Sir, – Prof Shaun R McCann (April 23rd), writing in response to the Savita Halappanavar case, incorrectly states that the only indication to use antipyretics such as paracetamol is in children under two years, as a means of preventing fits (febrile seizures). This is an unfortunate perpetuation of one of many myths surrounding fever and febrile illness in children (another, for example, is that the higher a fever is, the more likely the child has a serious illness).
There is no evidence that use of any antipyretic will prevent or reduce the risk of febrile seizures in children. Equally, there is nothing incorrect with prescribing antipyretics to patients with fever, as nearly any adult or parent will tell you that, in the main, bringing down a fever makes you/your child feel better, and that’s a very acceptable outcome.
Where Prof McCann and I fundamentally agree is that the first, and overriding, focus of any clinician assessing a patient with fever is to identify the cause of said fever. Giving patients antipyretics thereafter is perfectly acceptable. It is in another myth that problems often arise, namely that the patient whose fever responds to a drug such as paracetamol is therefore less sick than the patient whose fever remains. – Yours, etc,
Prof RONAN O’SULLIVAN,
Consultant in Paediatric
Emergency Medicine,
Cork University Hospital;
Director, Paediatric
Emergency Research Unit,
National Children’s
Research Centre, Dublin 12.
Sir, – Barry Walsh(April 23rd) states that a pregnancy with a foetus who has a fatal foetal abnormality has exactly the same effect on the mother as a normal foetus. This may be true from a physical point of view, but I would suggest it can have a totally different effect on the mother from a psychological and mental point of view.
To know possibly for six to seven months of a pregnancy that you are bearing a non-viable baby with a fatal foetal abnormality must be devastating; compounded by well-meaning friends not in the know asking questions such as, “Is it a boy or girl . . . when is it due?”. I would respectfully suggest that only those who have experience of this situation at close quarters can adequately comprehend, and comment on, such a situation. – Yours, etc,
Dr DOUGLAS BOWIE,
Pine Valley, Dublin 16.