When I was much younger, chickenpox hit my summer camp. We had an infirmary set aside with plenty of beds, but not enough medical staff to watch over all the people in it. They didn’t need much attention, just simple things like water, meals, and for the kids, supervision. Some of the the counselors were struck down but they were far too miserable to supervise anyone.
The camp administration asked for volunteers to sit in shifts and watch the sick kids. I was a junior counselor, all of seventeen, and therefore “old enough” to sit watch. But I couldn’t remember if I’d had chickenpox, the other requirement for volunteering. The need was acute, and I was allowed to use one of the two phone lines that served the camp to call my mother. She confirmed that I’d had chickenpox, and I was deputized.
I remember one kid I sat with for a while. She was miserable. Her throat was on fire, her skin a network of bumps, some oozing, some crusted, some just turning red, all terribly itchy. One of the older counselors was also there. He was in his twenties, old for chickenpox, and looked like hell. He couldn’t breath without feeling fire in his throat. He couldn’t eat. He couldn’t sleep.
Since then I’ve seen less than a dozen cases of chickenpox. Around the same time I started medical school, the chickenpox vaccine became widely available. Almost like a switch being thrown, chickenpox was gone as a regular part of childhood.
But the virus was not gone from medical practice. Varicella zoster virus (VZV) is a member of the herpes virus family, and the cause of chickenpox. It causes the miserable rash and malaise of chickenpox, the rash that says, “you can’t go to school until the last pox is dried and crusted.” But even though the rash is gone, the virus is not. Like other herpes viruses, it sits latent in the body, apparently doing nothing at all.
Until, once again, it decides to make an appearance. It creeps out of a nerve root where it’s been resting for perhaps decades. If it’s your nerve root, you may begin to feel a little under the weather. Then you may notice a slight tingle or itch in horizontal strip on one side of your body. This can quickly develop into severe pain. You may go to your doctor’s office complaining of back pain or flank pain, and she may take a look at you and see nothing in particular, sending you on your way with some ibuprofen.
Then comes the rash. It breaks out in a belt along the painful strip, looking remarkably like chickenpox, but localized, and with searing pain. Sometime the pain is mild, but often it is unrelenting, burning, electric. After a few weeks, like chickenpox, the lesions will crust over, maybe leaving small scars or pigmented areas, or perhaps nothing at all—except pain. Up to half the time, the pain of shingles will outlast the outbreak, often for years, unrelenting, minimally responsive to medications. Post-herpetic neuralgia (PHN) is the most common complication, but not the only one, not even the worst. Patients can develop meningitis, encephalatis (inflammation of the brain), scarring of the cornea. And the misery can be shared.
While the rash is there, virus is shedding, and can enter the air. It’s not easy to share the virus this way—you need just the right host, someone exquisitely susceptible. If you and your rash are near someone who isn’t immune to the virus—perhaps a newborn, a friend undergoing chemotherapy, or an older person who never had chickenpox—your shingles can spread the virus, causing chickenpox and often more serious disease such as meningitis, encephalitis, pneumonia.
Shingles is a nasty gift to those who’ve had chickenpox. The vaccinations against chickenpox and against shingles are a major advance in preventative medicine and public health. But not everyone thinks so.
As others have been documenting, “pox parties” are making a comeback. Among those whose superstitions keep them from vaccinating their children, there has been a move toward the old practice, where healthy kids are brought to the home of infected kids so that they get chickenpox when they are young and the disease is likely to be less severe. This primitive form of inoculation is dangerous and idiotic, but before vaccination was available, it made a bit of sense. True vaccination, rather than disease-causing inoculation is safer, and doesn’t lead to shingles.
I told you I’ve seen less than a dozen cases of chickenpox as a physician. This is a problem for Pox Partiers. They can’t always find an a “source” for the virus (i.e., a miserable child). But they’ve found a work-around. At least one facebook group is helping insane parents find each other, allowing these abusive but isolated parents to share virus. Among the methods they’ve “discovered” is taking objects like lollipops, having sick kids lick them, then sending them through the mail to other parents.
There are numerous reasons that this is a bad idea, in addition to being a violation of federal laws. You cannot just send live virus through the mail—that’s a job left for terrorists. This intentional attempt to inoculate children rather than vaccinate them exposes them to misery and the possible immediate complications of chickenpox, as well as the risk of shingles and PHN later in life. It’s just nuts.
There’s a reason that we have laws against sending live virus through the mail. In addition to the threat posed to the recipients, there’s the threat posed to anyone exposed (remember the postal workers who died of anthrax?).
These are basically acts of child abuse and domestic terrorism, even if the parents don’t realize it. The first time Homeland Security knocks on a door, they may get the hint. The first time a child dies, laws won’t matter to the parents.