Fort Worth, Texas,
15
December
2015
|
04:34 PM
America/Chicago

Chickenpox is no party

The Doc Smitty gives the facts on chickenpox

Generally Child Protective Services is called to a home because someone notices bruising on a child or hears a story in which a witness suspects that a child is being abused.

Last week, a Plano CPS agent responded to a different type of call after a Facebook post inviting parents to bring their children over to be exposed to chickenpox was reported

What is a pox party?

Pox parties were more common prior to the introduction of the chickenpox vaccine in 1995. The general feeling was that, if your child was going to get chickenpox at some point anyway, you might as well get it out of the way. It seemed like a rite of passage that everyone should go through. Because most people survived chickenpox with a few days of itchy annoying rash, there are some that ask me if the vaccine is necessary. “Wouldn’t it be better for us to just get the disease?”

Why do we vaccinate for chickenpox?

Most children with chickenpox develop fever, sore throat and loss of appetite which is followed by the classic rash. I was taught that the rash was like “dew drops on a rose petal” because of the clear, fluid-filled bumps that form on a red base. The rash would then crust over with the crusts lasting one or two weeks before falling off.

It was a memorable disease but not dangerous for most. I happen to remember riding around in the floorboard of my dad’s gas truck (it was a different time for lots of reasons) while I was recuperating, not able to go to school because our local farmer’s couldn’t wait for my rash to heal to have gas for their tractors.

Unfortunately, not all children with chickenpox have a simple course. Here is a list of possible complications that can arise from chickenpox:

1. Skin infections-These could be simple and treated with antibiotics but also can be deeper and involve muscle or other tissues. This would be more dangerous now that we see more antibiotic resistant bacteria.

2. Neurologic complications-Infection of the tissue around the brain could lead to confusion and infection of a particular part of the brain lead to a loss of coordination, both complications lead to hospitalization.

3. Less frequent complications-Pneumonia and hepatitis (liver infection) can also occur but do so less commonly.

Prior to the vaccination, there were 11,000 hospitalizations and 100 deaths from varicella yearly. About three children out of 1000 infected required hospitalization. Since 1996, hospitalizations and deaths have fallen significantly (70 and 88 percent).

Is there anything wrong with having a pox party?

As best as I can tell (I am not a lawyer), there is nothing illegal about throwing a pox party. One thing is clear, sending lollipops through the mail (even pox parties want to be the next Uber) to infect others is. There is also a picture that has been shared around the internet which reportedly quotes the mom from the Plano area pox party as saying, “I had to open my husband’s shingles blister and swab their mouths.” I have a feeling most of those out there who would throw or go to a pox party would consider this a little much.

Should CPS have been called?

I have to say when I first read this story; I thought that the call to CPS was a little overboard. CPS is busy as it is. Investigating pox parties is probably not the best use of their time. I have served on local CPS boards and the things that we talked about needed the full attention of a staff that was already stretched thin.

Secondly, the likelihood of serious harm resulting from contracting chickenpox is overall pretty low. Should CPS be called for every parenting infraction that minutely increases the risk of harm to children? No. That would mean I should report every family that turns their child’s car seat around at 21 months or that allows their baby to sleep on their stomachs. While I disagree with those decisions, I choose to educate as best as I can but don’t log on and report them to CPS.

My only pause in this case came from what I admit is a slippery slope argument but stick with me for just a second. What if one of these children ended up seriously harmed as a result of contracting chickenpox at this party?

Seeing children suffer from vaccine preventable diseases (pertussis is the most common which admittedly occurs in both vaccinated and unvaccinated babies) is hard. If I saw a child suffering from a complication of chickenpox only to discover that the child had contracted chickenpox intentionally at a pox party, this would be even harder.

How can we prevent against chickenpox?

The most effective and best way is through vaccination. Vaccination at age 1 and 4 years protects against 90 percent of chickenpox disease and 99 percent against severe disease. Rarely, children can get chickenpox after they have been vaccinated but the cases seem to be milder.

About the author

Justin Smith, M.D., is a Cook Children's pediatrician in Lewisville . View more from The Doc Smitty at his Facebook page. He attended University of Texas, Southwestern Medical School and did his pediatric training at Baylor College of Medicine. He joins Cook Children's after practicing in his hometown of Abilene for four years. He has a particular interest in development, behavior and care for children struggling with obesity. In his spare time, he enjoys playing with his 3 young children, exercising, reading and writing about parenting and pediatric health issues.

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