Roanoke Times
Copyright (c) 1995, Landmark Communications, Inc.
DATE: THURSDAY, May 5, 1994 TAG: 9405050155
SECTION: VIRGINIA PAGE: C-1 EDITION: METRO
SOURCE: By KEVIN DANIELS STAFF WRITER
DATELINE: LENGTH: Medium
Diane D'Orazio of Roanoke thought her 2-year-old son, Cory, had a typical case of chickenpox when she first noticed the sores April 16. His sores began scabbing over, and D'Orazio assumed that her son was recovering normally.
But six days after the sores appeared, Cory began vomiting and passing out.
"He had about five spells in about two hours," D'Orazio said. Cory quickly became dehydrated.
Complications from chickenpox, which is caused by the highly contagious varicella virus, are not unheard of, although they are relatively rare.
Of the nearly 4 million Americans who contract chickenpox each year, about 9,000 will be hospitalized with complications ranging from blood infections to brain damage. About 90 people a year die from chickenpox complications. Children with weak immune systems and adults are most at risk, along with children who are being treated with steroids or chemotherapy, said Dr. Douglas Althouse, a Roanoke pediatrician.
Dr. Michael Sisk, a Roanoke pediatric neurologist who was involved with Cory's case, said many people are unaware of how serious chickenpox can become.
"There's a perception that chickenpox is just part of growing up in America," Sisk said. "People see it as a nuisance disease, where kids itch for a while and then they're fine."
Parents who view chickenpox as an annoying fact of life or a danger eagerly await the Federal Drug Administration's approval of a vaccine that has been used for more than 20 years in Japan. Approval is expected at any time, said Richard Carney, public health adviser for the Richmond Health Department's immunization clinic. He is unsure about what form it will take, however.
"We don't know if [the vaccine is] going to be recommended for all children or only those with immune problems," Carney said.
Althouse said approval is being held up because the FDA has unanswered questions about Varivax, the vaccine developed by Merck & Co.
"There's a worry that immunity will wane and leave a generation of adults susceptible to chickenpox," Althouse said. "Those adults will be at risk for a more severe, invasive form of the virus."
Sisk said there are four major neurological complications that can result from chickenpox.
The most common is cerebellar encephalitis, an inflammation and irritation of brain tissues that occurs while the patient is recovering from chickenpox.
"The antibodies turn on the balance center of the brain," Sisk said, making patients wobbly and uncoordinated. Most of the disorder's effects are in the trunk and legs. Complete recovery usually takes about six weeks.
Cory developed this complication. His mother said his recovery is a few weeks ahead of schedule.
Sisk said he sees about 10 cases of cerebellar encephalitis a year in Southwest and Central Virginia. So far, it is the only complication he has seen.
Another possible complication is diffuse encephalitis, where the chickenpox antibodies attack the lining of the nervous system. It is often accompanied by meningoencephalitis, which affects the spinal cord in a similar manner. These complications occur in one of every 500 chickenpox sufferers, Sisk said.
Afflicted patients feel tired, experience convulsions and may enter a coma. In extremely rare cases, the complication results in death.
A problem that was feared in the past decade is Reye's syndrome, which Sisk said "has basically now disappeared." This devastating disease can follow almost any viral infection and is believed to be a result of the interaction of antibodies with aspirin products. It is most common in children under 16.
During the early 1980s, Sisk said, the disease had a 50 percent mortality rate. He credits today's relative infrequency of Reye's syndrome to the increased publicity of the danger aspirin poses to children with viral infections.
Sisk said that a final complication is Bell's palsy, which can follow viral infections, allergic reactions or physical trauma. The muscles in one side of the face become weak, and recovery occurs slowly over several months.
by CNB