by
KarenF
@ 2007-11-08 - 13:58:04
From BBC News:
Support for child chickenpox jabs
Vaccinating all children is the only way to prevent severe illness and death from chickenpox, researchers have said.
In one 13-month period in the UK and Irish Republic, there were six deaths and 112 cases of severe complications among children, they said.
Problems included blood poisoning and pneumonia and did not just affect those with other health problems, said teams including health experts from Scotland.
Ministers are awaiting a report on whether England should have a vaccine.
Chickenpox, caused by the varicella virus, is generally a mild infection and nine out of 10 cases happen in children under the age of 15.
However, rare but dangerous complications can happen in a small number of healthy children or those with other chronic health problems.
For every 1,000 children who catch chickenpox, on average between two and five of them will end up in hospital.
CHICKENPOX SYMPTOMS
Initially mild fever and headaches
Crops of red spots soon appear, which develop itchy fluid-filled central blisters
After a couple of days these scab over and dry up
In rare cases associated bacterial infection can lead to potentially fatal conditions, such as toxic shock syndrome
Other complications can include pneumonia, encephalitis and inflammation of the blood vessels
It should also be remembered that 1 in 10 cases will not be recognised due to lack of symptoms.
Various complications
Researchers from Health Protection Scotland and the universities of London and Bristol looked at cases over a 13-month period.
They found that the complications varied widely, with the most common being bacterial blood poisoning, pneumonia and encephalitis, and loss of muscle control.
Smaller numbers of patients suffered toxic shock syndrome or the "flesh-eating" infection necrotising fasciitis.
In total, there were six deaths, including one death of a baby in the womb.
The researchers, writing in the journal Archives of Disease in Childhood, concluded that the complications did not just happen in vulnerable children and that the only way to prevent them was to vaccinate all youngsters.
They wrote: "Universal vaccination would therefore be the only realistic option to prevent severe complications and deaths, as few, if any, could be identified as potentially preventable under the current UK policy."
Some of these serious complications could also be down to the lack of competence of medical staff. Often, staff are slow to recognise secondary infection: after all, even these researchers admit that it isn't chiken pox per se that causes these complications: it is usually secondary infections.
What isn't mentioned in this article also is that the average age of those suffering comlications is 3. This is an age when doctors often discount the concerns of mothers as they think they are being overprotective.
MMR extra
In an accompanying editorial, clinicians from Bristol Children's Hospital said that even if all children were not vaccinated, a smaller strategy of immunising teenagers who had not suffered the illness would prevent cases of severe disease in adults.
I've had chicken pox as an adult: it was the best illness I've ever had. I felt ill for a week, then had another three off while my spots disappeared (I was working with immunosuppressed patients at the time so I wasn't allowed back to work). Admittedly my boyfriend caught it then went on to have encephalitis, but that's the luck of the draw innit?
They said that one option for universal vaccination - adding the chickenpox jab to the existing MMR vaccine - might not win public support.
They also raised the possibility that rates of shingles, caused in adults by the same virus, might rise if all children were vaccinated against it.
Adults who have already suffered a bout of chickenpox do not usually develop it again, but the virus lives on in their nerves and if their immunity falls later in life, it can flare up as a painful rash.
However, living in households with children who have chickenpox acts as a "booster" to their immunity, and reduces the chances of a shingles attack.
Advice expected
Nigel Scott, from the Herpes Viruses Association, said: "If we had to choose between the two, we would advocate vaccinating the elderly, as shingles is far more likely to cause serious health problems in many more people than is chickenpox in the young.
"Any benefits to children from a chickenpox vaccine would have to be offset against any potential increase in adult chickenpox and shingles in the elderly.
"The effect on the whole population needs to be considered, not just one age group."
Many other countries routinely immunise their children against chickenpox, and the Department of Health is already considering whether this would be the right move.
A spokesman said: "The immunisation programme in England has been developed to meet the needs of the population and is based on independent scientific advice provided by the Joint Committee on Vaccination and Immunisation (JCVI).
"JCVI has commissioned an expert sub-group to look at all the scientific and medical evidence on chickenpox vaccines, including this recently published paper, and it will provide advice in due course."
I'm old enough to remember before the measles vaccine. People were genuinely concerned when you got measles, because it was well-known that the complications could be severe. I remember having measles, it was horrible. As was mumps, which everyone knew could be dangerous for boys.
No one ever seemed to be worried about chicken pox until the vaccine was invented. It's one of those illnesses you get, and yes, sometimes things go wrong.
Surely it would be better to educate medical staff about the possibility of secondary infection in chicken pox, rather than vaccinate all our children in order to prevent 6 deaths a year (and for all we know, this could have been an exceptionally bad year)?
Here are the complications of the chicken pox vaccine (from the insert in the box):
Body As A Whole
Anaphylaxis in individuals with or without an allergic history.
Hemic and Lymphatic System
Thrombocytopenia.
Nervous/Psychiatric
Encephalitis; cerebrovascular accident; transverse myelitis; Guillain-Barré syndrome; Bell’s palsy; ataxia; non-febrile seizures; dizziness; paraesthesia.
Respiratory
Pharyngitis.
Skin
Stevens-Johnson syndrome; erythema multiforme; Henoch-Schänlein purpura; secondary bacterial infections of skin and soft tissue, including impetigo and cellulitis; herpes zoster.
Those 6 deaths are obviously a tragedy to those concerned. But shit happens. Things always go wrong for someone. Vaccinating the whole population seems a disproportionate response. Obviously, the vaccine producing pharmaceutical companies will think differently....