Chicken Pox danger still at at 7 mg?

[Predderman2020]

I live in Malta and I am due to go back to UK on Thursday, (3 days time). One of my grandchildren (1 and a half) is suspected to be infected. While I won't see that child, I am scheduled to be in contact with several 30 somethings who have all been in close contact with the child. Indeed I would be staying in a small flat with them. I am worried. Do I need to be concerned at my dose? Is it too late to have the Shingrix vaccination (if available here) in the meantime. Thank you.

[Predderman2020]

Just to refine my question ... would I be in danger (in 3 days time) at that dose from prevously infected persons who have been in close contact with early stage (happening now) CP. Thanks!

[PMRpro Ambassador]

Like all vaccines it will take 2 weeks to have an effect so probably not. It won't stop CP anyway - it is for shingles and shingles alone. Have you had CP yourself? Have the 30-somethings had CP in the past or had the CP jab (unlikely if they are Brits, the NHS doesn't use it)?

You have to have had CP to develop shingles, you don't "catch" shingles. If you haven't had CP then personally I would be very unwilling to take the risk - CP in adults can be very serious and very nasty even fpr relatively young and healthy adults.

If you look at the Related Posts there are lots of posts discussing it and the risks. CP is highly infectious in the 24-48 hours before the first spot appears and until the spots have all scabbed over. The incubation period is 10-21 days. If you were to catch it, immediate contact with a doctor is needed to get antiviral medication which will make it less severe.

[Predderman2020 in reply to PMRpro]

Vaccines out! Thanks. I had CP. So have all the 30 somethings. I was checking the prevous posts - most useful. I guess my worry is Shingles, (my close friend was recenly very, very ill with it). Do you think in the scenario where I just see my older children who have been in contact with the newly CP grandchild, I am at risk? Thanks, PMRpro. T

[PMRpro Ambassador in reply to Predderman2020]

I honestly have no idea whether being in contact with them would have any implication for shingles - it can happen all on its own anyway! The same applies - if you were to develop any symptoms, immediate use of antiviral medication should improve the experience.

I suppose if you COULD get the Shingrix before Thursday it is one step of protection ... But only one step - it is a 2-step vaccine, 2 months apart.

[Predderman2020 in reply to PMRpro]

Excellent - incubation for shingles same period 14+ days? Thanks, PMRpro

[PMRpro Ambassador in reply to Predderman2020]

Well it isn't an incubation as such - it is something triggering the virus that is dormant in your nerve endings to come out of hibernation. Depends what the trigger is.

[Predderman2020 in reply to PMRpro]

thank you T

[HeronNS]

As far as I can tell from reading up on this in the past (when I thought I'd never had chicken pox) the only risk is for people who've never had chicken pox coming in contact with a chicken pox or shingles lesion, which can cause chicken pox. There is also some risk associated with being in contact with an individual who has just received the live shingles vaccine, Zostavax, (or really any live vaccine). I think the jury's out on whether the additional exposure to chicken pox added to your existing lifelong load can cause shingles to break out, but it seems extremely unlikely. If I were in your position I think I would simply avoid exposure to active lesions (and hopefully such a child wouldn't be out and about anyway), and carry on. And get your 2-dose Shingrix vaccine as soon as you can. They say 2 months apart in the UK but in fact it can be up to six months if things work out that way. Here they like four months, but my second one was delayed as I had to have a covid booster in the meantime and I felt (almost exactly a year ago) that the covid vaccine had to take priority. No problems!

[Predderman2020 in reply to HeronNS]

That is terrific. Thanks, and will do. T

[HeronNS in reply to Predderman2020]

I meant when I thought I'd never had CP - corrected now!.

[KASHMIRI1]

I would make a polite excuse not to see them and arrange a future date. My rheumatologist said not to have the shingrix vaccine while taking steroids and to avoid anyone with or suspected of having chicken pox

[Predderman2020 in reply to KASHMIRI1]

Thanks! Good advice. T

[HeronNS in reply to KASHMIRI1]

The advice against shingles vax refers only to the live vaccine, Zostavax - if at all possible apparently we should avoid all live vaccines. Zostavax is particularly problematic because PMR is actually a known possible side effect! (I wouldn't let my husband get Zostavax when he was first offered a shingles vax because even being in close contact with a person recently vaccinated with live vax can cause immune compromised ppl problems, e.g. live flu vax administered to small children. At the time he was offered Zostavax I was not yet PMR diagnosed, but I thought I would run the risk of catching chicken pox, which at the time I thought I'd never had, Only found out later I must have had a subclinical case through blood test. However Shingrix came along a couple of years later and there was no issue with him receiving that.)

[KASHMIRI1 in reply to HeronNS]

Thank you😊

[Tonimic]

If possible do Not go near anyone that might be carrying the Chicken Pox virus. It’s one of the most dangerous

[Predderman2020 in reply to Tonimic]

I won't - good advice - thanks

[Blearyeyed]

How many days will there have been between the 30 something's beginning in close contact with the child with chicken pox , and the day you should all be housed together?Taking the vaccination now probably wouldn't help. It could actually make the chance of you catching something , not just CP , worse , as current guidelines suggest that you should keep away from people whom could carry an infection for 14 days after a new vaccination as your immune system may be lower and susceptible to infection while your body copes with producing antibodies for the thing you were vaccinated for. That's why it's not uncommon to get a cold or flu after a vaccination.

Some people can get chicken pox more than once but it is rare. Some people do develop Shingles after contact with the Chicken Pox virus. It doesn't cause it , but infection with the virus can be the trigger that causes the Shingles to develop , especially in people with compromised immunity from another illness , medication or infection. Its part of the reason they recommend that older people whom are not vaccinated for Shingles keep away from a person with CP in the first days of infection , or someone whom has been in contact with that person.

If all of your 30 something's have had CP and are not showing any symptoms after 10 days the risk would be low , but if they are likely to be visiting the child, or others that spend time with them whom could still carry the virus , during their stay the risk to you could rise. But the same would be true if they were in contact with someone whom had COVID or the Flu. Obviously, with all of these viruses it is possible for someone to carry the virus but not have the symptoms or develop the disease but still able to pass it on to others for a certain period of time.

It all depends on what you feel comfortable with, and how many days there are between them being in contact with the virus without symptoms. You could always choose to take extra precautions and perhaps stay somewhere else alone for a few days until you are confident that nobody has developed the CP.

Or , you could choose to be careful , wear a mask around the people you are staying with and socially distance from them for a number of days while in the accommodation, using regular hand washing and separate crockery and utensils that you wash and keep away from others things. Plus , use a separate bathroom or make sure you clean surfaces before using the facilities and wash hands thoroughly afterwards. Basically , similar habits to those used during COVID.

The big question is what are you comfortable with?

It is just as likely that these people have also been in contact with others with various viruses including COVID or the Flu. If you feel it is safe enough for you to be around them with the chance of catching these illnesses then the possible risk is likely to be the same until 10-14 days after contact with the child for CP.

Hugging would be out , at least for a few days , just to be sure.

If you choose to go and take precautions just make sure you contact everyone and let them know you need to do that and why. It will make things easier if everyone is prepared before you arrive to adapt things to allow you to socially distance.

[Predderman2020 in reply to Blearyeyed]

Thanks so much for all the info. Most valuable. T

[MrsNails]

I’ve written a piece on Chicken Pox & the Immunocompromised- it’s in FAQ’s

I had my Bloods taken the day Theo’s Rash appeared (l was holding my Grandson the day before his spots came out) my GP also gave me a Prescription incase the rash appeared.

I am on MTX & 12.5mg Pred but luckily my Bloods came back that l had the Antibodies but that took a week - they are not done in local hospitals so mine went to Birmingham.

Even though l knew l’d had CP - l’ve had Chemo Therapy so who knows what that does to your immunity but on this occasion it was fine.

Personally, in general l would avoid kiddies with any of the infectious/notifiable diseases. Scarlett Fever is doing the rounds at the moment 🤦🏻

[Predderman2020 in reply to MrsNails]

I will then - a consensus! Thanks

[Karenjaninaz]

When in doubt about immunity to chicken pox the antibody titer can be measured.

I can’t believe the U.K. does not vaccinate their kids against this. It consigns their children to future misery from shingles.It makes no sense.

[Predderman2020 in reply to Karenjaninaz]

Agree - thank you

[HeronNS in reply to Karenjaninaz]

I haven't seen confirmation that vaccinating against CP (i.e. giving a person a subclinical case of CP) prevents you from getting shingles. The vaccines are live (attenuated) virus.

[Karenjaninaz in reply to HeronNS]

webmd.com/skin-problems-and...

[HeronNS in reply to Karenjaninaz]

No child receiving CP vaccine since mid-1990s is anywhere near the age at which shingles usually occurs. Think the jury will be out on this one for another 30 or more years!

[Karenjaninaz in reply to HeronNS]

pubmed.ncbi.nlm.nih.gov/345...

[Karenjaninaz in reply to HeronNS]

urmc.rochester.edu/encyclop...

[Predderman2020 in reply to Karenjaninaz]

Thanks!

[PMRpro Ambassador in reply to HeronNS]

The theory would be that if you haven't had CP - you can't develop shingles. However - since it is a live vaccine, there is potential to develop shingles from it later.

But the argument in the UK for NOT giving the vaccine is that meeting the virus later in life from children boosts the immune system so shingles is less likely to develop and that would mean a potential rise in cases of shingles, especially more severe shingles in older adults.

[HeronNS in reply to PMRpro]

Having trouble parsing this. You get your immune system boosted when you encounter CP infected children? Which means less likely to develop shingles? Which potentially means more cases and more severe in older people?

[PMRpro Ambassador in reply to HeronNS]

Because they haven't had the regular-ish boosts from encountering the virus if children have been vaccinated and aren't getting CP.. That was the argument they made ...

[MrsNails in reply to Karenjaninaz]

It’s being considered atm two of my Sons friends have paid for their children to be vaccinated after they saw poor Theo 😥

[HeronNS in reply to MrsNails]

I think I read somewhere that CP is becoming more virulent, do you think that is true?

[MrsNails in reply to HeronNS]

If you’d seen Theo you’d have thought so 😓

Scarlet Fever is doing the rounds in the U.K. and in some cases kiddies are getting it with Chicken Pox - can you imagine?

My boys were OK with CP even though J was only 12months old & M had his allergies/eczema just poor Mummy thought she was dying!……

You doing OK? We haven’t spoken in a while x

[HeronNS in reply to MrsNails]

I'm okay. And you?

My older son had a very mild case of chicken pox when he was little, and still young enough to share the bath with his younger brother who showed no symptoms. My daughter didn't catch it then, but several years later, when she was 15, did come down with it. She was fairly miserable but we got a salve from someone who was starting a business making her own remedies, I think a major ingredient was St John's Wort, although don't really remember. Daughter said it was much better than whatever we'd brought home from the pharmacy. Now that it's been determined that I had CP at some point in my life I've warned younger son that he might actually have had it, and should find out once he's old enough to consider shingles vaccination.