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A report suggests children should be routinely vaccinated against chickenpox to prevent deaths and serious complications. But just how necessary is it? Siobhan Ryan reports

Chickenpox is usually seen as just another childhood disease.

Not particularly dangerous, not that much of a deal and just a normal childhood rite of passage.

But a study at Bristol University suggests carrying out routine vaccinations would reduce the risk of complications from the disease and even death.

Unlike illnesses such as measles, chickenpox is not a notifiable disease so the exact number of cases across Sussex is not known although nationally, according to the Royal College of General Practitioners, there are usually fewer than 30 estimated infections a week.

A vaccine for varicella, the medical name for chickenpox, is available and could be added to the existing measles mumps and rubella jab by using the recently licensed MMRV vaccination says the report, Severe Complications of Chickenpox in Hospitalised Children.

The authors, who include Adam Finn, professor of paediatrics at Bristol University, say the previous controversy about the MMR jab and its alleged link with autism would make it difficult to introduce MMRV at present.

Instead, they suggest offering the varicella vaccine to teenagers who have not yet had chickenpox.

Brighton and Hove director of public health Tom Scanlon said there had been no deaths from the disease in the city but he could understand parents might still support a general vaccine.

He said: "Complications can arise from chickenpox but they are very rare and in the majority of cases it is a relatively mild disease. Deaths are very uncommon.

"The risks can get higher as a person gets older and there is a risk if pregnant mothers get it.

"However, the illness can be upsetting for a child.

"It is not an area we have pushed on. Our main focus has been on the prevention of conditions such as measles which has a much higher risk of complications.

"At the moment the take-up rate for the measles, mumps and rubella vaccination in the city is improving but it is still well below the recommendation that 95 per cent of a population should be protected to prevent an outbreak.

"We will be keeping an eye on developments in terms of whether chickenpox vaccines will be introduced as a matter of routine."

Kate Logan, 54, from Mile Oak, was diagnosed with ME in 1993 after falling victim to a series of illnesses as an adult including chickenpox and glandular fever.

She said: "I think I was always predisposed to ME but I assume having chickenpox helped trigger things off for me.

"I support the idea of a vaccine if it helps protect children and adults against any potentially serious problems although I could understand how some parents may think their young child is already getting enough vaccines so why add more to the list?

"If the child is older or a teenager then that would probably be a good idea."

Mother-of-two Sue Morton, 38, of Kemp Town, Brighton, has had her eight-year-old son and six-year-old daughter vaccinated with the MMR jab. She said: "I would be more than happy for them to have one for chickenpox as well. If the vaccine is there and has the potential to protect my children from possibly dying or getting seriously ill then I will take it."

GP Michael Edwards, from Horsham, said he supported the idea of routine vaccinations. He said: "Cases of deaths and serious complications may be rare but if the risk is there then vaccinations should be made available."

Routine immunisation for chickenpox is currently offered in Britain only to healthcare workers and others who are at risk of contracting the illness or passing it on. But the US, Canada, Australia and Finland have already introduced vaccination programmes for children.

Professor Finn said: "Chickenpox has traditionally been viewed as an irritating but inevitable infection to be endured during childhood.

This benign view persists despite evidence that c e r t a i n g r o u p s , including neonates, adults, pregnant women, and the immunocompromised have higher risks of severe disease."

The report was based on research in which paediatricians monitored children up to 16 admitted to hospital with severe complications as a result of chickenpox during 13 months in 2002-03. There were 188 cases reported, of which 112 were confirmed.

Complications include septic shock, pneumonia and encephalitis as well as toxic shock syndrome, the flesh-eating bacterial infection necrotising fasciitis, and ataxia, uncoordinated movement).

Five children between two and 14 died, including four with a preexisting medical condition.

An unborn baby also died in the womb during the study period.

The average age of those hospitalised was three and the average stay in hospital was seven days.

After they were discharged, 40 per cent of the children studied had continuing problems, most commonly ataxia or skin scarring.

Most of the children studied were healthy before they contracted chickenpox so would have been able to be immunised had a vaccine been available.

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