Medical Research Institute of New Zealand and Capital & Coast District Health Board, identified 8 (non-human animal) studies that met their inclusion criteria.

 

They found that the risk of mortality increased by roughly 33% when antipyretics were used in influenza infected animals.  This risk was observed with aspirin, paracetamol, and diclofenac.

 

 

This retrospective study was on animals, not humans, and so the question remains; Is it desirable to carry a low fever when battling influenza?

 

Over the next few months a clinical trial at special ward at Wellington Hospital in New Zealand may help answer that question. It will be used to monitor the progress of 80 influenza patients who will receive either paracetamol (acetaminophen) or a placebo for fever.

 

The story from Stuff.nz.co, then I’ll return with a bit more.

 

 

Flu study kicks off clinical trials unit

KATE NEWTON

A new clinical trials unit at Wellington Hospital will let researchers carry out studies that have not been possible in New Zealand before.

 

The first trial will be to study if giving paracetamol to people with influenza makes it worse.

 

The 14-bed unit is the first in a New Zealand public hospital.

 

It will let researchers keep participants in medical studies overnight for close monitoring – significantly widening the scope of what trials can be done.

(Continue . . .)

 

 

In a somewhat related story, I’ve written about studies that suggest that the concurrent use of antipyretics may inhibit the immune response when receiving vaccines.

 

In fact, it has even been theorized that one of the reasons that the elderly often develop less-than-robust immunity from the flu vaccine may be due to their frequent consumption of NSAIDs.

 

Several past blogs on this phenomenon include:

 

Anti-Inflammatory Meds And Vaccines

Common Pain Relievers May Dampen Vaccination Benefits

A Few Inflammatory Remarks

 

For now the evidence against the human use of antipyretics (and NSAIDs) in these situations is faint (at best).

 

But these reports do show that the effects of many over-the-counter medicines – even those used for decades by hundreds of millions of people - remain incompletely understood.