Monday, March 17, 2014

Chicken pox? Chicken pox!

There are still parents who, although generally vaccinating, question the need for a chicken pox vaccine. They do think of chicken pox as a harmful rite of passage, a handful of pox, crusted over in a few days - about as "dramatic" as in this child:

Windpocken

the benefit is assumed to be life long immunity (which it is, for about 90% of patients). Problem is - these are chicken pox, too:

 auchWindpocken

Hundreds of lesions, the entire back covered, incredibly painful, the infection so severe that the child had to be committed to the hospital, like 2000 of her peers in pre-vaccine Germany per year, on average for 5 days, 77% without pre-existing conditions. Chicken pox cases neurological complications (25.4% of hospitalisations), skin infections (23.2%) and gastrointestinal complications (15%), indeed, pox can be internal as well. About 20 per year died.

There is nothing to predict whether your child will be in the top group - "chicken pox? What's the fuss about?", or in the bottom group "chicken pox?! Looks like small pox to me!".  

That is why vaccination is worth it!

6 comments:

  1. I had initially decided against vaccinating for chicken pox, for reasons that I really can't support now that I know better, but changed my mind not terribly long after my mother had a bout of shingles. I'm almost ashamed that it took that for me to change my mind. My kids are now properly vaccinated.

    In one of my classes last year, I met someone who had had encephalitis as a result of chicken pox. While, by then, I understood the disease better, I'd never actually known anyone who had complications from it (aside from scarring.) But they're out there. I can't imagine how terrifying that must have been for that person's parents.

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  2. There was actually a girl in my brother's class who had the pox inside her mouth and throat. It left her not only susceptible to respiratory infections she also has trouble clearing them.

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  3. Something sad (that a physician would say this based on a small study) is this abstract about varicella rates in children with cancer in Argentina, where varicella vaccination is not a national recommendation. As the authors didn't see a lot a varicella in these children, they end their abstract ridiculously saying that maybe it's better to let them have chicken pox rather than vaccinate. Thankfully, a very common sense rebuttal was posted as part of the article: http://www.healio.com/pediatrics/vaccine-preventable-diseases/news/online/%7B6a92a406-d260-4e0f-9ae0-f21316b97148%7D/incidence-of-varicella-zoster-virus-infection-low-among-pediatric-cancer-patients

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    1. yikes - the older girl above was completely immuno-competent!

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    2. It bothers me that varicella gets no respect. One thing we need to be very thankful for is that the vaccine came out before MRSA emerged. I do not like thinking of what the hospitalization and death rates would be from secondary MRSA bacterial infections if we had the prevalence of chickenpox today that we did before the vaccine. Also, I've seen children with organ transplants (who are, of course immune suppressed to keep from rejecting the transplanted organ) battle varicella infection where the decision is between backing off the immune suppression (to fight varicella, but then you could lose the transplanted organ to rejection) or hope that the patient can fight off the varicella while immune suppressed and not have it spread to their brain or lungs, which can be fatal. It's a lousy situation, and when I see parents who are stupid about vaccines and care not a whit about anything than their own offspring-centric view of the world, it gets me mad.

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    3. you know that and I do, the general public is blissfully unaware though. The daughter of a friend of mine had a retinoblastoma and another family "imported" chicken pox into the children's cancer rehab center they spent a week at. The level of congnitive disconnect that must have taken...

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