Chickenpox parties via mail?

Some stories have come out in the past couple of days about someone selling chickenpox-infected lollipops through the mail for the benefit of parents who are afraid to immunize their children but want to give them “natural” infection.  (All references are at the end of this post.)

Apparently, the parents are so fearful of commercial vaccines, which use a weakened but still-living virus, that they are willing to use a crude, “wild-type” vaccination instead. Never mind that there is a fairly high rate of complications and a mortality rate in healthy children of about 2 deaths per 100,000 cases. If that many deaths were associated with a chickenpox vaccine, there would be an uproar, but apparently it's acceptable (or more likely, not understood) as long as it's “natural.”

 

I'm sure that nearly all the parents involved in this practice have simply not thought through all the implications. Virtually all parents would do almost anything for the well being of their children, and these are no exceptions. Their intentions are pure, I'm sure, but nature unfortunately doesn't care about intentions.

 

I've seen at least two children with severe chickenpox. One was a leukemia patient in remission and apparently with normal immune status at the time. She almost died but, perhaps due to outstanding ICU care at UCLA, she survived. The other patient was a Nigerian girl who was normal until she got chickenpox. She suffered a skin reaction over much of the body, becoming much like a burn victim. She died.

 

What about consequences to other children, especially those who cannot be immunized because their immune systems are depressed by cancer, HIV, or drugs? Chickenpox is highly contagious: “Household transmission rates are 80-90%. Second cases within the household are often more severe.” Chickenpox is not always just a minor illness. Uncommonly, there are serious complications even among otherwise normal children. (See the list below from CHOP, comparing the complications of the disease vs. the vaccine.) Worse, “among children with leukemia, the mortality rate of varicella is 7%.” It’s even worse if a pregnant woman is exposed at just the wrong time, in a window that gives the baby the virus but not the mother’s antibodies. “Neonatal varicella mortality rates can reach 30%.”

 

I assume that these parents are taking the greatest precautions to isolate their artificially-infected children from all other children, starting from the time of inoculation until they are non-infectious, but is that possible for all children, 100% of the time? Do they treat their children as carriers of a potentially fatal viral infection, or are they thinking of the mostly-benign course of disease in their own children without reckoning with the potential for contagion? In fact, if they think it’s beneficial to expose children to chickenpox, could they be just a little less than perfectly sure to isolate their kids?

 

What if one of these children plays with another unimmunized child whose father has had leukemia, or whose mother is pregnant? Besides this being unethical (think “Golden Rule” here, OK?), it seems to me that I would at least be inviting a civil lawsuit if not a negligent homicide charge if my child’s intentionally-caused chickenpox caused harm to someone else.

 

The whole thing makes me angry. Not at the parents—I can only feel sorry for them, having been made so fearful of vaccines that they will take these risks because they want to protect their children. Rather, it’s against the people making fame and fortune by selling fear. How do they justify this kind of thing?

 

References:

“American parents caught selling chickenpox-infected lollipops,” Telegraph, http://tgr.ph/rFT7Ik

 

Los Angeles Times, http://bit.ly/uRCd35. Notes that the chickenpox virus might not even survive the mailing, so technically not effective. And buying a virus from someone on Facebook? Maybe not a good idea.

 

Varicella on Emedicine, http://bit.ly/tAXX3c

In otherwise healthy children aged 1-14 years, the mortality rate is estimated at 2 deaths per 100,000 cases. The case-fatality rate in the general population is 6.7 cases per 100,000 population.

Among children with leukemia, the mortality rate of varicella is 7%.

Varicella during pregnancy can cause various adverse outcomes for mother and infant, depending on the stage of pregnancy. Neonatal varicella mortality rates can reach 30%

 

CHOP (Children’s Hospital of Philadelphia) parent pack, http://bit.ly/s4CXU1

Of 1,000 people with chickenpox:

• About 100 will require medical attention
• About two will be hospitalized 
• About 50 will suffer from infected blisters; in some cases the bacterial infection is caused by group A streptococcus (GAS). When GAS enters the bloodstream, it can lead to a mild infection or, less commonly, a more severe situation such as necrotizing fasciitis, also known as "flesh-eating bacteria," or streptococcal toxic shock syndrome (STSS). Necrotizing fasciitis destroys muscles, fat, and skin tissue. STSS causes a rapid drop in blood pressure and organ failure. About 1,500 people die from GAS in the U.S. every year; some of these as a complication from chickenpox.
• Other complications from chickenpox can include dehydration from vomiting or diarrhea, pneumonia, or swelling of the brain (known as encephalitis).

 

Before the vaccine about 50 children died each year from chickenpox infection or its complications; many of these were previously healthy children.

 

The vaccine

Of 1,000 children who get the vaccine:

• 700 to 900 will never get chickenpox; of the remaining 100 to 300 who may get chickenpox, the disease is typically less severe.
• About 200 will have redness or soreness where the shot was given 
• Less than 50 will experience a mild rash up to one month after immunization 
• 100 to 200 will have fever, about one of whom will experience a seizure related to the fever