Harpocrates Speaks: Varicella Vaccination Among Older Kids Protects Infants

Another timely article from Todd W.

Varicella Vaccination Among Older Kids Protects Infants

Turning on the news this morning, I was greeted with a story that caught my ear. Published online, ahead of print, a new study in the journal Pediatrics, "Varicella in Infants After Implementation of the US Varicella Vaccination Program", looked at the incidence of varicella (chickenpox) among infants under 12 months of age.

The varicella vaccine was approved in 1995 and is recommended for all children aged 12 months to 12 years. It is a "live" virus vaccine, meaning that the vaccine uses intact, though weakened, virus particles that grant immunity without causing full-blown disease. Vaccines of this sort are generally more effective than "killed" virus vaccines, which only use part of the virus. Because of the approved age range for the vaccine, it does not provide direct protection to infants under 12 months of age, but it can provide protection through herd immunity.

So what did the researchers find?

In the observational study, the authors looked at chickenpox incidence among infants under 12 months of age from 1995 to 2008. The population was broken up into 0-5 months and 6-11 months. They found that incidence among the total infant population fell 89.7% over the period examined. They also noted that complications and severity of disease was lower in the younger age group vs. the older group. The authors speculate that this may have been due to maternal antibodies (which generally provide some protection to infants for about 6 months).

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Harpocrates Speaks: The Sequelae of Pox

A follow up to a post by Todd W.  And I am recovering beautifully from my surgery thank you.

The Sequelae of Pox

A couple weekends ago, something of a firestorm erupted among skeptical bloggers. Namely, the news about parents sending pox-laden lollipops through the mail. It was covered by Mike the Mad Biologist, Emily Willingham, Reuben, Tara Smith, Orac and Phil Plait. Largely, the various bloggers, myself included, condemned the parents in the original story because they were knowingly sending infectious material in the mail.

Some folks in the comments of the various articles made the observation that every day, people lick envelopes, handle packages in perhaps less than sterile conditions and so, perhaps unwittingly, leave unintended presents for the recipients, not to mention the delivery personnel. How is that any different from what these parents have done?

First off, I will readily admit that what the parents were doing probably would not lead to anyone contracting chicken pox. Since the virus does not remain viable for very long at all in the environment, it would most likely be rendered harmless given the amount of time it takes the package to be mailed. Even if the pox package managed to reach its target quickly, fomites like lollipops and spit-soaked rags also are unlikely to cause an infection, as the virus is primarily spread via the respiratory system. The oral route is a bit rough on the bug, and it would likely be destroyed before it could actually cause an infection.

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The Vaccine Times: Why Kids Need the Chickenpox Vaccine

The Vaccine Times pointed me at this article, so I am doing the same as they are.

Dr. Mallika's 5 Fast Facts: Why Kids Need the Chickenpox Vaccine

A new trend finds some parents giving their children candy coated with chickenpox germs in an attempt to build their immunity without a chickenpox vaccine. Here, Everyday Health's medical director explains why that's not a good idea — and why it's so important to vaccinate your kids.

By Mallika Marshall, MD

FRIDAY, Nov. 11, 2011 — You may have heard about a disturbing new trend making headlines these days — one that involves parents who buy and sell contaminated items meant to intentionally sicken their kids. Parents who don’t want to give their children the varicella vaccine for chickenpox are purchasing mail-order lollipops that have been sucked by children with chickenpox, hoping to build their kids’ immunity against the disease “naturally.” Besides being illegal, this is incredibly dangerous. First, there’s no telling what other germs or bacteria are being spread through these “pox pops.” And second, exposing your kids to the varicella virus — assuming it can even survive on the candy, which isn’t clear at this point — puts them at risk for developing chickenpox, which can be serious or, in some cases, even deadly.

The pox pops trend is a variation on the decades-old tradition of “pox parties,” where healthy kids are invited to play with infected kids to expose them to the virus. Invitations to such events have been posted on Craigslist, Facebook, and even designated pox party Web sites. The idea is certainly popular — but that doesn’t mean it’s good.

The best and safest way to protect your kids and build their immunity is to give them the chickenpox vaccine, which the U. S. Centers for Disease Control and Prevention (CDC) recommends for all young people ages 12 months to 12 years. Some 6 percent of parents choose not to vaccinate their children against chickenpox out of either fear or principle, according to a recent study in Pediatrics, but research shows that’s a risky decision.

Here, five reasons to skip the pox pops and parties and get your kids vaccinated:

1. Getting the chickenpox vaccine is much safer than getting the disease. Many parents wonder whether it’s better for their child to get infected with chickenpox or to get the vaccine, and there really should be no question. The vaccine, which is given in two doses at least three months apart, usually around age 1, is made up of a weakened version of the virus that cannot cause full-blown disease. Adverse reactions are the exception, not the rule — and when they do occur, they’re generally very mild. About 20 percent will have temporary soreness or redness at the injection site, and 10 percent will have a slight fever. More serious problems like seizures are exceedingly rare: Less than .1 percent of kids who get the vaccine experience such a response, compared with 10 percent of kids who don’t get the vaccine and require medical attention for serious complications associated with chickenpox.

2. Chickenpox is no picnic — for you or your child. Even mild cases are uncomfortable and inconvenient. Most children with chickenpox first develop cold-like symptoms, followed by a fever and then as many as 500 itchy, fluid-filled blisters that begin on the head or chest and quickly spread to the rest of the body. Some unlucky kids may also experience vomiting or diarrhea. This can last for up to 10 days, during which time your child will be unable to attend school and will need to be cared for and watched for signs of infection. About 1 in 10 children will develop a complication such as pneumonia, secondary skin lesions, dehydration, or, in rare cases, encephalitis (swelling of the brain). A few may even die.

3. Not vaccinating your children puts other children at risk, too.

CLICK HERE TO READ THE REST OF THE LIST.

Related articles

• Doctor aghast as lollipops used to spread chickenpox (ctv.ca)
• Some parents are idiots (bio230fall2010.wordpress.com)
• Vaccine Drastically Cut Chickenpox Deaths: CDC (huffingtonpost.com)
• Parents Warned Not to Give Children Chickenpox Lollipops (shoppingblog.com)
• Chickenpox Lollipops? Vaccination Fears Lead to Pox Parties (inquisitr.com)

WTF?! Pox by Mail

I have restrained from overtly using profanity on this site (unlike my personal site), but upon hearing about this, I was flabbergasted!  And I am not the only one.  Again, I am going to turn to Todd W because he said it most in alignment with how I would have said it if I had not been having surgery for removing my palm from  my face...

Pox by Post

Something came to light today that made me despair for the human race. I first read it at Mike the Mad Biologist's blog. It was also covered by Emily over at The Biology Files, where Emily took a look at just who the people were that were involved. Reuben wrote about it at The Poxes Blog and Tara discussed it at Aetiology.

What could have gotten the medical and skeptical blogosphere in such an uproar? This story.

You may have heard of pox parties. These little bits of idiocy involve parents bringing their children who have not had the chickenpox over to the house of another family whose child is currently sick with chickenpox. The intent is to purposefully infect their little darlings with a disease that can become quite serious, with hospitalization rates that could be as high as 2-3 per 1,000 cases among healthy children. The reason they do this is because they have an irrational distrust of vaccines and the mistaken belief that natural infection is actually better, because, y'know, actually getting the disease and risking all the very real complications is better than a shot that makes you immune without getting ill or suffering the much more common secondary nastiness from the wild virus.

Well, the recklessness of people like this has gone up a notch. You see, thanks to vaccines, the rate of infection with the varicella virus has declined dramatically, so that it is much more difficult today to find a child with the chickenpox. This makes pox parties a bit harder to find. These paragons of wisdom (that's sarcasm, in case you missed it) have decided to mail the virus to each other. That's right. They're sending lollipops, spit, toys and other contaminated crap to each other. What could possibly go wrong?

Well, for starters, they're breaking the law. Varicella is classified in biosafety risk group 2, meaning the those working with it must be trained in how to handle it and follow certain protocols to prevent inadvertently letting it out into the environment. In order to ship material like this, the sender must be trained in proper packaging and handling of the material, and trained carriers with a permit can transport the package. Clearly, though, the law does not matter to these twits, since in response to someone pointing out that it was a Federal offense, one woman answered:

"Tuck it inside a zip lock baggy and then put the baggy in the envelope :) Don't put anything identifying it as pox."

But it isn't just the law about which they are clueless. They have absolutely no thought to the risk involved. These items may be carrying more than just the varicella virus. Hepatitis A and B viruses, meningococcal bacteria and other baddies may also be lurking on that tempting lolli they just received. They are putting their children at significant risk of very serious injury or, yes, even death, all because they think they know better than people who have spent their lives studying biology, immunology and infectious diseases.

But it isn't just their kids that they are putting at risk. They are also jeopardizing the mail carrier who picks up the package, the postal workers sorting things to the right trucks, the drivers that transport the packages, the mail carriers at the receiving end--in short, everyone who handles it along the way. Should any of their ziplock baggies fail, so much for containing the contagion. And what about the external packaging? I'm guessing these people are not practicing the best of sterile handling techniques. They have no clue whether the people who handle their mail may be immune compromised. If they have HIV, are on immunosuppressants due to receiving a transplant or have suppressed immune systems due to age or cancer treatment, they are at very high risk of serious complications from being infected. Even worse, these nitwits aren't content to leave it at just chickenpox; there are some who are even looking to get measles, mumps or rubella samples by mail.

The sheer arrogant ignorance of these people enrages me, to the point that I'm going to do something that I try to avoid, at least on the blog. I try to keep my language clean, but these assholes have no clue what the hell they're doing and the kind of shitstorm they could potentially unleash. For anyone that thinks that this is a good idea, I have just one question for you:

[This bit redacted, now that I've had a little bit of time to cool down. Just imagine a cursing, slug-related insult here, with apologies to slugs.]

I seriously hope that the police and FBI are investigating this issue and will bring the full force of law to bear on these sad wastes of human intellect. And who do we have to thank for thinking like this? People like Jenny McCarthy, Barbara Loe Fisher and the NVIC, Generation Rescue and Age of Autism and all the other anti-vaccine activists out there who advocate for natural infection and preach fear of vaccines. Any harm that comes of this idiocy can be laid at your feet.

Chicken Pox? Not a threat, right?

So I'm sure many of you have heard of those "Catch the Pox" parties, or even attended them in your younger days.  Of course,science has made advances.  Things change.  People don't need to go to these parties and catch the disease.  And this young lady could probably tell you that she would much rather have her hand back!

The National Institute of Health lists these possible complications:

• Newborns are at risk for severe infection, if they are exposed and their mothers are not immune.
• Women who get chickenpox during pregnancy are at risk for congenital infection of the fetus.
• A secondary infection of the blisters may occur.
• Encephalitis is a serious, but rare complication.
• Reye's syndrome, pneumonia, myocarditis, and transient arthritis are other possible complications of chickenpox.
• Cerebellar ataxia may appear during the recovery phase or later. This is characterized by a very unsteady walk.

Just keep this list in mind. Again, we so readily forget what things were like 50-60 years ago when people actually worried about these diseases, and you were reminded of the terrible penalties in schools, at the shopping centers, etc.  I would much rather have these things be memories and historical documents, but the anti-vax pro-disease nutters seem to want to bring these things back in actuality.  I wonder if they own stock in the manufacture of iron lungs, crutches, and the like?