“A fascinating history of a public health crisis. Compellingly written and insightful, Keep Out of Reach of Children traces the discovery of Reye’s syndrome, research into its causes, industry’s efforts to avoid warning labels on one suspected cause, aspirin, and the feared disease’s sudden disappearance. Largent’s empathy is with the myriad children and parents harmed by the disease, while he challenges the triumphalist view that labeling solved the crisis.” —ERIK M. CONWAY, coauthor of Merchants of Doubt
“Largent’s engaging and honest account explores how medical mysteries are shaped by prevailing narratives about venal drug companies, heroic investigators, and Johnny-come-lately politicians.” —HELEN EPSTEIN, author of The Invisible Cure
“Fascinating. . . . Thought-provoking.” —Booklist
“Well-researched. . . . A revealing work.” —Kirkus Reviews
Reye’s syndrome, identified in 1963, was a debilitating, rare condition that typically afflicted healthy children just emerging from the flu or other minor illnesses. It began with vomiting, followed by confusion, coma, and in 50 percent of all cases, death. Survivors were often left with permanent liver or brain damage. Desperate, terrorized parents and doctors pursued dramatic, often ineffectual treatments. For over fifteen years, many inconclusive theories were posited as to its causes. The Centers for Disease Control dispatched its Epidemic Intelligence Service to investigate, culminating in a study that suggested a link to aspirin. Congress held hearings at which parents, researchers, and pharmaceutical executives testified. The result was a warning to parents and doctors to avoid pediatric use of aspirin, leading to the widespread substitution of alternative fever and pain reducers. But before a true cause was definitively established, Reye’s syndrome simply vanished.
A harrowing medical mystery, Keep Out of Reach of Children is the first and only book to chart the history of Reye’s syndrome and reveal the confluence of scientific and social forces that determined the public health policy response, for better or for ill.
Mark A. Largent, a survivor of Reye’s syndrome, is the author of Vaccine: The Debate in Modern America and Breeding Contempt: The History of Coerced Sterilization in the United States. He is a historian of science, Associate Professor in James Madison College at Michigan State University, and Associate Dean in Lyman Briggs College at Michigan State University. He lives in Lansing, Michigan.
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 testimony to avoid "fingerprints" during 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.