A recent letter to the New Zealand Medical Journal has raised concern that Paracetamol should not be used for fever in influenza. The advice given is contradictory, stating that it is fine to use the drug for pain or headache which are most often associated with the fever but not for the fever itself. According to the letter, some animal studies have shown evidence of harm coming from paracetamol. The authors feel that this, coupled with the lack of evidence of benefit other than for symptoms measn that paracetamol should not be used for fever alone.

There is good reason to wonder whether treating the fever is a good idea as it does have a biological basis in helping to fight disease, but to date no human studies have shown evidence of harm from doing so. A quality review of paracetamol and other antipyretics in 2006 concluded that there was no evidence of harm or of illness extension due to the use of paracetamol but it is worth noting that the absence of evidence is not the same as evidence of absence of harm.If harm does occur, it is probably rare, though as stated, there have been no human studies. We respectfully suggest that animal evidence is not wisely extrapolated to humans, especially where it is not in concordance with general observation. Animal studies do not take into account the differences in treatment given to human patients who do not progress as well as expected during their illness and so poorer outcomes are to be expected.

It remains our advice that if you feel unwell as a result of fever, paracetamol is a sensible and reasonable treatment to use. If this advice changes, we will of course post it here first.

We should like to remind parents that it is unwise to give ASPIRIN to children under 18 and dangerous to use it for children under 12. There is a rareand often fatal neurological disorder called Reye's Syndrome which can be triggered by givin aspirin to young children (ibuprofen and paracetamol are safe)