CHICKENPOX ANOTHER KILLER ?!?!

There appears to be an emergence of articles looking at the dangers of chickenpox. This presumably coincides nicely with the possible introduction of the chickenpox vaccine, which has already been introduced in the USA. A good example of this would be an article featured in The Daily Mail's 'Good Health' section, 2/6/98. (Informed Parent)

A new vaccine to prevent chickenpox could be available to British children in as little as two years.

Most people think of chickenpox as a harmless childhood ailment. Irritating and itchy, it rampages through primary school playgrounds, sometimes infecting whole classes at a stroke.

But the truth is it's not quite so innocent after all.

'There are more deaths from chickenpox than there are from all the other once-common childhood infections added together - such as polio, measles, rubella, whooping cough and diphtheria,' says Professor Norman Noah of King's College,. London, who is completing an important study of the illness.

Two pharmaceutical companies -Pasteur Meneux MSD and SmithKline Beecham - are developing the chickenpox vaccine so that it could be given with the MMR immunisation now in use. The new combination dose, called MMRV, would cover measles, mumps, rubella and chickenpox -medically known as varicella.

A chickenpox vaccine is available in America but it has to be kept frozen. This means it could not be used in combination with the MMR, which is not frozen.

The European vaccines being developed do not need freezing. So far, the Department of Health has not decided whether it should call for a general immunisation programme against the disease.

Professor Noah has been conducting research into the seriousness of chickenpox in Britain and expects to publish his findings within a few months.

His is the first systematic British study to calculate all the costs of the illness - social, individual and medical- and it will provide the Government with much of the information it needs to decide if Britain's children ought to be protected.

It is estimated that up to 95% of British children will have had chickenpox by the time they are 15. Complications are not common, but when they occur they are often fatal. Diana and Kevin Woodward nearly lost one of their twin babies -conceived through IVF - last year when their four-year-old son Alastair brought a dose of chickenpox home from school.

'At first I thought nothing of it,' says Diana. 'Alastair became rather spotty and I smothered him in calamine lotion. I assumed that my twins, eight months old at the time, would also catch it, In a way I was glad to be getting it over and done with in one go.

'Frances was the first twin to get chickenpox but she kept smiling as usual. It was only when I saw how Felicity reacted that I started to worry.

'After a couple of days she looked significantly worse than her sister. Her hands and feet were freezing, but she had a high fever.

'Her head was lolling about, she could barely swallow and she seemed to be losing consciousness. Eventually I became so worried that I took her straight to hospital.'

Diana's instincts proved right and, on arrival, Felicity was given intensive treatment that saved her life.

She was diagnosed with haemorrhagic varicella, an unusual form of chickenpox which causes internal organs to bleed uncontrollably.

Diana is convinced that the quick thinking of the consultant paediatrician on duty saved Felicity's life. 'He gave her intravenous albumen and acyclovir, and found her an intensive care bed. After a few days her condition gradually started to stabilise.'

A year later, she is a healthy two-year-old, despite being scarred by the chickenpox spots. Apart from the haemorthagic variety, the virus can also cause encephalitis (inflammation of the brain). pneumonia and osteomyelitis (inflammation of the bones).

Complications tend to increase with age, leaving adults at greater risk, particularly if they smoke heavily. Pregnant women catching the virus expose themselves and their unborn babies to potential harm. In people with suppressed immune systems, chickenpox can be fatal.

In addition, anyone who has had the illness can later develop shingles. This happens when the dormant chickenpox virus is reawakened later on in adult life. Treatment for shingles is expensive and the chronic pain it causes can be unbearable and last for months.

Britain's population is ageing, and it is expected that shingles will become a significant problem for the health service. It is believed that the varicella vaccine might, however, carry the valuable benefit of lowering the risk of shingles occurring in adults.

Chickenpox vaccine has been available since 1995 in America, where it is recommended that children aged 12-18 months are routinely vaccinated. Tom Dick, director of business relations for Pasteur Meneux MSD, says that its MMRV vaccine will probably be licensed on a Europe-wide basis, and could be available here in two years, once data on the vaccine's safety has been fully analysed.

He says: 'In the US they took account of more than just the medical costs, the days off work, the school time missed - and found that a vaccination programme was very cost-effective. In the UK they tend to look at the cost to the health service only.' Professor Noah's study aims to look -as the Americans did - at the total costs of the illness, but he is concerned that any vaccination programme should cover as many children as possible.

'At present, up to 95 pc of the British population has immunity through catching chickenpox naturally. An immunisation programme would have to aim for the same level of coverage to prevent a large proportion of the country being unduly exposed to the virus as adults,' he says.

Because chickenpox is more serious in adults, this is an important consideration.

Even so, the lack of an available vaccine still leaves many counting the cost in terms of personal tragedy and loss.

Diana Woodward agrees with Professor Noah's assessment of chickenpox as 'a disease that people shouldn't take too lightly', and finds it easy to weigh up the benefits of the vaccine.

'Kevin and I spent ten years and many thousands of pounds on IVF treatment in order to have children. We nearly lost our daughter because of a common illness that could so easily have been prevented by an injection.

I hope that a vaccine is made available quickly so that no other family has to go through such a harrowing ordeal.'

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