Ah, the dreaded childhood viral infection, chickenpox. As a parent, it makes me itch just writing about it. Chickenpox is a viral infection in which a person develops extremely itchy blisters all over the body. It used to be one of the classic childhood diseases. However, it has become much less common since the introduction of the chickenpox vaccine.
Thanks to social media, ‘chickenpox parties’ – where when one child comes down with the disease, a bunch of mothers gather their kids to join the infected child for a sleepover – are becoming popular again. The hope is that all the kids will it at the same time, and then get it over with, and never get it again. It’s based on the myth that’s traveled all around the internet that a case of chickenpox provides more and/or better immunity than the vaccine does. This is untrue.
While there is widespread understanding that the classic childhood diseases of mumps, measles and rubella (i.e. German measles) which often leads to serious illness, there’s an unfortunate misconception that chickenpox is not all that serious. Though chickenpox is indeed fairly benign in most children, it is more severe in adults (and can lead to brain encephalitis) and can potentially cause birth defects if contracted by pregnant women. For the immunosuppressed, it spells disaster.
Today, information on the chickenpox front has been confusing to say the least. In 1996, we read that the zoster vaccine administered as a child could make one more vulnerable to shingles later in life. Then, last week we learned from a retrospective epidemiologist study of 2.8 million people that the apparent rise in the incidence of shingles was occurring before the single vaccine was in use; therefore not related to the vaccine.
The Shingles Continuum
Chickenpox is a skin manifestation of varicella zoster virus, one of eight different forms of the herpes family. It presents either as chickenpox (herpes zoster) in children or shingles (herpes zoster) in adults who had chickenpox as children.
Chickenpox is highly contagious and characterized by up to 500 small, very itchy round blisters (whose appearance resembles ‘dewdrops on a rose petal’) anywhere on the skin. It lasts for two to three weeks and afterwards leaves a child with lifetime immunity to chickenpox. However, like all herpes viruses, varicella zoster never leaves the body dwelling in nerve ganglia (bundles of nerves) in the central nervous system. In later years, due to emotional or physical stress such as pneumonia, it may rear to life again as shingles.
Two things have been worrying physicians about shingles:
- Shingles – an extremely painful condition involving the nerves on one side of the body that manifests along those pathways as a red rash and blisters on the skin – has always been considered a disease of the elderly. Yet large numbers of younger and younger people are getting it.
- The other worrying phenomenon is that one bout of shingles, typically running its course in three to five weeks, was previously thought to be all one person would get in a lifetime, though extreme pain and nerve damage could last for years afterward. But now we’re seeing patients who are getting it more than once.
Vaccination Notes
As for me, a physician and a mother, I urge you to immunize your children with the two-dose program against chickenpox. Ideally, the first dose should be at 15 months and the second between four and six years, though there is a lot of flexibility in this. As a physician, I urge all adults over the age of 50 to be immunized against shingles as well.
The vaccinations Varivax for chickenpox and Zostavax for shingles are not the same thing and should not be confused. To learn more the Centers for Disease Control describes them both. www.cdc.gov/vaccines/vpd-vac/shingles/hcp-vaccination.htm
Remember, chickenpox and shingles happen but they don’t have to show up on your skin.
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