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Medical Herbalists express concern over IMB recommendations on Echinacea.

The recent recommendation by the Irish Medicines Board (IMB) that products containing Echinacea should not be given to children under 12, has caused a great deal of distess to parents who have effectively used it in the past for preventing infections in their children.
The IMB’s recommendation has unfortunately lead to sensationalist reporting in the media, that “children under 12 can experience serious side effects”. However, the decision is actually based on an extremely small risk of allergic reaction in people who are also prone to conditions such as asthma, hayfever or other allergies. This risk is much smaller than the risk of severe allergy to other substances regularly given to children, such as peanut-containing products. There is also a significant risk of severe allergic reactions to many other medicines used in children, such as antibiotics and infant nurofen, the use of which will almost certainly increase as a result of this decision.

The main research paper on which this decision appears to have been based was published in 2002[1]. It detailed only five adverse reactions in adults, and it was not a controlled study.  Furthermore, there have been no reports of severe allergic reactions in the intervening years. The Irish Institute of Medical Herbalists, which is the leading professional body for Medical Herbalists in Ireland, considers the IMB’s decision to be an over-reaction to a small risk, especially when the IMB itself has indicated that ‘this is not a serious safety issue’ and that ‘parents should have no concerns if they have given Echinacea to children under 12 in the past’.

Medical herbalists have extensive clinical experience using this herb, and consider it to be very effective for preventing infections in both adults and children. Contrary to some reports in the media, there is also scientific evidence to support the efficacy of Echinacea in the treatment of respiratory tract infections[2], and for the prevention of these infections in children[3].

Although products containing Echinacea for children under 12 are currently not available over the counter, it is hoped that this decision will be reversed, and that more appropriate measures to address the small risk of allergic reaction will be considered. For example, Echinacea-containing products could carry a warning on the label that they may cause severe allergic reaction in people who are prone to allergies and who have never taken Echinacea in the past. In the meantime, Medical Herbalists will continue to prescribe Echinacea in the appropriate circumstances, since all patients are routinely screened for conditions such as asthma, hayfever and other allergic tendencies.

[1] Mullins, R.J. & Heddle, R. (2002). Adverse reactions associated with echinacea: the Australian experience. Annals of Allergy, Asthma and Immunology 88(1):42-51.

[2] Hudson, J.B., (2012). Applications of the Phytomedicine Echinacea purpurea (Purple Coneflower) in Infectious Diseases. Journal of Biomedicine and Biotechnology. [online] http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3205674/?toolDpubmed.

[3] Weber, W., Taylor, J.A., Stoep, A.V., Weiss, N.S., Standish, L.J. & Calabrese, C. (2005). Echinacea purpurea for prevention of upper respiratory tract infections in children.The Journal of Alternative and Complementary Medicine. 11(6): p.1021-1026.