Trends in the clinical pattern of Reye’s syndrome in the British Isles between 1982 and 1990, and their relation to the June 1986 warnings against the use of aspirin in children, were analysed at the PHLS Communicable Disease Surveillance Centre, London, and other Centres in the UK. Of 445 cases reported, 354 had confirmed diagnoses and received scores of severity ranging from non-classical “Reye-like” (low scorers) to classical Reye’s syndrome (high scorers). Classical cases occurred more frequently in the 4 1/2 year period before June 1986 compared with the subsequent period of surveillance. After June 1986, non-classical cases declined by 50% and classical by 79%. Classical, high scorers had received aspirin more frequently and were older than low scorers. 
COMMENT. Reports of Reye’s syndrome declined in the surveillance period between 1982 and 1990, with a greater reduction in the number of classical Reye’s syndrome cases than non-classical Reye-like cases after aspirin was withheld in 1986. Cases of classical Reye’s syndrome were older and were more likely to have received aspirin. The authors conclude that their findings support a subset of Reye’s syndrome but not all cases etiologically associated with aspirin. An inherited metabolic disorder is more likely in the Reye-like, non classical cases.