Abstract
Anecdotal observations that what we now know as Reye's syndrome (RS) was associated with ingestion of salicylates preceded the definition of this syndrome.1Reye and coworkers2first delineated the syndrome of encephalopathy and fatty degeneration of the viscera following a mild viral illness. We now know that RS follows influenza (particularly type B), chickenpox, and other viral illnesses. It occurs with an annual incidence of one to two children per 100,000 persons younger than 18 years. Of this total, 221 to 551 cases were reported per year for the years 1973 through 1981, with a death-to-case ratio of 22% to 42%. After many descriptive studies of RS, a variety of etiologic hypotheses have been entertained, including insecticides and related chemicals, aflatoxins, and salicylates.3 Case-control epidemiologic studies were initiated in three separate states to investigate many possible associations with RS. The first was by Starko and colleagues4
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