BMJ Press Releases, Saturday 31 August 1996
Volume 313 No 7056

EMBARGOED 00.01 HRS 30 AUGUST 1996

TEMPORARILY DISABLING NEUROPSYCHIATRIC SIDE EFFECTS AFTER TAKING THE ANTI-MALARIAL DRUG MEFLOQUINE (LARIAM) ARE MORE COMMON THAN PREVIOUSLY THOUGHT

[Comparison of adverse events associated with use of mefloquine and combination of chloroquine and proguanil as anti-malarial prophylaxis: postal and telephone survey of travellers]

The anti-malarial drug mefloquine (Lariam) is more effective than the older combination of proguanil (Paludrine) and chloroquine, but a paper in this week's BMJ reports a higher incidence of neuropsychiatric side effects in people taking mefloquine.

Researchers at the Medical Advisory Services for Travellers Abroad (MASTA) and the London School of Hygiene and Tropical Medicine followed up travellers who had been advised to take either mefloquine or the older combination of chloroquine and proguanil. They found that although both groups had an equal chance of experiencing a side effect of some description, one in 140 of those taking mefloquine experienced a temporarily disabling neuropsychiatric side effect severe enough to prevent them from carrying out their day-to-day activities. The equivalent rate for the combination of chloroquine and progunanil was one in 1,100.

Previous reports have shown that only one in 10,000 people suffered from "serious" side effects after taking mefloquine, but the authors point out that a particular definition of "serious" was used which excluded many people who suffered very unpleasant side effects.

The authors conclude that the risk of side effects must be balanced against the risk of contracting malaria but that these findings suggest that mefloquine should be reserved for those at high risk of contracting chloroquine resistant malaria.

Contact: Dr Paul Clarke

Medical Advisory Services for Travellers Abroad Ltd
Keppel Street
London WC1E 7HT

Tel: 0171 436 6104
Fax: 0171 323 4547

PEANUT ALLERGY IS BECOMING MORE COMMON AND ITS ONSET IS HAPPENING EARLIER

[Peanut allergy in relation to heredity, maternal diet, and other atopic diseases: results of a questionnaire survey, skin prick testing, and food challenges]

Allergy to peanuts is the most common cause of deaths related to food allergy. The results of a nationwide questionnaire survey, published in this week's BMJ, shows that the apparent epidemic in peanut allergy is a reflection of the general increase in other allergies over the past two decades. They studied 622 people with peanut allergy. Their figures show an increase over the generations - three out of 2409 grandparents, 19 out of 1,218 parents, 42 out of 609 brothers and sisters of the people with peanut allergy .

The authors, who included in their research skin prick tests on 50 children, say that increased consumption of peanuts by pregnant or breastfeeding mothers may be the reason why children are developing the allergy earlier. They also conclude that brothers and sisters of people who are allergic to peanuts are at an increased risk of also becoming allergic.

Contact: Dr Jonathan Hourihane

University Dept of Child Health
Nailpoint 803
Southampton General Hospital
Tremona Road,
Southampton SO16 6YD

Tel: 01703 794230/794887
Fax: 01703 796378
E-mail: jobh@soton.ac.uk

STUDY SHOWS ONE CHILD IN 100 IS ALLERGIC TO PEANUTS BY THE AGE OF FOUR

[Cohort study of peanut and tree nut sensitisation by the age of four years]

One in 100 children can become susceptible to peanut allergy by the age of four, according to the results of a study published in this week's BMJ. Peanut and tree nut allergy can develop in early childhood. It is likely to be life-long and has the potential to be life-threatening.

Parents are advised that young children should not eat whole nuts. There is also concern about hidden nuts in processed foods and improved labelling is needed, say the authors.

Researchers from the Isle of Wight in the UK followed a group of more than 1,200 children from birth to four years. Skin or blood tests showed 15 of the 1218 children (1.2 per cent) were susceptible to allergic reactions from peanuts or tree nuts. Six had allergic reactions to peanuts, one to hazelnuts and one to cashew nuts - three had anaphylactic (severe, frightening, life-threatening) reactions. Seven children had positive skin tests results to peanuts without clinical symptoms showing.

The authors suggest that babies born to allergic families are at high risk of developing peanut and tree nut allergy and should therefore avoid them. Children with allergy to peanuts invariably have another atopic (allergic) disorders such as eczema, asthma, rhinitis or allergy to eggs. They found that breast feeding and maternal ingestion of nuts were not associated with peanut allergy but call for further research into risk factors.

Contact: Dr Syed Tariq
Research fellow

Asthma and Allergy Research Centre and Dept of Biochemistry
St Mary's Hospital
Newport
Isle of Wight
PO30 5TG

Tel: 01983 822928
Fax: 01983 822569

Issued on behalf of the authors by: Public Affairs Division, British Medical Association, BMA House, Tavistock Square, London, WC1H 9JP
Telephone: 0171 383 6254, (between 08.30 - 18.00), (After 6pm & at weekends): 01895 239687, 0171 727 2897, 0181 674 6294, 0171 727 2897, 01491 651405

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