By Shannon Henry
Special to The Washington Post
Tuesday, September 20, 2005
When Trish Thackston's 7-year-old son, Connor, broke out with chickenpox recently, she quickly scheduled play dates with four families over the next four days at their Alexandria house.
The kids made art projects with glue and glitter, worked side by side on dinosaur puzzles and shared spoons, all with the intention of transmitting the illness to the healthy children. Her son, thrilled not to be sequestered from friends as he usually is on sick days, said excitedly one morning: "Who's coming over to catch my chickenpox today?"
Some parents, including Thackston, are shunning the chickenpox vaccine, introduced in 1995 and considered safe and effective by most health authorities, in favor of the old-style method of exposing children to the real thing at an early age. Today's parents may remember their own moms and dads tucking sick siblings in bed with healthy ones and inviting friends over to spread the illness.
Many who choose to expose their children believe that catching the illness at "chickenpox parties" is safer and more effective than using vaccines.
But some doctors and other health experts are warning that the practice is dangerous. They say that chickenpox is an unpredictable disease. A "wild" exposure may not necessarily make for a milder case, or, on the other hand, guarantee the child will catch the virus. They say complications from chickenpox can be life-threatening.
"Chickenpox is not necessarily a benign disease or a childhood rite of passage," said Curtis Allen, a spokesman for the Centers for Disease Control and Prevention (CDC). "We don't recommend parents expose their children. The vaccine is best."
Allen points out that before the vaccination was available, there were 11,000 hospitalizations and 100 deaths annually in the United States from chickenpox, also known as varicella. During 2003 and the first half of 2004, the CDC reported eight deaths from varicella, six of whom were children or adolescents. While the vaccine protects 70 percent to 90 percent of those who receive it, he said, those who do contract the disease after vaccination usually get a milder case than what occurs naturally.
The American Academy of Pediatrics (AAP) recommends that children get the vaccine between the ages of 12 months and 18 months. Schools and day-care centers are increasingly adding the shot to their list of requirements for attendance.'Like Old Days'
Chickenpox is a highly infectious disease that causes tiredness and fever in addition to its blister-like rash. In a mild case, a child may get only a dozen or so lesions, while a full-blown case could sprout several hundred pox. The lesions usually appear first on the face and chest, but can spread over the whole body.
Chickenpox is generally transmitted by direct contact or through the air from coughing or sneezing and lasts about five to 10 days. Treatment usually consists of making the patient more comfortable, often with fever-reducing medicines, topical lotions and soothing baths. About one in 10 children has a complication from the disease, according to the AAP. Complications can include infected skin, dehydration, pneumonia and encephalitis. The CDC recommends keeping children's fingernails short and discouraging scratching to avoid infection.
Darlene White of Bealeton, Va., who successfully exposed all four of her children (even one who had been vaccinated) to chickenpox, said she questioned her decision when her 2½-year-old contracted the illness.
"You could not even see healthy skin between the majority of the pox, and her scalp had them so bad that she looked like she had gone through radiation treatment," said White. However, now that her daughter is healed without a scar, she said she would do it again, because she now believes her family has lifelong immunity -- something experts say does not exist.
"I am very glad for people who have chickenpox parties," she said. "A little playing, some conversation and some passing of the pox to the next family. I am glad there are still enough of us who see the benefit and have these play dates."
In an AAP survey published in May, 70 percent of responding physicians reported that at least one parent had refused an immunization for a child in the past 12 months. The chickenpox vaccine was the second most refused immunization, trailing only the shot that combines measles, mumps and rubella.
For those in favor of pox play dates, finding each other has become much easier through the Internet, where parents can post e-mails on message groups seeking the pox or offering their homes for a party.
Many parents who don't vaccinate their children or who use vaccines sparingly worry that ingredients in the shots could cause autism or other disorders, although no connection between vaccines and these disorders has been proven.
When Laura Eisen wanted to expose her son before he started preschool this year, she posted messages on Mothering.com and two message boards. Eisen, who lives in Bethesda, asked friends and her pediatrician to also point her toward any leads. She heard about a child attending summer camp at a local school who had caught the pox and contacted the child's family through the camp nurse. The parents rejected Eisen's suggestion that they sponsor a pox party, saying they thought sharing the pox might be a legal liability.
"That's when I knew I lived in Washington," Eisen said.
This summer, Eisen and her son both caught chickenpox, though she's not sure where. Eisen, who came down with it first, immediately called a friend who also was searching for the pox, who brought her son over.
"I hugged him, coughed on him, let him touch the pox," said Eisen.
The same friend a few years ago had brought her younger child over to catch the pox from Eisen's youngest. "It's like the old days," said Eisen of the growing chickenpox party network. She remembers pox parties being part of her own childhood.Mind of Its Own
While chickenpox is sometimes extremely contagious, parents are also finding it's not always easy to contract. That child who touched Eisen's pox is, a few weeks later, still perfectly healthy. Sally Holdener of Nokesville has been trying to infect her youngest three children (her older two have already had the disease) with no luck.
She's been to a chickenpox party. And she went to a play group where one of the kids had recently contracted the pox ("prime time" in chickenpox party vernacular) and stayed five hours. Part of the problem is that children are most contagious just before the pox show up, although they can still pass the disease until the scabs heal over, a window of about five to 10 days. Holdener will keep trying, because her family embraces a lifestyle that includes eating mainly whole foods and not using any vaccines.
Mothering, the Magazine for Natural Family Living, published a story last year celebrating the exposure method. The story suggests asking pediatricians to contact you when a child comes down with the illness. "Pass a whistle from the infected child to the other children at the party," it recommends.
The story warns against exposing adults who have never had chickenpox, as they are likely to get a more severe case than children, and pregnant women who could put their unborn babies at risk.
But Robert B. Shearin, chief of staff with Capitol Medical Group, a pediatric practice in Chevy Chase, said even children who get the disease naturally can contract it again. Shearin said both children and adults will likely be offered chickenpox boosters over the next few years because there is no such thing as lifetime immunity from the illness.
"The immunization is the way to go," said Shearin. He calls chickenpox parties very dangerous and says they represent an outdated way of thinking because it is impossible to predict how severe chickenpox will be in individual cases.
"We only have to have one child die of chickenpox to put this into perspective," Shearin said.
Still, not every doctor agrees. Andrea Falack said the pediatrician who treats her five children in Brooklyn, N.Y., called her to come in when another patient had just been there with the pox. (Her doctor and another doctor who also let a patient know when chickenpox was in the office either did not return phone calls or did not want to be quoted in this story).
Falack, who does not use vaccines, says she doesn't like the idea of her children ever being sick but believes it's better for children to get the chickenpox over with at a younger age. The doctor's visit didn't work, so she's still on the lookout. "If I know someone with chickenpox I'll expose the kids," Falack says.
Weeks after Thackston's four-day pox party, none of the children exposed had caught the illness. Still, she'd do it again.
"It's a little weird to help other kids get sick," she admits, but she believes it's the right thing to do, because the pox vaccine is "mediocre at best."
"People are trying to find another way to protect their kids," Thackston said. ·
Shannon Henry, a former Washington Post staff writer, is working on her second book. She last wrote for the Health section about online moms. E-mail: email@example.com.