Killer Chickenpox.. eek!

iVillage Member
Registered: 06-16-2009
Killer Chickenpox.. eek!
21
Thu, 02-25-2010 - 11:28pm
Myths 3.2 Chickenpox “the disease can be severe”
February 25, 2010 by generic
Filed under: CDC Watch, Parents' Pages, Vaccine/Disease Analysis

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iVillage Member
Registered: 04-09-2008
Fri, 02-26-2010 - 8:46am

I think this would be good to take one step further because we've talked about this quite a bit on these threads... (Emphasis mine).


There are steps parents can take to prevent chickenpox complications. This news story indicates one simple method of reducing the severity–don’t give fever reducers: Parents who treat their children with acetaminophen to reduce the fever of chickenpox may unwittingly prolong the illness by defeating the virus-fighting benefits of an elevated body temperature, physicians at John Hopkins Children’s Center have concluded.


Question:

Rands

iVillage Member
Registered: 10-18-2007
Fri, 02-26-2010 - 9:43am
It is the case for all illnesses. Using fever reducers is a knee-jerk response based on fear, and I'd like to know how many complications from the scourges of childhood involve their use.
iVillage Member
Registered: 04-09-2008
Fri, 02-26-2010 - 9:47am
Yeah - I get that we get that... but, what I found interesting is that JH used this on chickenpox and I just can't help but wonder if they realize what they stated - because, what is typically the advice from doctors when dealing with what they call 'normal reactions' after vaccines (slight fevers...) Tylenol..

Rands


Rands

iVillage Member
Registered: 10-18-2007
Fri, 02-26-2010 - 10:01am

There is an old piece in Pediatrics that stated this recommendation was based on nothing more than parental concern.

I see people recommend it all the time, and I think it's a horrible practice... bringing a fever down has a time and place, and it's not during an acute infection. Imagine if the MMWR gave the courtesy to those reading to inform them when complications and deaths occur, in otherwise self limiting disease, that antipyretics were used, etc...

iVillage Member
Registered: 04-09-2008
Fri, 02-26-2010 - 10:07am
It would be interesting to see what would happen if this recommendation just stopped being given; but I agree, my MIL is horrible.

Rands


Rands

iVillage Member
Registered: 06-16-2009
Fri, 02-26-2010 - 7:10pm

http://archinte.ama-assn.org/cgi/content/full/160/4/449


I really like this article on fevers.

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iVillage Member
Registered: 01-02-2009
Fri, 02-26-2010 - 10:41pm

The "suppress fevers in children" meme has done a huge amount of damage.

In some ways, the urge to vaccinate is part of the same idea. Illness is bad and has to be suppressed, driven out, prevented at all costs.

In my experience, a good dose of childhood illness, complete with at least 24 hours of fever, has a good effect on a child and is usually followed by a developmental jump.

Saw this recently in my granddaughter, after she had what might have been the swine flu (or just a feverish cold). She has matured significantly in the last few weeks since the sickness. Coincidence?

I've heard the same story from other parents or grandparents.

There is also some reason to believe that the occasional childhood illness, in a basically healthy child, helps develop an effective immune system.

http://insidevaccines.com/wordpress
iVillage Member
Registered: 04-09-2008
Mon, 03-01-2010 - 12:46pm
Good read. I know in my anecdotal experience of dealing with the fevers with the kids, luke warm baths worked wonders. I couldn't tell you how high the fevers were, just that their body temp. went down in the course of about the 1/2 hour bath time.

Rands

iVillage Member
Registered: 06-16-2009
Thu, 03-04-2010 - 4:15pm

Interesting article from 1993---


http://www.nytimes.com/1993/07/07/news/doctors-weigh-the-costs-of-a-chicken-pox-vaccine.html?pagewanted=1


Doctors Weigh the Costs Of a Chicken Pox Vaccine
By ELISABETH ROSENTHAL
Published: July 7, 1993

Ever since vaccines have consigned measles, mumps, rubella and polio to the history books, chicken pox has been the only major childhood illness that parents weather with their children.


Now, a chicken pox vaccine that has proved both safe and 97 percent effective in trials in children may be about to enter the United States market. But as eager parents await news of its release, doctors and Federal officials are hesitating about whether to use it.


Scientists have worried that the immunity granted by the new vaccine may wane over time, so that those who avoid chicken pox in childhood might get it as adults, when it is a more serious disease. They have also raised the theoretical concern that the vaccine, which consists of a live weakened strain of the chicken pox virus, might itself cause symptoms.


But at heart they are all struggling with a subtler question: Is chicken pox a bad enough disease that all children should avoid it?


"The major controversy is whether the medical consequences of chicken pox are serious enough to warrant a major vaccination effort, whether chicken pox is worth preventing," said Dr. Walter Orenstein, director of the national immunization program ofthe Centers for Disease Control and Prevention, who will probably have to make that decision for the country within a year.


The new vaccine, which is made by Merck & Company, is being reviewed by the Food and Drug Administration. If the agency deems it "safe and effective," it will be approved for marketing, and doctors will then turn to the Centers for Disease Control for guidelines on its use. 2 Sides of Debate


Parents who have lost nights of sleep and days of work dabbing calamine lotion on that notorious "dew-drop on a rose petal" rash, as it is described to medical students, know how they would answer. Chicken pox affects 90 to 95 percent of Americans by the end of adolescence, according to the Centers for Disease Control, and another 2.5 percent over the age of 20. More than 60 percent of the cases occur in children aged 5 to 9.


But from a medical perspective, chicken pox is more a monumental nuisance than a danger. Unlike measles, which is often followed by pneumonia, or polio, which can result in permanent paralysis, chicken pox in children is usually a benign short-lived illness with virtually no long-term consequences, which grants lifetime immunity. A vast majority of the economic cost of the disease is attributable to lost pay of parents who become housebound with children who are not allowed to go back to school or day care until their pockmarks have disappeared.


Some scientists say that it is nonetheless time to approve a chicken pox vaccine.


"To me there are enough complications and parents lose so much time from work taking care of kids with chicken pox that it is worth vaccinating," said Dr. Anne A. Gershon, head of pediatric infectious disease at Columbia University's College of Physicians and Surgeons. She added that chicken pox can be devastating, even fatal, in children with poor immune systems, like those with cancer or those taking steroids for asthma. Ruling Is Awaited


But others balk at the idea of giving the shot to every child.


"Do you want to give a vaccine -- with unknown side effects -- to prevent a very mild disease?" asked Dr. Philip Brunnell, head of pediatric infectious disease at Cedars Sinai Hospital in Los Angeles. "I think it's a difficult question and I'm glad I don't have to make the decision." He and others emphasize that to justify vaccinating everyone against a disease that for most is more inconvenient than harmful, the shot itself must be unquestionably safe.


The vaccine was discovered in Japan more than a decade ago and is now used to immunize all children in that country. It has been close to release in this country several times, but each time it has run into obstacles: a manufacturing glitch, now corrected, that resulted in a vaccine that produced a chicken-pox-like rash, and persistent demands from cautious public health officials for more and more data on the rate of side effects and how long the immunity might last.


"I've given up trying to predict when it will come out," Dr. Orenstein said. "In 1982 I said it was likely to come out soon. Now I'd say within the next year."


The extraordinary hesitation regarding the vaccine is partly a result of evidence that it is effective only for a limited time. A widespread vaccination program could cause a reduction in the number of cases of chicken pox in children, but an increase later in adults.


Although the total number of cases would be far lower, the number of deaths and hospitalizations might well rise. That is because chicken pox is a far more serious disease in adults, lasting many weeks and frequently accompanied by complications like pneumonia and, sometimes, inflammation of the brain. Dormant Herpes a Concern


Some doctors have also expressed concern that the active ingredient of the chicken pox vaccine is a live, though weakened, varicella zoster virus. This virus belongs to the herpes virus family, a group of viruses notorious for their ability to outwit the human immune system and persist in the body for life.


These viruses often lie dormant in the nerves or lymphatic system, but occasionally re-emerge, producing disease flare-ups. Reactivation of herpes simplex virus produces recurrent oral or genital herpes. Reactivation of the latent varicella virus in people who have had chicken pox produces a painful blistering rash called shingles or herpes zoster; shingles most often occurs in the elderly or in people whose immune systems are weakened, generally many decades after chicken pox has disappeared. Dangers of Miscalculation


Could doctors in good conscience inject patients with a virus that would infect them forever? Would this mutant strain of the chicken pox virus be more likely to result in shingles many years later? A miscalculation would be unfortunate, since shingles is far more painful and heals far less well than chicken pox in children.


New research has alleviated some of the worries: Studies in children successfully treated for leukemia, who are prone to shingles, have suggested that the vaccine virus is less likely to produce shingles than the true chicken pox germ. But the answers to other questions, like how long protection will last, are not likely to be forthcoming.


"Some things can't be answered in a trial," Dr. Brunnell said. "You're just going to have to license the vaccine and see what happens. All the information you're ever going to have you have in hand."


Research in Japan has shown that children who are vaccinated retain immunity for at least 10 years. But it has also shown that while 97 percent of children develop protection from chicken pox after one immunization, only 75 percent of adolescents are similarly protected. Many experts say that adolescents and adults will probably need two shots.


The Centers for Disease Control recently commissioned a cost-effectiveness study to try to weigh these many variables. The results, which were presented last month, showed that for every dollar spent on chicken pox vaccine, society could expect to reap only 94 cents in medical benefits.


But the analysis changed strikingly if the indirect costs of chicken pox, like a parent's lost wages, were figured in. With such indirect costs included, the study found that society got $5.50 in benefits for every $1 spent on vaccine.


The benefit cost ratio for the combination measles-mumps-rubella vaccine is $3 for each dollar spent when only direct medical costs are included, and $14.40 per dollar spent when indirect costs are added in, according to Dr. Sandra Holmes, a medical epidemiologist at the Centers for Disease Control. The ratio for the hemophilus B vaccine is $2.40 for every dollar spent for direct medical costs and $2.80 with indirect costs added.


For research purposes, the centers assumed that the vaccine would cost $35 for a single dose, although no one is sure how Merck would price it, and many vaccines have cost more than predicted when they actually reached the market. Easier Way to Cut Costs


Some experts, like Dr. Brunnell, have suggested that there is an easier way than vaccinating to reduce the cost of chicken pox to society: by simply reducing the number of days children are kept home when they have the disease. Many schools do not allow children to return until the last of their lesions has crusted over, in the mistaken belief that the child is contagious up to that point. But the disease is most contagious before the rash appears. Most children feel well enough to return to class far earlier, Dr. Brunnell said.


"If the parent's lost work is the problem, then maybe we should send children back to school sooner," he said.


Anticipating that the drug agency may well approve the vaccine this time around, the Centers for Disease Control recently asked its vaccine advisory panel to determine how it should be used.


"From what I know right now, if it were my kid, I think I'd rather he get the vaccine than chicken pox," Dr. Orenstein said. "My 10-year-old had a very mild case, and I thought, what's the big deal? But when my 5-year-old got it, the child was very uncomfortable and we were up for several nights. It's that kind of problem that the vaccine would eliminate rather than serious disease."


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iVillage Member
Registered: 04-09-2008
Fri, 03-05-2010 - 7:27am

Seems like this has been one of the biggest arguments used on this issue with the disease. In most children, this disease was not an issue, it was based solely on money (economic).

Rands

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