Why anyone, with any flu, would be an idiot to take Paracetamol

[Momtezuma Tuatara]

First of all, look at this:

[Momtezuma Tuatara]

Now why might this be?

Well, it's pretty simple, but the problem is that the only two studies which point to the why, were done in Saudi Arabia in the 1990's. And no, no-one's done anything after that to confirm this, as per their usual "You cannot say anything until we've spent 80 years, doing 200 studies,..." :blah: :blah:

So having not bothered to do ANY studies at all... ( at least, I can't find any) paracetamol continues to be recommended on a totally unscientific basis.

And really, why would we be surprised?

The reasons why paracetamol is dangerous in infections are in these two studies attached.

To try to explain to you in simple terms here is why.

acetaminophen/paracetamol/tylenol paralyses polymorphonuclear leukocytes.

Polymorphonuclear leukocytes are the first cells to arrive at sites of infection and play a crucial role against bacterial, viral, fungal and parasitic infections. They increase oxidative strategies by the body to kill pathogens by using the ability to make hydrogen peroxide in the body and hydroxyl radicals. These metabolites have a very powerful bactericidal effect. BUT not only does paracetamol inhibit the formation of these metabolites, paracetamol scavenges HOCL and thus paralyses the MPO-H202-Cl- antimicrobial system of the front line neutrophils.

So when you take paracetamol, the paracetamol opens the door and says to influenza, meningitis, whatever... "Welcome, enter, do your flipping worst, for the paracetamol will now prevent the body's natural protection system from working properly."

What's the bet that most of the swineflu, any flu deaths, have taken paracetamol? Of course, because that's what the doctor, the health department tells you to do. And the father of the med student who died of meningitis (http://forums.beyondvaccination.com/showthread.php?t=1024) said just that too didn't he? "Take paracetamol and see a doctor... " and that paracetamol might just have been the difference between surviving and dying... who knows? Scientists sure don't, because they continue to refuse to look at the very evidence in front of their eyes.

That's the first article.

The second article attached shows that the HIGHER the temperature you have the MORE paracetamol INHIBITS neutrophils and prevents phagocytes from engulfing and dealing with the pathogen.

So why would any doctor, in their right mind prescribe paracetamol?

You tell me, and then we'll both know.

[Momtezuma Tuatara]

By 2003, the WHO had admitted much of this:

[Momtezuma Tuatara]

NOTE WHO's first reference, which is this:

http://www.australianprescriber.com/magazine/18/2/33/5/

Paracetamol: use in children


Frank Shann, Intensive Care Unit, Royal Children's Hospital, Melbourne

Summary


It is sensible to use paracetamol to reduce the discomfort caused by minor acute infections, surgical procedures and triple antigen. It is also sensible to use paracetamol to reduce fever in patients with cardiac or respiratory failure. However, there is little evidence to support the use of paracetamol to treat fever in patients without heart or lung disease, or to prevent febrile convulsions. Paracetamol may prolong infection and reduce the antibody response in mild disease, and increase morbidity and mortality in severe infection. The dose in children is 10-15 mg/kg 4 hourly, to a maximum of 100mg/kg/day, and no patient should receive more than 4 g/day.
Key words: fever, pain, analgesia, antipyretic

(Aust Prescr 1995;18:33-5)

Despite the widespread use of paracetamol, there is still confusion about when it should be used and the correct dose.1 (http://forums.beyondvaccination.com/#sha)

Indications for paracetamol

Fever

In patients with cardiac or respiratory failure who are febrile, it can be helpful to give paracetamol to reduce oxygen consumption, carbon dioxide production and cardiac output. However, in patients without heart or lung disease, fever is harmful only at temperatures over 41oC. Such high temperatures are usually caused by heat stroke or brain injury2 (http://forums.beyondvaccination.com/#sch), and, if so, they do not respond to paracetamol or aspirin.

Febrile convulsions

There is no evidence that antipyretics prevent febrile convulsions; this is probably because the convulsion is caused by the rapid rise in temperature that usually occurs at the beginning of an illness.2 (http://forums.beyondvaccination.com/#sch)

There are no controlled trials comparing an antipyretic to placebo for febrile convulsions, but one study comparing phenobarbitone plus antipyretic to placebo plus antipyretic found a high risk of febrile convulsions in the placebo plus antipyretic group, suggesting that antipyretic therapy did not protect against convulsions.3 (http://forums.beyondvaccination.com/#cam)

In a recent controlled trial in children who had had a febrile convulsion4 (http://forums.beyondvaccination.com/#sch), children given paracetamol 15-20 mg/kg every 4 hours were just as likely to have another convulsion as children given paracetamol only when their rectal temperature exceeded 37.9oC.

Discomfort

It is sensible to give paracetamol to reduce the unpleasant symptoms caused by mild acute infections. However, paracetamol does not have a dramatic effect: a recent controlled trial5 (http://forums.beyondvaccination.com/#cra)found that paracetamol caused only a modest improvement in activity and alertness in children with acute infection, and that there was no significant improvement in mood, comfort, appet ite or fluid intake. Because many patients with infection have fever and discomfort, it is often assumed that fever causes discomfort but strenuous exercise causes temperatures up to 40oC without causing discomfort.

Triple antigen reactions

Two studies6 (http://forums.beyondvaccination.com/#ipp),7 (http://forums.beyondvaccination.com/#lew)have shown that paracetamol reduces fever and abnormal behaviour in children who have had triple antigen injection. A third study8 (http://forums.beyondvaccination.com/#uha)found that paracetamol had no significant effect, but only one dose of 10 mg/kg of paracetamol was given 4 hours after immunisation. A reduction in adverse reactions to triple antigen is likely to improve immunisation rates.

Postoperative pain

There has been little systematic study of the use of paracetamol for postoperative pain, but controlled trials of nonsteroidal antiinflammatory drugs9 (http://forums.beyondvaccination.com/#dah)and experience with paracetamol suggest that paracetamol provides adequate analgesia for minor surgery, and allows a reduced dose of opiates after major surgery. Paracetamol should probably be given before surgery, rather than waiting for pain to develop after surgery.9 (http://forums.beyondvaccination.com/#dah)

The dose of paracetamol

While a single dose of 5 mg/kg of paracetamol results in some reduction in the temperature of febrile children, there is a much larger fall with 10 mg/kg and an even larger and more prolonged fall with 20 mg/kg.10 (http://forums.beyondvaccination.com/#sha)

The maintenance dose of paracetamol in children is 10-15 mg/kg 4 hourly10 (http://forums.beyondvaccination.com/#10), to a maximum of 100 mg/kg/day, and no patient should receive more than 4 g/day. An initial dose of 20 mg/kg can be given if it is felt that maximum effect is needed quickly. A dose of 30 mg/kg 8 hourly gives levels in the therapeutic range.10 (http://forums.beyondvaccination.com/#sha)A single dose of 30 mg/kg of paracetamol at bedtime can increase the amount of sleep for the whole family when a child has mild acute infection, but the danger of repeating this dose has to be emphasised.

In Australia, paracetamol is sold in preparations containing 60mg in 0.6 mL (or 100 mg/mL), 100 mg/mL, 50 mg/mL, 120 mg in 5 mL (or 24 mg/mL) and 240 mg in 5 mL (or 48 mg/mL). It is difficult to calculate a dose of 15 mg/kg from these formulations. Parents often give a very low dose of paracetamol because they use the infant dropper, designed for 100 mg/mL preparations, to measure a dose of the more dilute preparations designed for use in older children.10 (http://forums.beyondvaccination.com/#sha)
Cost
Liquid preparations of paracetamol are expensive, with the MIMS price varying from $1.11 to $5.39 per g of paracetamol (mean $2.52 per g). In contrast, the MIMS price of 500 mg tablets of paracetamol is 10c to 45c per g. Tablets are a much cheaper form of paracetamol than liquid preparations, and some brands of paracetamol tablets are very much cheaper than others (the brands listed in the Schedule of Pharmaceutical Benefits tend to be less expensive).


Antipyretics may be harmful

Immunity

Too many parents and health workers think that infection is bad, infection causes fever, and that therefore fever is bad. In fact, fever is often a beneficial host response to infection, and moderate fever improves immunity.11 (http://forums.beyondvaccination.com/#rob)

Therefore, it may not be a good idea to give drugs that reduce temperature to patients with severe infection.

I have recently reviewed 1 the results of 9 controlled trials in mammals of the effect of paracetamol or aspirin on mortality or virus excretion.

Four trials found that aspirin increased mortality in bacterial or viral infection.

Viral shedding was increased by paracetamol or aspirin in 3 studies, possibly increased in one, and not affected in two (one used only pharyngeal washings, and one had only 9 subjects in the aspirin and placebo groups).

One study found that antibody production was impaired by both paracetamol and aspirin, but no effect on antibody production was detected in the study with only 9 subjects in the aspirin and placebo groups.

This evidence suggests that aspirin and paracetamol increase mortality in severe infection, and that they may prolong the infection and reduce the antibody response in mild disease.

Direct toxicity

Despite the millions of children treated with paracetamol, very little serious toxicity has been recognised (but note that the association between aspirin and Reye's syndrome was not recognised for many years). Penna and Buchanan 12 (http://forums.beyondvaccination.com/#pen)reviewed reports of 7 deaths and 11 cases of hepatotoxicity associated with paracetamol in children. The children who died had had more than 300 mg/kg/day of paracetamol for 1-6 days, except for one child where the plasma level suggested that the actual dose may have been much higher than the reported dose. The children who had hepatotoxicity but survived had all had 150 mg/kg/day for 2-8 days, except for two children where there was a discrepancy between the low reported doses and the high plasma levels of paracetamol (which was probably due to miscalculation of the dose or deliberate poisoning). Presumably, other cases of paracetamol toxicity in children have occurred and have gone unrecognised or unreported, but the evidence suggests that toxicity from paracetamol is rare with doses less than 150mg/kg/day. The dose of paracetamol should not exceed 100mg/kg/day in children, and no patient should receive more than 4 g/day.

In acute poisoning from paracetamol, treatment with acetylcysteine should be started within 10 hours if possible. If the delay in starting acetylcysteine is more than 10 hours or if there is established liver failure, a longer course of acetylcysteine should be given.13 (http://forums.beyondvaccination.com/#smi),14 (http://forums.beyondvaccination.com/#kea)The best regimen has not been determined; I suggest giving 150 mg/kg of acetylcysteine in 5% dextrose intravenously over 15 minutes; then 12mg/kg/hour (200 microgram/kg/minute) for 4 hours; then 6mg/kg/hour (100 microgram/kg/minute) for at least 16 hours if the delay in starting was less than 10 hours, for at least 28 hours if the delay was 10-16 hours and at least 68 hours if the delay was more than 16 hours. Acetylcysteine should be continued as long as the patient has encephalopathy, abnormal liver function tests or paracetamol detected in the serum.

Conclusion

The antipyretic action of paracetamol is useful in febrile patients with cardiac or respiratory failure. The analgesic action is useful in minor acute infection, for postoperative pain and after vaccination with triple antigen.

There is little evidence to support the use of paracetamol to treat fever in patients without heart or lung disease, or to prevent febrile convulsions. Indeed, paracetamol may decrease the antibody response to infection, and increase morbidity and mortality in severe infection. It should be explained to parents that fever is usually a helpful response to infection, and that paracetamol should be used to reduce discomfort, but not to treat fever.


Although an initial dose of 20 mg/kg of paracetamol can be given, this is rarely necessary. The maintenance dose in children is 10-15 mg/kg 4 hourly. Hepatotoxicity has been reported with doses of 150 mg/kg/day, and no patient should be given more than 100 mg/kg/day (up to a maximum of 4 g/day).

References
1. Shann F. Paracetamol: when, why and how much [editorial; comment]. J Paediatr Child Health 1993;29:84-5.

2. Schmitt BD. Fever in childhood. Pediatrics 1984;74:929-36.

3. Camfield PR, Camfield CS, Shapiro SH, Cummings C. The first febrile seizureantipyretic instruction plus either phenobarbital or placebo to prevent recurrence. J Pediatr 1980;97:16-21.

4. Schnaiderman D, Lahat E, Sheefer T, Aladjem M. Antipyretic effectiveness of acetaminophen in febrile seizures: ongoing prophylaxis versus sporadic usage. Eur J Pediatr 1993;152:747-9.
5. Kramer MS, Naimark LE, RobertsBrauer R, McDougall A, Leduc DG. Risks and benefits of paracetamol antipyresis in young children with fever of presumed viral origin [see comments]. Lancet 1991;337:591-4. Comments in: Lancet 1991;337:1045,1347-8.

6. Ipp MM, Gold R, Greenberg S, Goldbach M, Kupfert BB, Lloyd DD, et al. Acetaminophen prophylaxis of adverse reactions following vaccination of infants with diphtheriapertussistetanus toxoidspolio vaccine. Pediatr Infect Dis J 1987;6:721-5.

7. Lewis K, Cherry JD, Sachs MH, Woo DB, Hamilton RC, Tarle JM, et al. The effect of prophylactic acetaminophen administration on reactions to DTP vaccination. Am J Dis Child 1988;142:62-5.

8. Uhari M, Hietala J, Viljanen MK. Effect of prophylactic acetaminophen administration on reaction to DTP vaccination. Acta Paediatr Scand 1988;77:747-51.

9. Dahl JB, Kehlet H. Nonsteroidal antiinflammatory drugs: rationale for use in severe postoperative pain [see comments]. Br J Anaesth 1991;66:703-12. Comment in: Br J Anaesth 1992;68:118.

10. Shann F. Paracetamol and fever. Aust Pharm 1991;10:217-20.

11. Roberts NJ Jr. Impact of temperature elevation on immunologic defenses. Rev Infect Dis 1991;13:462-72.

12. Penna A, Buchanan N. Paracetamol poisoning in children and hepatotoxicity. Br J Clin Pharmacol 1991;32:143-9.

13. Smilkstein MJ, Knapp GL, Kulig KW, Rumack BH. Efficacy of oral Nacetylcysteine in the treatment of acetaminophen overdose. Analysis of the national multicenter study (1976 to 1985) [see comments]. N Engl J Med 1988;319:1557-62. Comment in: N Engl J Med 1989;320:1417-8.

14. Keays R, Harrison PM, Wendon JA, Forbes A, Gove C, Alexander GJ, et al. Intravenous acetylcysteine in paracetamol induced fulminant hepatic failure: a prospective controlled trial. Br Med J 1991;303:1026-9.


This article has been reprinted (with minor modifications) from the Journal of Paediatrics and Child Health 1993;29:84-5.

[cartersmom]

Great into thanks Hilary....

I NEVER use Tylenol...even for pain relief

Is there any literature on Ibuprofen?? I personally do not treat fevers at all, but if one were to feel that they needed to if it got above a level they were comfortable with, would giving ibuprofen be ok??

[Momtezuma Tuatara]

Ibuprofen is just as bad. There is plenty of literature on it, but I've never bothered to collect it.

quite apart from that, if fever has a survival function, why would you want to reduce it with anything? I don't even use tepid washing... I wrap the kids up warmly and keep their faces cool.

[cartersmom]

Ibuprofen is just as bad. There is plenty of literature on it, but I've never bothered to collect it.

quite apart from that, if fever has a survival function, why would you want to reduce it with anything? I don't even use tepid washing... I wrap the kids up warmly and keep their faces cool.

After I posted that last question I got to reading that PDF you posted from one of the old testbooks and it talks about aspirin and how it is not advisable to get in the way of an inflamatory response and since ibuprofen is an anti-inflamatory , that makes sense to avoid that as well.

I don't treat fevers, (well i have used a homeopathic remedy twice) but I know a couple moms IRL who have a "threshold" .
Despite my attempst to educate them on the benefits of fever, they each have a point where they feel they should give something. For one it is as high as 104, for another 102. So I wanted to know if ibuprofen was any less dangerous to given than tylenol since they will give something no matter what I say. Seems like it's just as bad.....

What do you do for pain relief? I never ever use tylenol for myself either, but very rarely on occasion have used ibuprofen for pain that has not responded to homeopathics or when I have not had access to anything else and felt desparate.

[Momtezuma Tuatara]

Infectious fevers are physiologically regulated. Not like fevers which happen from a thyroid storm; sunstroke or.. an overdressed baby. Those fevers can rise and keep on rising.

infectious fevers rarely rise above 41.1 degrees celcius.

I dont have a threshhold in terms of infectious fevers. I go by what the child looks like, and how the child behaves. What I do is designed to help them cope, not reduce the fever.


In terms of pain, I have a high pain tolerance. I've used 6 paracetamol, (a total of three incidents) in my whole parenting life on myself. all three were breast infections, and I waited until I was climbing the walls, with my hair and toenails hurting... . Two tablets were enough to relax me, and after that I coped.

[Momtezuma Tuatara]

I'm not the only one asking these nasty questions:

here is a BMJ letter which I can't access but someone sent me>

LETTERS:
Call for flu research under way
Walley (8 July 2009) [Full text]
Call for flu research under way
Re: Influenza treated with NSAIDs or oseltamivir: case-control studies urgently needed 13 July 2009

Rokuro Hama,
Chairperson: Japan Institute of Pharmacovigilance, Editor:
Kusuri-no-Check (a drug bulletin)
#902 Ueshio3-2-17, Tennoji-ku Osaka, Japan 543-0002 Send response to journal:
Re: Re: Influenza treated with NSAIDs or oseltamivir: case-control studies urgently needed



Perez-Padilla et al [1] reported a total of 18 cases with pneumonia and confirmed 2009A/H1N1 influenza virus infection in Mexico City. The patients, most of them previously healthy, had an influenza-like illness that progressed during a period of 5 to 7 days, had pneumonia, and had findings during the first day of hospital admission that fulfilled the criteria of acute lung injury or the acute respiratory distress syndrome. Seven patients died, all from multiorgan system failure (MOF). They reported that concurrent bacterial infection does not appear to be a major contributing factor to the severity of illness, in contrast with 1918 pandemic in which a large number of deaths were associated with bacterial infection.

(1) What was the major cause of progression during a period of 5 to 7 days before admission? (2) What was the major cause of progression to MOF and cause of death after admission?

For the first question, it may be the most important whether ibuprofen, aspirin or other NSAIDs were administered or not. Because ibuprofen itself increases the mortality rate with Peto odds ratio of
7.12 (95%CI:0.97-52.3, p=0.0538) when used in mice infected with Coxackie virus B3 (calculated from the following data shown in the literature [2] : four deaths in 50 mice*week compared with no death in
45 mice*week). Combined with total of 16 infected animal experimental data including ibuprofen, salicylates indomethacin and diclofenac, NSAIDs increase mortality of infected animals (Pooled Peto OR: 7.68; 4.70-12.56, p<0.0001)[3].

Perez-Padilla et al [1] reported that none of the patients had received oseltamivir before admission; 14 received it in the hospital, at a dose of 75 mg twice a day for a minimum of 5 days; 11 began receiving it at admission (a mean of 8 days after the onset of
symptoms) and 3 between 2 and 10 days after admission. Four patients who survived did not receive oseltamivir.

This means that 7 among 14 treated with oseltamivir died from non- bacterial MOF and none died among 4 without oseltamivir. Peto odds ratio for case fatality comparing oseltamivir user vs non-user is 7.29 (95% confidence interval : 0.80-66.83, p=0.0787).

It is not significant at p<0.05 level and confounding with the severity at admission is not ruled out. However,several characteristics of oseltamivir phosphate (OP or Tamiflu) should be taken into account: oseltamivir (OT) easily enter into brain under hypercytokinemia at admission (which might be induced by NSAIDs), suppress central nervous system leading to central/respiratory suppression, neuropsychiatric symptoms and sudden death [3,4].

Neuraminidase contributes to maintenance of normal human immune and repair system [5], neuraminidase inhibitor such as OC cause renal damage as well as glucose intolerability and may worsen infection leading to MOF [3,4]. .

This is one of the most important points to consider the second issue:
cause of progression to death after admission, I believe.

References

1) Perez-Padilla R and the INER Working Group on Influenza. Pneumonia and Respiratory Failure from Swine-Origin Influenza A (H1N1) in Mexico. N Engl J Med. 2009 Jun 29. [Epub ahead of print]

2) Costanzo-Nordin MR, Reap EA, O'Connell JB, et al A nonsteroid anti -inflammatory drug exacerbates Coxsackie B3 murine myocarditis.
Robinson JA, Scanlon PJ. J Am Coll Cardiol. 1985 Nov;6(5):1078-82.

3) Hama R, Fatal neuropsychiatric adverse reactions to oseltamivir�F case series and overview of causal relationships. Internat J Risk Safety Med 20, 5-36, 2008: available at :
http://npojip.org/english/no11.html (http://npojip.org/english/no11.html)

4) Hama, R. Pharmacological toxicological clinical and epidemiological evidences of neuropsychiatric adverse reactions to oseltamivir and misleading analysis due to serious miscalculation in Japanese MHLW's
2006/07 epidemiological study report. Jap J Clin Pharmacol Therap 40
(2) (2009): 13S-14S.

5) Miyagi T, Wada T et al. Sialidase and malignancy: a minireview.
Glycoconj J 20(3) (2004):189-98.

Competing interests: None declared

[Momtezuma Tuatara]

Now, read this reply. Astonishing. someone else has got it.

http://www.bmj.com/cgi/eletters/338/jun15_1/b2345

[Momtezuma Tuatara]

Hmm... Interesting study.

[cartersmom]

good article...there seems to be plenty of literature that highlights the potential dangers of reducing fevers with drugs, or at least make it clear that that it MAY not be safe and needs to be studied further, yet nothing is done and it continues to be recommended routinely. this is amazing to me. I wonder how many people have died needlessly.

I wonder if that med student that just died would have fared better had he refrained from taking paracetamol

[Momtezuma Tuatara]

Now's here's a funny comment in a review on a book at Amazon: http://www.amazon.com/Why-We-Get-Sick-Darwinian/dp/0679746749/ref=pd_bxgy_b_text_b


Some other interesting ideas: Fever has a purpose. It raises body temperature enough to interfere with the chemistry of some pathogens, thereby killing them. If we take medicines that reduce fever, are we prolonging our illness? In some cases, the authors answer, yes. If we take medicines that suppress coughs and sneezing can that also prolong our illness? Again the answer is in some cases, yes. The point is that in treating the symptoms of disease we need to make a distinction between which are defensive mechanism of our bodies and which are not. Some pathogens, for example, make us sneeze or cause diarrhea in order to better spread themselves to the next victim. The rabies virus makes a dog bite other animals in order to spread itself. But our bodies cause us to cough and sneeze primarily to expel pathogens.

How "revolutionary"... :giggle:

[3monkeys]

I was watching one news tonight and they had a segment about swine flu in pregnancy. As I watched it I said to DH "If Hilary had a TV it would be about now she would be throwing it out the window" Let me see if I can find the link

http://tvnz.co.nz/health-news/swine-flu-fears-pregnant-women-2851450


The Ministry of Health says expectant mums who get symptoms should stay home and limit contact with others especially if they are ill, drink plenty of fluids, call their GP or healthline for advice and treat fever straight away with paracetamol.
Pregnant women are also being advised not to worry If Tamiflu is recommended by their GPs.


No wonder so many people get sick with such "great" advice...........

[Momtezuma Tuatara]

:D

http://www.bmj.com/cgi/eletters/338/jun15_1/b2345 (http://www.bmj.com/cgi/eletters/338/jun15_1/b2345)

[Quickening]

and treat fever straight away with paracetamol.

They're so good with using language to create a sense of urgency and fear/panic aren
t they? "and treat fever STRAIGHT AWAY with paracetamol" Better run to the shops real quick if you don't have any in stock!

[Momtezuma Tuatara]

http://www.bangkokpost.com/news/asia/149784/australia-trials-flu-vaccine-as-world-toll-leaps

Australia trials flu vaccine as world toll leaps

Writer: AFP Published: 22/07/2009 at 10:59 AM Australia on Wednesday began human trials for a swine flu vaccine as concerns grew over the disease after the global death toll leapt suddenly past 700.

http://www.bangkokpost.com/media/content/20090722/52838.jpg

Medical face masks which can prevent from swine flu. :giggle:

Australia on Wednesday began human trials for a swine flu vaccine as concerns grew over the disease after the global death toll leapt suddenly past 700

Some 240 adults and 400 children are involved in the trial at Royal Adelaide Hospital, with the government hoping to start mass immunisations within months.

"As soon as I have confirmation that the vaccine is safe and effective, I will ensure it can be rolled out to the community," Health Minister Nicola Roxon said.

Australia has pre-ordered 21 million shots of vaccine from CSL Biotherapies after being badly hit by A(H1N1) with more than 14,000 cases and 38 deaths linked to the disease -- the worst figures in the Asia-Pacific region.

Scientists fear swine flu, which has so far been reasonably mild, will mutate to a more deadly form in a reprise of the Spanish and Asian influenza pandemics of 1918 and 1958.

CSL spokeswoman Rachel David said many people had volunteered for the swine flu vaccine trial because they wanted to avoid catching the disease.

"We're talking about kids aged between six months and nine years and it involves two injections and two blood tests, so four needles to monitor the results," she told public broadcaster ABC.

"I think that is a big commitment for families, but in spite of that we've had a number of people come forward because they're interested in not getting the flu."

Australia is witnessing daily deaths linked to swine flu, with a 59-year-old woman with other health problems becoming the latest fatality late on Tuesday. Some 231 people are in hospital nationwide including 96 in intensive care.

On Tuesday, a 19-year-old Aboriginal woman with swine flu lost her unborn child, prompting warnings for expectant mothers to avoid mass gatherings and protect themselves with flu shots.

The woman, who remains in serious condition in hospital, comes from Palm Island in Australia's northeast, where doctors fear some 10 percent of the 3,500 population may have been infected, according to The Australian.

The newspaper also said the mother-of-two Alma Palmer had been sent home from hospital with paracetamol, a day before collapsing and being airlifted to the mainland.

"I am angry with the hospital," her grandfather Roderick Geesu was quoted as saying. "She went to the hospital and instead of giving her a thorough check-up they gave her a packet of Panadol (paracetamol)."

Hospitals have complained they are under growing pressure with a Sydney intensive care specialist saying they were "tearing their hair out" to find enough staff to cope with the sudden influx of patients.

A union in Queensland state has also warned up to 20 percent of nurses could be put on sick leave with swine flu during the ongoing southern hemisphere winter, double the normal figure.

The World Health Organization on Tuesday said the global death toll had shot up from 439 to more than 700, a leap of some 40 percent.

[MinorityView]

boy that para whatsis really works great, doesn't it?

Some people just never learn from experience.

[Momtezuma Tuatara]

I've sent this in. Let's see if they publish:


Yet another death after paracetamol.Hilary Butler,
Freelance Journalist
Home, Tuakau 2121, New Zealand.
Send response to journal:
Re: Yet another death after paracetamol. (http://www.bmj.com/cgi/eletter-submit/338/jun15_1/b2345?title=Re%3A+Yet+another+death+after+paraceta mol.)



Dear Sir,

The silence following previous queries, is resounding.

Yet, we continue to read stories like this, daily, from all around the world:

"The Ministry of Health says expectant mums who get symptoms should stay home and limit contact with others especially if they are ill, drink plenty of fluids, call their GP or healthline for advice and treat fever straight away with paracetamol." (1)

so it's natural to then read:

"... the mother-of-two Alma Palmer had been sent home from hospital with paracetamol, a day before collapsing and being airlifted to the mainland.
"I am angry with the hospital," her grandfather Roderick Geesu was quoted as saying. "She went to the hospital and instead of giving her a thorough check-up they gave her a packet of Panadol (paracetamol)." (2)

No doubt the experts will say that OF COURSE all deaths had been taking paracetamol. Standard protocol. "So of course paracetamol has NOTHING to do with the deaths."

Right????

Like Dr Johnson says, when will large scale randomised trials begin?

Why is it, that standard advice flies in the face of both medical literature, principles of immunology, and common sense?

Where is the evidence based science to justify such routine pronouncements? And "coincidental" dismissals?

Hilary Butler.

(1) http://tvnz.co.nz/health-news/swine-flu-fears-pregnant-women- 2851450
(2) http://www.bangkokpost.com/news/asia/149784/australia-trials-flu- vaccine-as-world-toll-leaps Competing interests: None declared

[Momtezuma Tuatara]

boy that para whatsis really works great, doesn't it?

Some people just never learn from experience.

I guess it's a bit hard to, once it kills you. :alien:

[MinorityView]

True, dead is dead. But you'd think some doctors might connect the dots.

Patient calls in with fever. I tell patient to take a drug. Patient dies. This happens over and over. Do I never stick my neck out and try telling the patient NOT to take the drug?

[Momtezuma Tuatara]

No. Pharma rep may not buy your staff their weekly Monday lunch and they might complain.

I kid you not.