Chicken pox in school again but now using Cimzia- what to do?

[Moomin8]

Hi peeps- hope you're feeling the weekend? It looks like a sunny day here in the SE of England 😎

I have posted before about chicken pox (or pops as it's usually referred to in my workplace) but that was before Cimzia was added to my arsenal of meds. I was told by my nurse to be very aware of the virus as with a mix of mtx, sulfasalazine and Cimzia I would be much more susceptible to getting shingles; apparently the virus lays dormant in those of us who have had chicken pox - which I have. This is what I found on the NRAS website:

'Shingles

Shingles can occur in individuals who have had previous chicken pox, as the virus that causes it can remain in nerve cells in a dormant state. Shingles is reported to occur more frequently in patients on anti-TNF although less so in patients on Enbrel than with Remicade or Humira. It is not yet known how frequently it occurs in Cimzia treated patients but it is assumed that there may be a small increased risk. In the event of an itchy, painful, blistering rash of shingles-type occurring over one area of the body you should report this to your GP as soon as possible, as there are medications that can help settle it down if taken early. Your rheumatologist or GP will be able to advise on whether Cimzia needs to be stopped temporarily as in the case of other infectious complications.'

My dilemma is: I teach in every class in a primary school and so I am with the children when they're most contagious! The children are of an age when their hands are often in their mouths therefore spreading the virus on most surfaces etc. I know that I should be immune but having Cimzia increases my risk. The school are very good about letting me know about each new, confirmed case but by then I have already spent time with them or will do that week with their sibling! Any suggestions would be much appreciated. 😷

[AgedCrone]

See if you are eligible for the Shingles Vaccine...I suspect not as you are a young person ......so ask your Rheumy nurse what she advises.

I had Shingles in. 2015 .....I had it across my eye & in my scalp.I got the anti virals within 24 hrs of noticing the rash ...I went to a Minor Injuries Unit on a Sunday morning......they told me to call 111 & explain the situation & I got a GP Appoinment within the hour.

I was relying on Depo injections at the time having had a bad reaction to yet another Dmard, so no drug involvement.

The rash only lasted about 10 days....I felt a bit washed out, but as I got the anti virals & anti biotics quickly it wasn't too bad & apart from a "pins & needles" type minor headache for a few weeks I was fine with no lasting problems.

Hope you don't pickup anything from the little darlings!

[Moomin8 in reply to AgedCrone]

Thanks AgedCrone , you are correct: I am too young for the Shingles vaccine; I did ask 😇

[AgedCrone in reply to Moomin8]

If it makes you feel any better having shingles was the first time in 18 years on RA meds that I caught anything we are told to beware of!

Apart from sensible precautions like carrying hand disinfectant there is not much more you can do. (Or I suppose you could spray each child you come into contact with ! ( I'm joking!)

Keep healthy!

[Moomin8 in reply to AgedCrone]

Spray each child...🤔the buggers wouldn't stay still enough 🤣but I'm liking your thinking!

[AgedCrone in reply to Moomin8]

Sorreeeee...forgot to say...you get someone else to tie them up first!

[hawker955]

I would think that you should [a] keep well away from pox virus infections, and use a hand-gel antiseptic routinely. Personally I think if you cannot avoid possible exposure then stop a biological treatment because they hit your basic level of immunity [t-cells]. Pox viruses are nasty if they are not fought off. Check with your rheumatology nurse or doctor, but I know that I would stop my Humira for a while.

[Moomin8 in reply to hawker955]

Thanks Hawker955, but the trouble is: it will circle around for a few months! I haven't fully benefited from talking Cimzia yet and so I am reluctant to break any good it may have done to date 😕

[AgedCrone in reply to hawker955]

The problem is Hawker....when it became apparent I had shingles I could have infected everybody I had been in contact with as I had no idea I had it.....so I couldn't keep away from people, & more importantly anyone with a compromised immune system couldn't keep away from me!

Now I'm on the Biologic Retuximab which is infused into a vein every six months....so I can't just stop it! So what if one of the little darlings I come into contact with has Chickenpox?

I'm afraid I just go with the flow & deal with it when it happens, & I don't think about it otherwise.

But as I said to Moomin, I've been on various RA drugs since 1999, &'Shingles was the first infection I had that we are told to beware of.

[Jewels94]

I understand your concern. I had the same worry when a child I worked with got chickenpox. I contacted my GP who was able to reassure me that you can not catch shingles from somebody who has got chickenpox. I was able to get a blood test to make sure that I was immune from chickenpox. People often get confused about this but apparently you can catch chickenpox from somebody who has shingles but you can't catch shingles from somebody who has chickenpox. The chicken pox virus remains dormant in our systems and can be reactivated later causing shingles.

beta.nhs.uk/conditions/shin...

[janmary]

Just a 2-penny worth. As far as I understand it, exposure to chicken pox doesn't make you any more liable to get shingles ; the varicella virus is already lurking in any one who's had the pox before. Age, stress, tiredness, infection with other viruses etc are the precipitating factors for shingles. So everyone with lower immunity is at risk and should be aware of the early symptoms and get treatment ASAP.

Don't blame the little darlings...........

[Arthursslave]

Hi as Jammary says shingles is reactivation of the chickenpox virus you have already had not from being in contact with chickenpox. A lot of people get confused by this and think you get shingles if you catch chickenpox when you are older which isn't the case.

It's the same virus family as the cold sore virus and other herpes viruses which once caught sits in the nerve endings and then reactivates. It isn't known why but increasing age,stress and immunodeficiency increase the risks.

Unfortunatley we can't have the shingles vaccine on Biologics as it is a live vaccine.

Xx