Healthy Me - At Home and Away: Chickenpox

Showing posts with label Chickenpox. Show all posts

Wednesday, May 27, 2009

It is not just a childhood illness

CHICKEN POX
Elderly also at risk as they tend to have weaker immune system

ESTHER NG, estherng@mediacorp.com.sg

CHICKEN pox is mild and patients usually make a full recovery, but it tends to be treated as a childhood illness. Which may explain why the elderly don't bother to get themselves vaccinated against it.

A check by Today with eight clinics in Tampines, Bukit Merah and Commonwealth showed that requests for immunisation are usually from parents for their young children.

"We've not seen a marked increase though SM Goh getting chicken pox has generated a lot of publicity. Most of my patients (for the vaccination) are young children and teenagers," said Dr Lawrence Soh from Shalom Clinic and Surgery at Bukit Merah.

Recently, Senior Minister Goh Chok Tong, 68, was hospitalised for 12 days for chicken pox.

At SingHealth Polyclinics, 145 children under 12 years old were immunised against the illness between January and March this year. Only 49 people older than that were vaccinated.

Yet it is the elderly that are more at risk when they contract the virus, as they tend to have a weaker immune system. On his discharge, SM Goh advised the elderly who have not gotten the illness before to get themselves vaccinated.

Most people get chicken pox when young, but the elderly can get a condition called shingles, said Dr Leslie Tay from Karri Family Clinic at Tampines. "This is a reactivation of the same virus that causes chicken pox," said the general practitioner.

However, the vaccine is not suitable for everyone.

SingHealth Polyclinics' assistant director of clinical services, Dr Ruth Lim, said that anyone who has a life-threatening allergy to gelatin or the antibiotic neomycin should not ask to be immunised as the chicken pox vaccine contains these.

"If you've had a previous serious reaction to your first dose of the chicken pox vaccine then obviously you should not come back for the second dose," she said.

People with a weakened immune system, such as those receiving a high dosage of steroids or those undergoing chemotherapy should not be vaccinated as well.

"The vaccine is a live virus — meaning that the chicken pox virus has been rendered weak so that it won't cause the disease. But if your immune system is not strong enough, you may still get an outbreak of chicken pox," said Dr Tay.

Pregnant women or those planning to get pregnant within the month are also advised not to immunise themselves. This is because "the effect of the vaccine on the foetus are unknown", said Dr Lim.

Serious complications like septicaemia (an infection of the blood), pneumonia, and brain inflammation can occur during a bout of chicken pox. But such occurrences are "very rare", according to Dr Lim and Dr Tay.

When these happen, they tend to be in adults with weak immune systems.

The chicken pox vaccine is 70 per cent effective if administered within 72 hours of exposure to the virus. Depending on age and the type of vaccine used, a single or a double dose is required. A single dose costs between $60 to $72 at polyclinics, while a two-dose package will cost more than $120.

From TODAYOnline.com, Singapore News – Wednesday, 27-May-2009; see the source article here.

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Tuesday, May 26, 2009

Addressing concerns on infections in children

Immunity Advisory
All parents want the best for their children and constantly worry about their well being. Children who fall sick often miss out on learning opportunities and playtime which affects their overall growth and development. In this week’s column, A/Prof Daniel Goh helps parents to clarify uncertainties regarding infections in children.

Q1: Are there any vaccinations that my child should take? Are there any side effects to vaccinations? – Evelyn Lee

A: Apart from the routine vaccines in our national immunization programme, there are several other vaccines that you should consider for your child. These include the rotavirus vaccine (given orally, only for babies less than 6 months of age), chicken pox vaccine (above 1 year old), influenza vaccine (which should be taken once a year), hepatitis A vaccine and the pneumococcal conjugate vaccine. Do speak with your family doctor who will be able to guide you in your child’s immunization needs.

Side effects of vaccines are usually mild and self-limiting and include pain, redness and fever. Allergy to vaccines is very rare. If your child has egg allergy, she should not receive influenza or yellow fever vaccines as these contain traces of egg. The measles vaccination is safe even in a child with egg allergy. If you notice that your child develops rashes, eye swelling or breathing problems after receiving a vaccine, you should bring your child immediately to your doctor for further assessment and management.

Q2: What are auto-immune diseases and what are the symptoms? – Belinda Ang

A: Auto-immune diseases occur when the body’s immune system reacts erratically against itself and forms antibodies to attack healthy cells, tissues and organs. Some examples of auto-immune diseases include Lupus, Dermatomyositis and Type 1 Diabetes Mellitus. The symptoms of auto-immune diseases vary according to the type of disease. Some of the symptoms can be subtle and include persistent fever, weight loss, general tiredness and malaise, persistent or recurrent skin rashes, joint pain and swelling. Do consult your doctor should your child have such symptoms.

Q3: The doctor usually prescribes a course of antibiotics for a child to clear an infection. How does it actually work against the virus? – Gloria Phua

A: Infections can be caused by bacteriae, viruses and other pathogens. Antibiotics are used to treat specific bacterial infections such as some ear and sinus infections, and some types of pneumonia. However, antibiotics have no effect on viruses at all and should not be used in viral infections such as the common cold and the  u. When prescribed, it is also important for you to take your antibiotics properly and to complete the course as instructed by your doctor. Overuse/misuse of antibiotics can lead to other complications. It can also cause the development of resistant strains of bacteriae that are even more difficult to treat.

A/Prof Daniel Goh is the head of both Department of Paediatrics and Division of Paediatric Pulmonary and Sleep at the University Children’s Medical Institute, NUH. A/Prof Goh also pioneered the “I CAN!” programme (a comprehensive programme for the management of asthma and allergies in children at NUH). He is the President of the Singapore Paediatric Society and the Vice-President of the College of Paediatrics and Child Health, Singapore as well as the Vice-President and President-elect of the Asean Paediatric Federation.

DID YOU KNOW?
Childcare centres and playgrounds are ideal breeding grounds for germs that cause infections. Therefore, maintaining a high level of personal hygiene such as thorough handwashing, proper disposal of used tissue paper and staying at home when your child is unwell will help reduce the spread of infection.

The advice offered by the featured expert in this series should not be misinterpreted to be a recommendation of any product. This series provides the opinions of specialists and readers should consult their own doctors if they should have further enquiries.

From TODAY – Tuesday, 26-May-2009

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Wednesday, May 13, 2009

Take another shot

Disease is more severe if older adults get it; vaccination is advised

by Eveline Gan

05:55 AM May 12, 2009

OLDER adults are often advised to go for regular flu and pneumococcal shots.

Now, doctors are urging them to add another shot - against chicken pox - to their vaccination schedule, if they have not been exposed to the virus during their childhood days.

Each chicken pox jab, which ranges in cost from $80 to $100, is optional in Singapore. Adults require two doses while children below 13 need only one.

The advice came after Senior Minister Goh Chok Tong, 67, was hospitalised for chicken pox last week.

It is rare for senior citizens, such as SM Goh, to get chicken pox, said Dr Reshma Merchant, a geriatrician at National University Hospital's University Medicine Cluster.

Dr Merchant explained that this is because about 90 per cent of the population would have had chicken pox when they were less than 15 years old. She added that it is more common for seniors to get shingles - caused by a reactivation of the chicken pox virus - after their earlier childhood attack.

But there are some who aren't immune to it.

"Most people don't consider the fact that if you don't get chicken pox as a child, you might get it as an adult, just like SM Goh did," said Dr Leslie Tay, a general practitioner at Karri Family Clinic.

Sufferers usually experience fever and red, itchy blisters on the body and face.

In most cases, the childhood disease is harmless and "mild". "However, in adults and older people, the disease tends to be much more severe," Dr Tay said.

According to Dr Leong Hoe Nam, a consultant at Singapore General Hospital's (SGH) department of infectious diseases, adults who get chicken pox often end up with a lot more blisters on their faces and bodies.

"A child may get a few hundred chicken pox lesions, but adults can get several thousands. This causes more severe scarring," said Dr Leong.

More worryingly, he added, older adults have a higher risk of chicken pox-related complications. Under five per cent of adult chicken pox sufferers require hospitalisation, Dr Leong estimated.

Dr Sim Kwang Chuor, a general practitioner and medical director of Aesthetic Works Medical Associates, explained that older people generally have lower immune systems.

"They are more prone to severe complications due to the body's reduced ability to fight the virus," said Dr Sim.

Those with impaired immune systems or underlying chronic diseases which decrease immunity, such as diabetes, are also more susceptible to serious complications.

Possible life-threatening complications include secondary bacterial infection, as well as lung and brain infection.

According to Dr Merchant, warning signs of severe chicken pox infection or complications include respiratory symptoms such as breathing difficulties and wheezing, bleeding rashes or densely packed blisters.

Other signs include neurological changes that cause unsteadiness or drowsiness.

A regular bout of chicken pox typically clears up within two weeks.

Prompt treatment and medication, especially within the first 48 hours, can significantly reduce the number of blisters and other symptoms.

"If you think you have chicken pox, my advice is to drop everything and see a doctor straightaway to confirm it and get medication. It can significantly reduce your suffering," said Dr Leong.

How chicken pox spreads
According to SGH's Dr Leong Hoe Nam, you can get chicken pox within 10 to 21 days after contact with an infected person. The person is usually infectious about one day before the rash appears until after the blisters dry up.

The highly contagious virus is present in saliva and in the fluid of the vesicles (blisters).

"When the affected person sneezes or coughs, the virus gets into the air and is inhaled by others. It can also spread through direct contact since the virus is also on the skin of the affected person when the vesicles burst," said general practitioner Dr Leslie Tay.

The virus is so contagious that if someone in your household gets it, there's an 80 to 100 per cent chance that it will infect you if you haven't been exposed to the virus before, said Dr Leong.

From TODAY, Health – Tuesday, 12-May-2009

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