Keep Out of Reach of Children

February 16, 2015
In 1985, the federal government required that aspirin bottles warn about the drug's potential to cause Reye's syndrome in children. But was the claim true? This meticulous book by science historian Largent (Vaccine: The Debate in Modern America) says the answer is murky. Cases plummeted after a 1980 peak "in concert with the decreasing use of aspirin in children," precluding gold-standard causal proof. The toxic behavior of some involved parties, Largent found, was easier to spot. Despite studies finding a "strong" link between aspirin use and Reye's, the labeling movement was slowed by the anti-regulation mood of the 1980s. "Almost every area of vital concern to consumers was adversely affected by the Administration's relentless drive to deny the role of government in protecting citizens," said the National Consumer League. Unsavory tactics included one official's use of private calls and meetings instead of memos and testimonyâto avoid "fingerprints"âduring his anti-labeling campaign. Yet many labeling advocates were overly triumphant about the eventual labeling, Largent says, and mysteries remain, including the fact that Reye's disappeared "even in countries where aspirin consumption was always quite low." If one thing becomes clear in Largent's narrative, it's that the regulatory process itself is disordered.

December 1, 2014
A well-researched history of Reye's syndrome that explores how science, medicine and politics interact.Largent (Associate Dean/Lyman Briggs Coll. at Michigan State Univ.; Vaccine: The Debate in Modern America, 2012), a childhood survivor of Reye's syndrome and currently a historian of science, tackles a malady that is still not well-understood. Named for the Australian physician who described it in the 1950s, the syndrome was at first thought to be caused by aflatoxins, then by ingredients in a pesticide, and then, in 1980, by aspirin. Largent relates each of these stories of searches for a cause, focusing mainly on aspirin. There is a brief chapter on therapies developed to treat Reye's, which was often fatal or left survivors with severe disabilities, but the author's primary concern is not treatment approaches but rather the long controversy over its link to aspirin. As Largent examines the dispute over whether to require warning labels on bottles of aspirin, he also scrutinizes the actions and interactions-some might say the machinations-of pharmaceutical companies, consumer rights groups, epidemiologists, public health officials, courts and the U.S. Congress. In 1985, the Department of Health and Human Services ordered that warnings about Reye's syndrome appear on all bottles of aspirin sold in the United States, giving advocates of this measure the opportunity to create a narrative about the triumph of science over big pharma. However, as Largent points out, uncertainty remains. The incidence of Reye's declined sharply in the 1980s and then virtually disappeared, leaving scientists without cases to investigate to determine whether aspirin was indeed the culprit. The author's take-home message is that despite all the earnest efforts, sometimes there are no final answers. A revealing work that validates the statement that watching policy being made is like watching sausage being made-not a sight for the squeamish.

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February 1, 2015

In the past, Reye's syndrome--a condition that causes swelling in the brain and liver-- affected some healthy young children who were recovering from the flu or other minor maladies. They would become suddenly very ill, suffer liver failure, and often end up in a coma. Many died. The author (science, technology, public policy, Michigan State Univ; Vaccine) who survived this disease, documents the attempt to find a cause and prevent further cases. When the syndrome was first noted in 1963, researchers thought that the use of aspirin to lower fevers was the cause. Others suspected pesticides applied to eradicate spruce budworm or aflatoxins in moldy food. Congress held hearings and wanted warning labels put on aspirin, but the drug companies were against this. Eventually, a mild warning was added and physicians counseled parents about not using aspirin for children. Investigations never found anything more than correlation and the disease disappeared in the late 1980s. The book is an absorbing study of the interrelationships of science, business, politics, and public health. It is part of the publisher's "Pathographics" series, dedicated to the memory of popular science writer Dr. Lewis Thomas. VERDICT An intriguing look at research and its shortcomings. Both professionals and lay readers interested in science will enjoy this work. Academic and large public libraries will want to add it to their collections.--Barbara Bibel, Oakland P.L.

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