Tag: complications

Who Dies from Chicken Pox?

Chicken pox is supposed to be a mild disease, right?

A rite of passage for kids?

“My life changed forever on June 30, 1988, when I had to stand by helplessly as an infectious disease claimed the life of my oldest child, Christopher Aaron Chinnes, at the age of 12.”

Rebecca Cole on Chickenpox Claimed the Life of My Son Christopher

Sure, a deadly rite of passage that we had to hope that our kids got through unscathed…

Who Dies from Chicken Pox?

Believe it or not, some folks continue to think that chicken pox was never deadly, even as kids continue to die from this now vaccine-preventable disease.

Remember, the chicken pox vaccine was added to the vaccine schedule way back in 1996, after being licensed in 1995.

Chicken pox can kill quickly.
Chicken pox can kill quickly.

Tragically, there are plenty of stories and case reports that prove them wrong:

  • a previously healthy, unvaccinated 23-month-old boy developed chicken pox and died three weeks later after developing sepsis, possible viral meningoencephalitis, bacterial endocarditis, and heart failure. (1996)
  • a previously healthy, unvaccinated 21-month old developed chicken pox and died four days later because of hemorrhagic complications (1997)
  • an unvaccinated 5-year-old boy with asthma was treated with one dose of prednisone at home for an asthma attack while recovering from chicken pox and died the next day (1997)
  • a healthy, unvaccinated 6-year-old boy developed chicken pox, was hospitalized three days later, and died the next day (1998)
  • an 8-year-old being treated for leukemia developed chicken pox and died two weeks later (1998)
  • an unvaccinated 9-year-old girl was exposed to an unvaccinated children with chicken pox in after-school child care and school, developed chicken pox and died three days later with secondary cellulitis and sepsis. (2002)
  • a previously healthy, unvaccinated 11-year-old girl developed septic shock and died soon after being admitted to a Pediatric Intensive Care Unit. (2002)
  • an unvaccinated 12-year-old boy was exposed to an unvaccinated classmate with chickenpox, developed chicken pox two weeks later, was admitted to the hospital after three days because of trouble breathing, and died on his second hospital day after suffering a cardiopulmonary arrest. (2003)
  • an unvaccinated 10-year-old girl developed chicken pox, with worsening 10 days later, including ataxia and mental status changes. After being hospitalized for three days, she began to have seizures  and was declared brain dead the next day. (2004)
  • an unvaccinated 14-month-old girl developed chicken pox and worsened over the next three to five days. She eventually developed septic shock, was treated in an ER, and died within one hour of being transferred to a children’s hospital for further care. (2004)
  • a previously healthy, unvaccinated 15-year-old developed chicken pox, was admitted to the hospital three days later in septic shock, and died three weeks later. (2009)
  • a partially vaccinated 4-year-old girl who was being treated for acute lymphoblastic leukemia (ALL) was exposed to a cousin with chicken pox and later developed multi-organ failure and died (2012)

Chicken pox has always been a deadly disease.

“In the prevaccine era, approximately 11,000 persons with varicella required hospitalization each year. Hospitalization rates were approximately 2 to 3 per 1,000 cases among healthy children and 8 per 1,000 cases among adults. Death occurred in approximately 1 in 60,000 cases. From 1990 through 1996, an average of 103 deaths from varicella were reported each year. Most deaths occur in immunocompetent children and adults”

Epidemiology and Prevention of Vaccine-Preventable Diseases

Although chicken pox is definitely riskier if you are older and have pre-existing medical problems, as you can see from these kids who died, many were otherwise healthy and many were very young.

And almost all were unvaccinated, even though a safe and effective chicken pox vaccine could have prevented these deaths and probably the exposures that led to the deaths of the high risk kids being treated for cancer.

More on Chicken Pox Deaths

Believe It or Not, Chicken Pox Parties Are Still a Thing

Do you remember having chicken pox?

Oh boy, I sure do!

I was about six or seven years old and it was bad. Still, I’m not sure if I remember because I had such a bad case or because it made me miss Halloween that year.

It was almost certainly both, as I remember being covered in spots from head to toe.

What I don’t recall is having many visitors. Why didn’t my mom throw me a chicken pox party!

I also don’t remember going to a chicken pox party to get sick.

Believe It or Not, Chicken Pox Parties Are Still a Thing

Whether or not chicken pox parties were ever that popular, the approval of the chicken pox vaccine in 1995 should have put an end to the practice.

After all, why intentionally expose your child to a potentially life-threatening disease, when a safe and effective vaccine is readily available?

“Chickenpox (varicella) is generally a much milder illness in children than in adults, with considerably lower rates of severe disease and death. Varicella is also virtually universal in many populations, meaning that very few individuals escape infection over a lifetime. Thus, a sound logic underlies the idea of chickenpox parties, at which susceptible children can acquire the contagious causative pathogen, varicella zoster virus (VZV), from their peers. However, chickenpox is not without risks, even for children of this age; severe, complicated, and occasionally fatal varicella occur in previously healthy children, as well as the immunocompromised (who are at very considerable risk).”

Hambleton et al on Chickenpox Party or Varicella Vaccine?

Most folks understand that. They get their kids vaccinated and have helped get chicken pox under very good control, with outbreaks of chicken pox declining over 95%.

“Each year, more than 3.5 million cases of varicella, 9,000 hospitalizations, and 100 deaths are prevented by varicella vaccination in the United States”

CDC on Monitoring the Impact of Varicella Vaccination

Apparently, not everyone has gotten the message though.

Remember when CPS had to investigate the mom who was having chicken pox parties in Plano, Texas a few years ago?

“On the page, parents post where they live and ask if anyone with a child who has the chicken pox would be willing to send saliva, infected lollipops or clothing through the mail.”

CBS 5 Investigates mail order diseases

Or when anti-vaccine folks were selling and mailing lollipops contaminated with chicken pox to folks so that they could skip the trouble of finding a chicken pox party?

And then there’s that time that a family served chicken pox contaminated punch at their chicken pox party. Oh wait, that was The Simpsons

Chicken pox party - The Simpsons did it.
Chicken pox party – The Simpsons did it in the Milhouse of Sand and Fog episode in Season 17.

So what are they up to now?

Folks are still advertising chicken pox parties in anti-vaccine Facebook groups.
Folks are still advertising chicken pox parties in anti-vaccine Facebook groups.

More of the same…

Does she know that the chicken pox vaccine likely decreases your risk of getting shingles later in life?
Does she know that the chicken pox vaccine likely decreases your risk of getting shingles later in life?

Apparently, there are still plenty of folks looking for chicken pox parties to infect their kids.

Why?

It is easy to see a lot of cognitive biases at play in the decision to host or bring a child to a chicken pox party, including ambiguity aversion (prefer what they think are the known risks of getting the disease), bandwagoning (they think everyone else is doing it, because in their echo chambers of anti-vaccine propaganda, everyone might), and optimism bias, etc.

There is also a very poor perception of risks, as the risks from a natural chicken pox infection are far, far greater than any risk from the vaccine.

Don't forget to tent!!!
Don’t forget to tent and share breath!!!

In bigger news, Facebook has groups who’s mission is “finding pox,” so that parents can get their kids sick!

The mission of PX Colorado is finding pox!
The mission of PX Colorado is finding pox!

How many other PoX type groups are there on Facebook?

How many other parents are intentionally not vaccinating their kids and intentionally exposing them to chicken pox?

Do any of them quarantine or isolate their kids for 10 to 21 days after the chicken pox party, so as to not expose anyone who is too young to be vaccinated, too young to be fully vaccinated, or has a true medical exemption to getting vaccinated, including those who are immunocompromised?

Do they understand the consequences of having these pox parties?

The latest chicken pox party hostess is apparently a nurse - at least for now...
The latest chicken pox party hostess is apparently a nurse – at least for now…

Of course, an investigation from CPS, the health department, or a medical board isn’t the most serious consequence that should discourage folks from hosting or attending a chicken pox party.

Chicken pox can be a serious, even life-threatening infection. Sure, many kids just get a mild case, but others get more serious cases and have bad complications, including skin infections, encephalitis, sepsis, or stroke.

And some people do still die from chicken pox, which is supposed to be a mild, childhood illness.

“This report describes a varicella death in an unvaccinated, previously healthy adolescent aged 15 years.”

Varicella Death of an Unvaccinated, Previously Healthy Adolescent — Ohio, 2009

Fortunately, these deaths have been nearly eliminated thanks to the chicken pox vaccine.

And that’s why parents who are on a mission for “finding pox” should rethink things and switch to a mission to get their kids vaccinated and protected.

More on Chicken Pox Parties

Complications of Vaccine-Preventable Diseases

We know that vaccine-preventable diseases can be life-threatening.

In the pre-vaccine era, when these diseases were much more common, way too many people died, but still, most people did recover.

They didn’t always survive without complications though.

Tragically, we are starting to see more of these complications as more kids are now getting some of these vaccine-preventable diseases again.

Complications of Vaccine-Preventable Diseases

That we can prevent these serious complications is another benefit of getting vaccinated!

How serious?

Have you ever seen someone who has survived a meningococcal infection?

Do they always have all of their arms and legs?

How about their fingers and toes?

"Baby" Charlotte survived her battle with meningococcemia and continues to take on new challenges!
“Baby” Charlotte survived her battle with meningococcemia and continues to take on new challenges!

There is a reason that we say that you have to earn your natural immunity. You have to survive these diseases to get it. And you want to survive without any long-term complications, which can include:

  1. chicken pox – shingles, secondary bacterial infections, pneumonia, meningitis, encephalitis, seizures, transverse myelitis, Reye syndrome, neonatal varicella, congenital varicella syndrome
  2. congenital rubella syndrome – neonatal death, heart problems, deafness, cataracts, intellectual disability, liver and spleen damage, glaucoma, thyroid problems
  3. diphtheria – myocarditis, heart failure, nerve damage, muscle paralysis
  4. Haemophilus influenzae type b – meningitis, epiglottitis, pneumonia, osteomyelitis, cellulitis, hearing loss, brain damage, loss of limbs
  5. hepatitis A – can rarely lead to liver failure
  6. hepatitis B – chronic hepatitis B, cirrhosis, liver failure, liver cancer
  7. HPV – genital warts, cancer
  8. influenza – parotitis, pneumonia, myocarditis, encephalitis, myositis, rhabdomyolysis, multi-organ failure
  9. measles –pneumonia, seizures, encephalitis, SSPE
  10. mumps – orchitis (inflammation of the testicles), oophoritis (inflammation of the ovaries), pancreatitis, meningitis, encephalitis
  11. pneumococcal disease – pneumonia, mastoiditis, meningitis, bacteremia, sepsis, empyema, pericarditis, hearing loss, brain damage
  12. pertussis – pneumonia, seizures, apnea, encephalopathy, rib fractures
  13. polio – meningitis, paralysis, post-polio syndrome
  14. rabies – it is very rare to survive a rabies infection without treatment
  15. rotavirus – dehydration, intussusception
  16. rubella – arthritis, congenital rubella syndrome
  17. shingles – postherpetic neuralgia, pneumonia, hearing problems, blindness, encephalitis
  18. tetanus – seizures, laryngospasm, fractures, pulmonary embolism, aspiration pneumonia
  19. typhoid fever – intestinal perforation, internal bleeding, peritonitis, hepatitis, osteomyelitis, arthritis, meningitis, myocarditis,
  20. yellow fever – pneumonia, parotitis, sepsis

Anti-vaccine folks rarely talk about the complications of vaccine-preventable diseases. For that matter, they also often push the idea that vaccines don’t even work and that these diseases aren’t even vaccine preventable, don’t they?

Don’t believe them. Vaccines work and they are safe and necessary, especially if you want to avoid these diseases.

More on Complications of Vaccine-Preventable Diseases

What Are the Benefits of Natural Immunity?

In the pre-vaccine era, we had outbreaks of polio, and other, now vaccine-preventable diseases.
What are the benefits of getting polio?

Is natural immunity – the kind of immunity you get from actually getting a disease – better than immunity from a vaccine?

All things being equal, sure.

Unfortunately, all things aren’t equal when it comes to the question of natural immunity vs ‘artificial’ or vaccine induced immunity.

Vaccines are safe and have few serious side effects, while vaccine-preventable diseases can be life-threatening and can leave survivors with serious disabilities.

What Are the Benefits of Natural Immunity?

There are benefits of natural immunity.

If you get a disease, like measles or rubella, you typically have life-long immunity and won’t get it again.

That immunity comes at a price though.

In addition to being sick for a few days or weeks with the symptoms of the disease, many vaccine-preventable diseases can have serious complications. Most are life-threatening.

“…the high price of natural immunity, that is, occasionally severe and fatal disease, is a risk not worth taking.”

Paul Offit, MD

So instead of just getting a vaccine, you have to earn your natural immunity by surviving the disease and hoping that you don’t have any of these serious complications:

  • chicken pox can be associated with meningitis, encephalitis, secondary pneumonia, skin infections, and sometimes death, and folks who have had chicken pox are thought to be at higher risk for shingles than those who have had a chicken pox vaccine
  • diphtheria can cause myocarditis, neuritis, and diaphragmatic paralysis, and death in 5 to 20 percent of people
  • about 50 percent of children (and 90 percent of infants) with hepatitis B develop chronic hepatitis B infections and can later develop scarring of the liver (cirrhosis), liver failure, and liver cancer
  • Hib can cause hearing impairment, neurologic sequelae, and death in 2 to 5 percent of cases
  • measles can cause pneumonia, seizures, and encephalitis, and death in about 1 in 1000 cases and Subacute Sclerosing Panencephalitis (SSPE) is a fatal, late complication of natural measles infections and which might occur in as many as 1:1700 people who have had measles.
  • mumps can cause orchitis (testicular inflammation), oophoritis (ovarian inflammation), pancreatitis, meningitis, encephalitis, deafness, and sometimes death
  • pertussis can cause pneumonia, seizures, and encephalopathy, and death in 0.2 percent of cases.
  • polio can cause meningitis, flaccid paralysis, and death in 2 to 5 percent of children and 25 to 40 percent survivors are at risk for Post-Polio Syndrome, with new symptoms of pain, fatigue, and weakness developing later
  • rotavirus can cause severe diarrhea and dehydration and used to cause 20 to 60 deaths a year.
  • rubella can cause arthritis, thrombocytopenic purpura, and encephalitis, but the bigger concern is pregnant women who get rubella, which can lead to spontaneous abortions, neonatal deaths, and congenital rubella syndrome.
  • tetanus can cause generalized muscle spasms and death in 11 percent of cases. Neonatal tetanus is also a concern.

That’s why for most of us, there is no question.

Our kids are fully vaccinated and we are very glad that they have artificial immunity against measles, Hib, pneumococcal disease, and hepatitis B, etc.

Myths About Natural Immunity

And people shouldn’t get confused about “natural” immunity.

It doesn’t mean that you just wake up and have immunity against a disease one day naturally. Again, you have to earn that immunity, by getting sick with the disease and hoping you don’t have any complications, some of which can be life-threatening. That’s why it is silly to think about checking titers if you haven’t been vaccinated or had a disease already, even though some anti-vaccine people propose doing that.

Even the idea that getting an infection provides life-long immunity isn’t always true. It certainly isn’t for some diseases, like pertussis or tetanus.

And getting one type of an infection doesn’t always mean that you will be protected against others. There are three serotypes of polio, for example, and immunity is serotype-specific. You would have to get all three serotypes of polio to equal the protection of the polio vaccine!

Other myths about natural immunity you may hear include that it is good to have childhood diseases, like measles or diphtheria.

That is of course ridiculous.

“Vaccination has greatly reduced the burden of infectious diseases. Only clean water, also considered to be a basic human right, performs better. Paradoxically, a vociferous antivaccine lobby thrives today in spite of the undeniable success of vaccination programmes against formerly fearsome diseases that are now rare in developed countries.”

Andre et al on Vaccination greatly reduces disease, disability, death and inequity worldwide

In fact, we now know that people who survive a measles infection can have some immunosuppression for up to two to three years! This measles-induced immune damage puts them at risk of dying from other diseases and helps explain why kids who are vaccinated against measles are also less likely to die from other childhood infections.

That’s not a benefit that you can get without a vaccine. And since the risks from vaccines are so small, there is no benefit of seeking natural immunity over getting vaccinated.

What to Know About the Benefits of Natural Immunity

The benefit of natural immunity, developing life-long immunity, comes at such a high price that it is not worth skipping or delaying your child’s vaccines to get it.

More on the Benefits of Natural Immunity