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Tag Archives: Chickenpox

Shingles and Multiple Sclerosis linked?

A recent study in Taiwan has brought to light a probable link between that extremely nasty and disabling autoimmune disease Multiple Sclerosis, and our old friend Varicella Zoster (which also calls itself Chickenpox or Shingles). Some sort of link had already been suspected between the herpes viruses (a band of microscopic ‘hood thugs which lurk in the nervous system, sneering at passers-by and occasionally going on a rampage) and MS, which is the result of damage to the myelin sheath that protects our nerves and enables them to deliver their electric messages despite Rain, Sleet, or Glom of Nit. However, this is the first study to say: yes, there is.

The trouble is, they can’t yet say what the link is. Does the slow onset of MS (the study took cases that were diagnosed with MS up to a year after the shingles attack) trigger the shingles episode? Or was it shingles that kickstarted the MS? Is V. Zoster the only herpes virus involved, come to that?

Fortunately MS is a very rare disease (especially among Asians, lucky sods). In my life so far, I have met only two people suffering from it. It tends to attack the young, between the ages of 20 and 40. If a causal link can be established to something like V. Zoster for which a vaccine exists (once you’re infected it is incurable, although drugs like acyclovir may help reduce the severity of episodes), this may open the way to more effective treatments and prevention for MS.

Here is the abstract of the published paper (reproduced with permission from the Journal of Infectious Diseases). If you are up to wading through the technical stuff in the study itself, I recommend doing so as it does put the conclusions into perspective as well as suggesting useful areas for future study.

Abstract

Objective.
Varicella zoster virus (VZV) has been proposed to be involved in the pathogenesis of multiple sclerosis (MS). However, the epidemiological data regarding the MS occurrence rate following herpes zoster are still scanty. The goal of this study is to investigate the frequency and risk for MS following occurrence of herpes zoster.

Methods.
This study used the Taiwan National Health Insurance Research Database. A total of 315,550 patients with herpes zoster were included as the study group, and the control group consisted of 946,650 randomly selected subjects. The stratified Cox proportional hazard regression was performed to calculate the 1-year MS-free survival rate.

Results.
Of 1,262,200 sampled patients, 29 from the study group (.009%) and 24 from the control group (.003%) had MS during the 1-year follow-up period. After adjusting for monthly income and geographic region, the hazard of MS was 3.96 times greater (95% CI = 2.22−7.07, p < 0.001) for the study group than controls.

Conclusions.
Our findings support the notion that occurrence of MS could be associated with herpes zoster attack. We found a significantly higher risk for MS within 1 year of herpes zoster attack compared with the control population.

Lastly, just for those who still think chickenpox is a fun childhood disease and only old folks get shingles:

Shingles Returns More Often Than Thought MedicineNet.com

Pox parties, or how to be a terrible parent

29 May

The late Spike Milligan once wrote “The Army works like this: if a man dies when you hang him, keep hanging him until he gets used to it”. I get the distinct impression that a small, but significant proportion of what passes for civilised (and supposedly educated) humanity also subscribes to this dangerous philosophy. From Wikipedia:

A pox party is a party held by parents for the purpose of infecting their children with childhood diseases, most commonly chickenpox, thus acquiring some immunity to the disease. According to the Washington Post, parents who expose their children to the virus in this manner believe that this method is “safer and more effective than using vaccines.”

Leaving aside for the moment the fact that “pox” as a generic term also includes smallpox and syphilis – would any sane parent deliberately expose their child to those? – how do these people justify their actions? Vaccination exists, is effective (greatly reducing the risk of contracting the disease, and attenuating the severity if you are unfortunate enough to contract it despite vaccination) and easily available.

The reasoning is simple, though rooted in strange logic and astonishing arrogance. Arguments advanced to justify a deliberate attempt to make your children ill include:

Thanks to everyone else being vaccinated, this illness is now rare, so we’re not a threat to anyone if we don’t vaccinate;
So-called “childhood illnesses” are benign;
Vaccination is a medico-politico-pharmaceutical mega-conspiracy;
The vaccine is rumoured to be ineffective, or only short-lived, or unsafe.

The breathtakingly self-centred I’m-all-right-Jack attitude of “You’re all vaccinated so we’re no threat” leaves me nigh-speechless. Tell that to infants too young to be vaccinated, the elderly, the immunodepressed (HIV, transplantees etc.), and other people with medical conditions that preclude vaccination. Tell it also to people who come from countries where the vaccine is not widely available. Incidentally, the number of cases of preventable “childhood illnesses” is on the rise again (statistics widely available, so no link), almost certainly because of parents refusing to vaccinate vulnerable children.

Benign childhood illness? Well, I don’t think any of them has signed a contract stating they’ll only attack children and never cause complications.

Catching chickenpox does not in fact make you immune: you carry the virus around for the rest of your life, and it may manifest itself later as shingles or Ramsay Hunt Syndrome. What they mean by “immune to chickenpox” is that normally the virus should never manifest itself in that way again. You’ve still got it, and it can be extremely painful and incapacitating.

Catching measles is not a good idea if you’re under 5 or over 20, or have a weakened immune system for any reason. And yes, measles can kill.

For the record, my mother tried to get me infected with mumps when I was about 7, since at that time no vaccine existed. Nobody considered it a benign illness, since it was notorious for causing sterility in the post-pubescent and being damn painful. I was not happy when I found out what she was doing, and am still extremely glad that she failed. Both my children received the MMR vaccine.

Vaccination is a medico-politico-pharmaceutical mega-conspiracy? The bigger the group, the harder it is to organise, so the chances of a successful conspiracy here are vanishingly small. Oh, and the press would also have to be involved. Worldwide. Including the whistleblower ones like Private Eye and Le Canard Enchaîné. How are they covering up the many millions of vaccine-caused autism cases we must have if the antivaxers are to be believed? I think RangeIMD’s blog post here sums up the tinfoil hat brigade’s case quite well. Incidentally, it was recently pointed out to me that the same issue of The Lancet that published Andrew Wakefield’s misleading and ill-conducted “study” purporting to find a link between MMR vaccine and autism also carried a commentary that pointed out the flaws in Wakefield’s paper. Unfortunately, unlike the damaging and inaccurate paper it criticised, this commentary is still hidden behind a paywall. If the truth is being deliberately suppressed, wouldn’t it rather be the truth that MMR vaccination (and by extension other vaccines, since this seems to have sparked all the panicking) is generally safe?

Actually, I prefer to look for stupidity and incompetence before I start believing in successful, worldwide conspiracies.

Ineffective or short-lived vaccine? See conspiracy theory comments above. Ineffective vaccines don’t make it to market – check out your country’s stringent approval process if you don’t believe me. Yes, some vaccines need to be renewed at regular intervals, say every 5 or 10 years (or annually in the case of influenza, as it mutates so fast). I’m due to renew my DTP jabs in 2014 and, trust me, I will. Tetanus is a horrible way to die, and diphtheria and polio are no better. As for the chickenpox vaccine, the booster shot is apparently 5 years after the original. Not exactly short-lived, even if some vaccines do last longer.

All in all though, what annoys me most about “pox parties” is the blithe assumption that there is only one germ on offer. Illnesses like chickenpox, measles, ‘flu or even the common cold are all bad enough on their own. All have incubation periods, so you may feel fine but already have contracted them. You really don’t want to start a mix’n'match pathogen party. Two respiratory infections at once? Hello A&E!

Oh, and sending rags you’ve wiped chickenpox or shingles sores with through the post so that people who can’t get to your get-sick get-together can try to infect their own offspring isn’t just stupid, it’s illegal.