Monday, November 3, 2014

Chicken Pox

In "the old days", parents expected their children to catch chicken pox.  Everyone got it.  It was not considered to be a big deal.  Starting with red spots, then blisters on the trunk, it could evolve into hundreds of blisters all over the body.  It itched.  It sometimes scarred.  It took several days for the rash to get crusts and be declared, five or six days later, non-contagious (suitable for return to school, church, scout meetings, etc.).  If there were several children in a family, they could get chicken pox sequentially and result in prolonged absence from work by the care-taking parent(s).  Schools might experience a prolonged period of absenteeism as the infection went through the grades.  

The Center for Disease Control has a web page for the public about chicken pox (varicella virus) here and the chicken pox vaccination here.  A more detailed report for health care professionals is here, starting with this paragraph:  "Varicella (chickenpox) is a febrile rash illness resulting from primary infection with the varicella-zoster VIRUS (VZV). Humans are the only source of infection for this virus. Varicella is highly infectious, with secondary infection occurring in 61%-100% of susceptible household contacts.[1-5] Transmission occurs from person to person by direct contact with persons with either varicella or herpes zoster (shingles) lesions or by airborne spread from respiratory secretions or lesions of persons with chickenpox. The incubation period for varicella is 10-21 days, most commonly 14-16 days. Varicella is characterized by a pruritic, maculopapular vesicular rash that evolves into noninfectious dried crusts over a 5- to 6-day period."

So, what's your approach to chicken pox?  The initial vaccine is recommended for one year olds with a booster later per the CDC schedule.  A lot of people just want their child to get the chicken pox "naturally", which is hard to do when the majority get the vaccine, so they wait for them to get exposed.  If they don't get the chicken pox, they may decide to go ahead with the immunization, or they may decide to download a form from the Ohio Department of Health to submit to the school nurse opting out of the vaccination.  Ohio is one of thirteen states that lets parents opt out of any or all immunizations.

The decisions about chicken pox are simple and complex.  We study a lot about infectious diseases, the immune system, immunizations and human behavior to help people with decisions about vaccine preventable diseases. Chicken pox is a good example.

What do you think?

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