Rethinking the benefits of anti-fever meds

CONTRARY to popular belief, fever-reducing medication may inadvertently cause more harm than good, says new research from McMaster University (Hamilton, Ontario).

McMaster researchers have discovered that the widespread use of medications that contain fever-reducing drugs may lead to tens of thousands more influenza cases, and more than a thousand deaths attributable to influenza, each year across North America. These drugs include ibuprofen, acetaminophen and acetylsalicylic acid.

“When they have flu, people often take medication that reduces their fever. No-one likes to feel miserable, but it turns out that our comfort might be at the cost of infecting others,” said lead author David Earn, an investigator with the Michael G. DeGroote Institute for Infectious Disease Research (IIDR) and professor of mathematics at McMaster University.

“Because fever can actually help lower the amount of virus in a sick person's body and reduce the chance of transmitting disease to others, taking drugs that reduce fever can increase transmission. We’ve discovered that this increase has significant effects when we scale up to the level of the whole population.”

The study, published in the Proceedings of the Royal Society B on Tuesday, was co-authored with McMaster professors Ben Bolker, of the departments of mathematics & statistics and biology and the IIDR, and Paul Andrews of the Department of Psychology, Neuroscience and Behaviour.

“People often take -- or give their kids -- fever-reducing drugs so they can go to work or school,” Professor Earn said. “They may think the risk of infecting others is lower because the fever is lower. In fact, the opposite may be true: the ill people may give off more virus because fever has been reduced.”

From left to right: Ben Bolker, David Earn and Paul Andrews

The researchers assembled information from many sources, including experiments on human volunteers and on ferrets (which are the best animal model for human influenza). They then used a mathematical model to compute how the increase in the amount of virus given off by a single person taking fever-reducing drugs would increase the overall number of cases in a typical year, or in a year when a new strain of influenza caused a flu pandemic.

The bottom line is that fever suppression increases the number of annual cases by approximately 5% —corresponding to more than 1,000 additional deaths from influenza in a typical year across North America.

“This research is important because it will help us understand how better to curb the spread of influenza,” said David Price, professor and chair of family medicine for McMaster’s Michael G. DeGroote School of Medicine.

The family physician agrees with the researchers’ conclusions. “As always, Mother Nature knows best. Fever is a defence mechanism to protect ourselves and others. Fever-reducing medication should only be taken to take the edge off the discomfort, not to allow people to go out into the community when they should still stay home.”

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