Childhood Illnesses Up Close: Chicken Pox

Did you contract chicken pox as a child? I know I did. It was a basic thing to do in childhood. Adults were worried about you if you didn’t get it when you were little. They said it was much worse to get it as an adult. I remember that it itched and made icky red spots on my skin that I was repeatedly reminded not to scratch. I don’t remember being all that miserable, I don’t remember it lasting all that long, and I don’t remember any of the children I knew at the time having their lives threatened by it. Most importantly, I remember being told that if you got it once, you’d never get it again {unless there was something really wrong with you}.

But let’s see if what I think I remember is entirely, or even remotely, accurate.

What is chicken pox?

According to the Centers for Disease Control and Prevention {CDC}, the disease is caused by the varicella zoster virus. Symptoms include

A skin rash of blister-like lesions, covering the body but usually more concentrated on the face, scalp, and trunk. Most, but not all, infected individuals have fever, which develops just before or when the rash appears. If exposed, persons who have been vaccinated against the disease may get a milder illness, with less severe rash {sometimes involving only a few red bumps that look similar to insect bites} and mild or no fever.

Chicken pox is, according to Dr. Anthony Papadopoulos, air born, which surprised me. Apparently, a person can contract the infection by touching the sores of an infected person, but this sort of thing is rare. What is more common is catching chicken pox from “contaminated respiratory droplets” much in the way one would catch a cold or flu virus.

In my research, I didn’t find any evidence that chicken pox itself is all that dangerous. Issues arise when there are complications. In normal, healthy children, complications are rare, usually “manifesting as impetigo, cellulitis, or erysipelas.” Around 1 in 80,000 healthy children who get chickenpox die as a result of the disease. In rare cases, “[l]ocalized bacterial superinfection may…result in septicemia, culminating in a secondary bacterial pneumonia, otitis media, or necrotizing fasciitis.” I am assuming these rare cases include children with leukemia, who are predisposed to having complications should they contract the virus.

Also, there are certain risks involved if a pregnant woman were to contract the virus during a pregnancy:

Maternal chickenpox during pregnancy may produce latency of the VZV virus in the dorsal root ganglia of the fetus. These children may remain asymptomatic, or they may develop herpes zoster at a young age without previous history of primary chickenpox infection. Primary maternal chickenpox infection during the first 20 weeks of gestation may also rarely produce the congenital varicella syndrome, which is characterized by limb hypoplasia, muscular atrophy, skin scarring, cortical atrophy, microcephaly, cataract formation, and rudimentary digits.

Again, I see the benefits of having gotten chicken pox out of the way as a child!

In my research, it became quite evident that those whose immune systems are compromised or suppressed {which can include being suppressed by anti-rejection drugs due to some type of transplant} are the ones who are in danger of complications. These complications include varicella pneumonia, myocarditis, hepatitis, and glomerulonephritis. Also, nervous system reactions such as Reye syndrome, Guillain-Barré syndrome, acute cerebellar ataxia, and encephalitis.

That was interesting to me, since Guillain-Barré syndrome is often associated with vaccine injury. Perhaps it is simply that these viruses do damage to some patients?

Lastly, there are some instances in which the chicken pox becomes malignant {cancerous}. The death rate in these cases is around 70%.

So, to summarize my research: in normal children, chicken pox is fairly benign. However, if you have reached puberty and/or have some sort of immune system dysfunction, be prepared for a dangerous ride.

Is chicken pox treatable?

I was surprised to learn that there are a number of medicines available to assist those for whom the disease is dangerous:

1. Varicella-zoster immune globulin offers what is called “passive immunization” and is used on immunocompromised or immunosuppressed populations. “When given within 96 h of exposure, can modify the course of disease but does not prevent it. Maximal effectiveness is seen with administration as soon as possible after exposure.”
2. Antiviral agents including Acyclovir, which inhibits viral activity and may prevent recurrent outbreaks in patients whose immune systems are defective, as well as Famciclovir, which is thought to inhibit viral replication. There is also Valacyclovir, which is similar to Acyclovir, more expensive, but apparently “has a more convenient dosing regimen than acyclovir.” These drugs, by the way, have not been confirmed as safe for pregnant women and their unborn children.

What are the possible side-effects of the vaccine?

If you have children, or know someone who does, then you are probably familiar with the existence of the varicella vaccine, often called “the chicken pox shot” by parents. Well, just like drugs, vaccines have side effects and risks associated. I can tell you from personal experience that the vaccine is not wholly effective. We have been exposed to a few chicken pox outbreaks over the years, and every single time, the outbreak began with a vaccinated child.

I chose to list the risks associated with the Varivax vaccine. This is the live, attenuated virus used by our own pediatrician. There are a couple other vaccines, including the Proquad, which combines measles, mumps, rubella, and chicken pox all in one. I would never, ever, ever give my child Proquad.

Ever.

Anyhow…

In children 1-12 years of age, there were few side effects:

In addition, the most frequently {³1%} reported adverse experiences, without regard to causality, are listed in decreasing order of frequency: upper respiratory illness, cough, irritability/nervousness, fatigue, disturbed sleep, diarrhea, loss of appetite, vomiting, otitis, diaper rash/contact rash, headache, teething, malaise, abdominal pain, other rash, nausea, eye complaints, chills, lymphadenopathy, myalgia, lower respiratory illness, allergic reactions {including allergic rash, hives}, stiff neck, heat rash/prickly heat, arthralgia, eczema/dry skin/dermatitis, constipation, itching.

Pneumonitis has been reported rarely {<1%} in children vaccinated with VARIVAX; a causal relationship has not been established.

Febrile seizures have occurred rarely {<0.1%} in children vaccinated with VARIVAX; a causal relationship has not been established.

In adolescents and adults aged 13 and up, side effects were:

In addition, the most frequently {³1%} reported adverse experiences, without regard to causality, are listed in decreasing order of frequency: upper respiratory illness, headache, fatigue, cough, myalgia, disturbed sleep, nausea, malaise, diarrhea, stiff neck, irritability/nervousness, lymphadenopathy, chills, eye complaints, abdominal pain, loss of appetite, arthralgia, otitis, itching, vomiting, other rashes, constipation, lower respiratory illness, allergic reactions {including allergic rash, hives}, contact rash, cold/canker sore. As with any vaccine, there is the possibility that broad use of the vaccine could reveal adverse reactions not observed in clinical trials.

Since the vaccine has been marketed, these additional complaints have been made:

Body as a Whole

Anaphylaxis in individuals with or without an allergic history.

Hemic and Lymphatic System

Thrombocytopenia.

Nervous/Psychiatric

Encephalitis; cerebrovascular accident; transverse myelitis; Guillain-Barré syndrome; Bell’s palsy; ataxia; non-febrile seizures; dizziness; paresthesia.

Respiratory

Pharyngitis; Pneumonia/Pneumonitis.

Skin

Stevens-Johnson syndrome; erythema multiforme; Henoch-Schönlein purpura; secondary bacterial infections of skin and soft tissue, including impetigo and cellulitis; herpes zoster.

Since very few normal, healthy children are actually threatened by chicken pox, I found it interesting that

[t]he safety and efficacy of VARIVAX have not been established in children and young adults who are known to be infected with human immunodeficiency viruses with and without evidence of immunosuppression.

Is the trade-off worth it?

Varicella is interesting because I’m not sure we have to see this as a trade-off. Many of the DAN! {Defeat Autism Now!} doctors are suggesting that, rather than automatically giving a child the shot, there should first be a blood test, called a varicella titer. If the child is already immune, there is no reason to vaccinate.

Because the vaccine was only introduced in 1999, there is no evidence of long-term efficacy. In fact, Yale researchers found that the effectiveness decreases significantly after the first year. If the vaccine wears off in the future, we are risking a number of adults getting sick at a time in life when the disease is much more threatening. However, once a child has had actual chicken pox, the IGG response is lifelong and efficacious {unless there is a compromised immune systems overall}.

The vaccine, according to Dr. Sears, “should not be given to persons allergic to any component of the vaccine, such as neomycin and gelatin. The vaccine does not contain preservatives or egg protein, so that egg allergy is not a contraindication to getting the VV. [It should not be given to] persons with immuno-deficiencies, such as HIV or leukemia, persons taking large doses of cortisone, or persons on any medications that lower the immune system.”

We do not get the chicken pox shot any longer. Our reason for this is that there is no ethical version of the vaccine available at this time.

Parting thoughts

In my research, I found that much of the information out there encouraged vaccinating children because chicken pox was “annoying.” When children get sick, their parents, who apparently have better things to do with their time than be hassled by sick children, are “stranded at home” {according to one site}. My personal belief is that the varicella vaccine exists for our convenience more than anything else. It is a symptom of a culture where mothers do not want to be bothered by their children.

This is, my friends, looking at the vaccine as and idea rather than merely trying to decide whether or not to get it.