WHEN CHICKENPOX STRIKES!

Picture courtesy of Wikipedia

It was an agonizing week, most of which I spent in a daze. The cycle would start with a chills, my whole body shaking uncontrollably as the fever steadily and surely rose to 40⁰C and there was nothing I could do to stop it.

My whole body would be on fire, my tongue so dry it stuck to my palate, my head pounding like a parade orchestra and the itch, oh the itch! My fingers would absolutely not obey any command from my brain and I scratched like I was demon-possessed.

I would stand in the shower and let the ice-cold water wash over me, if only to numb my senses and provide temporary relief from the itch. They said calamine lotion would relieve the itch. They lied. They said piriton combined with cetirizine was the magic bullet. They lied. Nothing worked. The only relief I would get was from standing in the freezing shower and turning into a lump of ice.

Just when I would begin to fall asleep, the warmth would wash over me under the covers and I would start to itch again. The cycle would repeat itself every three hours without fail. I had blister-like rashes all over my face and body. Not even my legs were spared. I had rashes on the inside of my mouth. Eating was a luxury.

They taught us in medical school that chicken-pox in adulthood was far worse than in children. They forgot to tell us it was a hellish experience.

I was finishing my paediatric rotation as an exitable, energetic intern, when I was asked to review a five-year old in the paediatric emergency department. Her parents brought her in with complaints of runny nose, cough and fever. She also had a fine rash on her neck.

Chickenpox was the last thing on my mind and I didn’t mind too much when she coughed in my face. Having spent three months with children, my immunity was just great. I wasn’t moved by a minor cold.

Three days later, on a Monday morning, I turned up in the ward with huge swollen neck glands. Everyone made fun of me, trying to guess the diagnosis. The resident doctors who were pursuing their specialist training in paediatrics teased me mercilessly, saying I had gotten the kissing disease (Epstein Barr Virus infection, common in teens and passed on through kissing) after a weekend off from work. It made for a good laugh around the wards.

However, Tuesday morning brought the jokes to an end. I had woken up a little late and rushed through my morning preparations before work. I never quite looked in the mirror. When I got to work, everyone who saw me took a step back and asked what was wrong with my face. I looked in a mirror and the horror dawned on me. I had chickenpox at 26 years. I was mortified.

I put on a face mask so as not to  infect anyone and waited for the rounds to begin. It was one of the two days in a week when we had a major round, with all the consultant paediatricians in attendance. The head of the ward asked about my mask and when I mentioned the chickenpox, she threw me out of the wards by giving me an immediate sick-off. I went home dejected.

It was 2007, the country was experiencing a wave of chicken pox after years of absence. Many younger doctors had never even seen an actual case of chickenpox. I vividly remembered the cough from my little patient and wondered how I had not thought of chickenpox. I had to stay away from the wards so as not to endanger my patients, most especially the young ones on chemotherapy for cancer, as their immunity could not handle it.

It was a rough outbreak. I survived it but I know several adults who did not make it through. It was a year when HIV was seriously beating us and many of our patients were not yet on antiretroviral treatment. Chickenpox felled them like a bad tsunami. Babies with HIV died in our wards and we were helpless to stop it.

I couldn’t help remembering how I had escaped a chickenpox attack when I was ten. We had a new classmate who had just emigrated from Punjab. His whole family got chickenpox soon after arrival and they spread it around the school. All my classmates went down except two of us. I always thought that maybe I had already suffered it and my mom forgot about it. Now I really wished I had gone down with my classmates.

Childhood chickenpox is generally a simple affair that fades off in a few days, leaving minimal damage. However, in adults and the immunosuppressed, it can deliver a heavy blow. It can lead to inflammation of the brain, deadly pneumonia, and death. In early pregnancy, it can cause severe abnormalities in the newborn, while in late pregnancy, it can pass onto the newborn, causing complicated infection and neonatal death.

For several weeks, I wore my spots with pride. They faded over time but they served to remind me that some were not as lucky as I was. I no longer worry about catching the infection as it is a once in a lifetime ordeal, but I do know that immunosuppressed patients can develop shingles from a previous infection. This is when the inactive virus sitting in the nerve roots becomes active and causes severe inflammation on the skin. The rash is unique in that it only appears on the area supplied by the affected nerve. It blisters and eventually breaks down like a burn, and it is extremely painful.

Thankfully, since 1995, we have been able to prevent chickenpox by vaccinating all those who have never had the disease. Children are vaccinated from one year of age. Women planning to be pregnant are advised to take the vaccine to protect themselves and their newborn. The little shot, is well worth having. Saves us a pile of trouble!