Myths 3.2 Chickenpox “the disease can be severe”
Filed under: CDC Watch, Parents' Pages, Vaccine Myths, Vaccine/Disease Analysis
Parents who take their children to chicken pox parties have forgotten how devastating this childhood disease can be according to vaccination experts:
“What happens if you bring your child to a chicken pox party and they’re the one in 10 who has a complication and is hospitalized?” said Dr. Jane Zucker, head of the city Health Department’s immunizations bureau.
We went back to 1951, when chickenpox afflicted millions of children every year in the U.S. to see if complications and hospitalization from chickenpox were common:
In general, chickenpox is a disease of young children and in them it usually runs an uneventful, if uncomfortable, course without leaving behind it any permanent bad effects. In very rare instances, a case of encephalitis or inflammation of the brain may occur after chickenpox, causing such symptoms as sleepiness, stiff neck, convulsions, coma, and even death.
Ordinarily, however, chickenpox is a mild though highly contagious disease…
This view of chickenpox as mild continued to exist in the U.S. for many years as this two part video snippet illustrates.
In countries where universal vaccination for chickenpox has not yet been implemented, you can find information for parents like this example, from the UK:
Chicken pox is a highly infectious but usually mild, disease caused by the herpes group of viruses. The virus is spread either by direct contact with the rash or by droplets expelled into the air by coughing or sneezing.
Chicken pox tends to affect children under ten. Most children have had the infection by this age. In older children and adults, chicken pox can be more severe.
Chicken pox occurs worldwide and is seen throughout the year in areas with temperate climate, peaking during the months of March through May. 90% of cases are seen in children aged 14 years and younger.
Before the vaccine was invented, doctors even asked if a vaccine was necessary to prevent this childhood illness:
However there is no immunization against chickenpox (varicella), and many doctors believe that none is necessary.
By 1993 a vaccine was imminent and the discussion was lively:
Ever since vaccines consigned measles, mumps, rubella and polio to the history books, chickenpox has been the only major childhood illness that parents weather with their children.
Now a chickenpox vaccine that has proved safe and 97 percent effective in trials in children may be about to enter the U.S. market. But as eager parents await news of its release, doctors and federal officials are hesitating about whether to use it. Scientists worry that the vaccine’s immunity may wane, so that those who avoid chickenpox in childhood might get it as adults, when it is more serious. They have also raised the theoretical concern that the vaccine, made of a live weakened form of the chickenpox virus, might cause symptoms.
But they are all struggling with a subtler question: Is chickenpox bad enough that all children should avoid it?
Today the CDC is absolutely clear on the devastating results of unchecked chickenpox.
Chickenpox in children is usually not serious. Why not let children get the disease?
It is not possible to predict who will have a mild case of chickenpox and who will have a serious or even deadly case of disease. Now that there is a safe and effective vaccine, it is not worth taking this chance.
However, the CDC tells a different story in the Pink Book which is meant for health professionals:
The clinical course in healthy children is generally mild, with malaise, pruritus (itching), and temperature up to 102°F for 2 to 3 days. Adults may have more severe disease and have a higher incidence of complications. Respiratory and gastrointestinal symptoms are absent. Children with lymphoma and leukemia may develop a severe progressive form of varicella characterized by high fever, extensive vesicular eruption, and high complication rates. Children infected with human immunodeficiency virus also may have severe, prolonged illness.
So which is it, CDC? Is chickenpox now a potentially serious or even deadly disease in children with no way to predict when problems will arise?
Or is it a mild illness in healthy children?
There are steps parents can take to prevent chickenpox complications. This news story indicates one simple method of reducing the severity–don’t give fever reducers:
Parents who treat their children with acetaminophen to reduce the fever of chickenpox may unwittingly prolong the illness by defeating the virus-fighting benefits of an elevated body temperature, physicians at John Hopkins Children’s Center have concluded.
The course of chickenpox can vary, but, as this series is demonstrating, the description of childhood illnesses takes a sharp turn for the worse once a vaccine is available.
Added note: A reader asked if the 1 in 10 hospitalization rate for chickenpox is correct. I did a cursory search on PubMed and turned up this article.
The complication rate was 29.2 cases/10,000 cases of varicella.
One in 10 would work out to 1,000 complications per 10,000 cases of varicella. Dr. Zucker was off by roughly 970. Oh well.