How catching chickenpox from a sibling makes it worse
Rosie got it from her big sister and ended up on a drip in hospital
WHEN I spotted the tiny blister on my two-yearold daughter Rosie’s forehead last month, I felt relieved. Her big sister Sophia, aged five, had breezed through chickenpox two weeks previously and I’d been hoping Rosie would get it, too.
A month earlier, chickenpox swept through Sophia’s reception class and when it was her turn she had a smattering of spots and spent a week on the sofa enjoying the attention (and extra TV).
The worst part for her was missing own-clothes day at school, and the hardest bit for me was keeping her entertained while I worked from home.
Children are banned from school during the infectious stage of chickenpox. This period — which starts two days before the rash appears and ends when the last blister has scabbed over — can stretch to two weeks, making it a potential nightmare for working parents such as my husband Dan, an accountant, and me.
So, I ignored the official advice to keep Rosie and Sophia apart. They continued to bathe together, shared towels and flannels, as they normally do, and Rosie climbed into Sophia’s bed for a story every night.
We even visited friends who were housebound with chickenpox because, as I rationalised it, Rosie was going to get it anyway — surely it was better to get it out of the way in both children in one hit?
But when Rosie did catch chickenpox three weeks later — her first spot appeared on June 29 — she was hospitalised for four terrifying, heart-wrenching days.
I’d gone from wishing this illness on Rosie to holding down my tiny, sobbing daughter while a team of nurses put drips in her little hands.
Earlier that day, three days after Rosie’s spots appeared, some started turning dark green and then black. Within a couple of hours she became hotter, floppier and increasingly tearful. Despite worrying that I was being paranoid, my instincts kicked in and I took her to our GP. Noting she had tachycardia (rapid heart rate) and a soaring temperature — 40.5c — he sent us to A&E.
There, the consultant broke the news that they suspected her spots had become infected with bacteria, which were getting into her bloodstream, and she was promptly hooked up to intravenous antibiotics.
Quite why Rosie developed the infection is unclear — she may have had bacteria on her skin already or picked it up from someone else, and they may have got into her spots and the bloodstream when she AND, scratched herself.
as I would later discover, one reason Rosie reacted so seriously may have been because she caught chickenpox from her sister rather than fleeting contact with a classmate, allowing a stronger dose to be passed on.
Whatever the cause, fortunately Rosie was admitted to hospital within hours of her illness starting, rather than waiting for the bacterial infection to take hold. The infection was brought under control within four days, but others haven’t been so lucky. Most of us are familiar with chickenpox, a contagious condition caused by the varicella zoster virus, which results in a rash of red, itchy spots that turn into blisters filled with fluid.
A few days before the rash appears, the patient will have fever, aches and headaches. It’s so common in childhood that 90 per cent of adults are immune because they have already had it and it’s rare to get it twice. Dan and I had it as children.
The NHS describes chickenpox as a ‘mild’ condition. However, it can have potentially serious complications.
During Rosie’s illness, I discovered that a little boy the same age as Sophia and living a mile from us had died in the same hospital from infected chickenpox in January 2014.
Four-year-old Kai Lourdes Wise had a cardiac arrest caused by sepsis — a potentially life-threatening condition where the body’s immune system goes into overdrive in response to infection — resulting from his chickenpox.
At an inquest into his death, the assistant coroner Dr Karen Henderson criticised Frimley Park Hospital in Surrey for ‘ appalling’ care and concluded: ‘The potential complications of chicken pox, albeit rare, were not taken into consideration.’
For our part, we found the staff there competent and quick-acting, and I couldn’t help but wonder whether it was a result of what had happened to Kai 18 months earlier.
Over the next few days, I asked the nurses and doctors about complications arising from chickenpox. One nurse told me she sees a case like ours every few months.
The official figures say one in 100 cases of chickenpox causes complications and 6,700 children are admitted to hospitals every year as a result. If they’re seen and treated early, most children are fine — but some aren’t.
The problem is t hat ‘ t he seriousness of chickenpox is disguised behind the mass of mild cases,’ says Adam Finn, a professor of paediatrics at the University of Bristol. ‘The majority of children get a harmless, if unpleasant, case of chickenpox, which gives it its mild reputation. But parents, and sometimes medics, don’t realise that in hundreds of cases each year chickenpox is very bad news.’
There’s a long list of chickenpox complications, including cellulitis (an infection in soft tissue under the skin), meningitis, blood poisoning or sepsis (which can result in organ failure), even stroke.
‘Children are being hospitalised, suffering long-lasting neurological problems from brain damage to balance problems, and even dying from chickenpox,’ says Professor Finn. ‘Yet people continue to trivialise it.’
The reason why Rosie’s case had been so severe may have been linked to the fact she has eczema, which can i ncrease the risk of complications.
Professor Finn explains: ‘Eczema often leads to an increase in skin bacteria. And chickenpox punches holes in your skin. This combination of holes and more bacteria enhances the risk of problems.’
Another possible factor is that she caught it after Sophia.
‘When children in a family are affected, the child who gets it second or third will often get a worse case,’ says Professor Finn.
‘The infecting dose (the amount of virus the child is exposed to) is higher because of closer, more frequent contact compared to a passing dose from a classmate.’ HE
IS concerned about socalled chickenpox parties. The thinking behind these is that it is better to contract the virus while young, because symptoms can be more severe in adults.
Indeed, adults are more likely to be admitted to hospital, and five to 14 per cent will develop lung problems, such as pneumonia.
‘ But putting i nfected and uninfected children together to spread the disease encourages close and intense contact, which can be courting disaster because the infecting dose rises.’
Rather than wishing the illness on your child to ‘get it out the way’, Professor Finn says parents should consider getting their child vaccinated, so they need never catch the virus.
‘It makes little sense to go for the potentially dangerous option when there’s a safe one,’ he says.
However, the chickenpox vaccine isn’t available on the NHS to healthy children, only to those with weakened i mmunity, for example, cancer patients or their immediate family.
‘ You find a lot of paediatric doctors pay for their own children to be vaccinated because they’ve seen what chickenpox can do,’ says Professor Finn.
Your GP may be able to recommend a clinic where the vaccine is available, for a cost of £50 to £100.
One argument against being vaccinated is that once you have chickenpox, the virus lies dormant in the nerves and can come back as shingles when you’re older.
This is an infection of a nerve and the surrounding skin caused by the same varicella zoster virus.
Symptoms include a painful rash, with one in five sufferers developing nerve pain, sometimes permanently.
The good news is that when adults who have had chickenpox are exposed to the virus again, immunity against shingles is given a bit of a boost.
‘But there’s a worry that if we vaccinate children, when today’s parents are elderly they won’t have as much immunity against shingles,’ says Professor Finn.
‘This is because they won’t have had this immunity boost.
‘However, it’s only a theoretical worry. Chickenpox vaccines have been in widespread use in the U.S. since 1996 and don’t appear to have caused problems.’