Pox Parties of Yore

September 14, 2015
Terry Brenneman, MD

Mailing a lollipop licked by a child infected with chicken pox is: A. Stupid. B. Illegal. C. All of the above. D. Other.

[[{"type":"media","view_mode":"media_crop","fid":"41245","attributes":{"alt":"","class":"media-image","id":"media_crop_4407207609254","media_crop_h":"0","media_crop_image_style":"-1","media_crop_instance":"4318","media_crop_rotate":"0","media_crop_scale_h":"0","media_crop_scale_w":"0","media_crop_w":"0","media_crop_x":"0","media_crop_y":"0","style":"height: 415px; width: 620px;","title":"©Pressmaster/Shutterstock.com","typeof":"foaf:Image"}}]]Before the introduction of the varicella vaccine in 1995, “Pox Parties” were not uncommon, where healthy, chicken-pox naive children were invited to spend some time with an infected child.  It sounds a little crazy for a parent to purposely expose a child to an infectious disease but to be honest, these parties offered some benefits to families. It was fair to assume in this prevaccine era that your child had a more than 95% chance of contracting varicella before the age of 15. Parents also realized that the risk of complications from the disease was worse in adults, so since infection at some point in a person’s life was almost inevitable, why not have it done with during childhood.

Another advantage to sending your child to a Pox Party was that you had a good idea of when your child would become ill, usually about 2 weeks later but with a range of 10-21 days after exposure. 

Having been a pediatrician in the prevaccine era, I remember distraught parents having to cancel vacations and not-so-distraught teens missing final exams, SATs, etc, as the disease set in.

On the other hand, chicken pox is not always a benign illness. Before 1995, about 11,000 hospitalizations per year occurred with 100-125 deaths per year. Sadly, a variation on the Pox Party still occurs.  In 2011 a federal prosecutor in Tennessee investigated reports of a ring of parents who were mailing lollipops licked by a child with varicella to other antivaccine parents wanting to infect their children. Let's see how you do with one legal question and one medical one on the topic.

1. Mailing an infected lollipop is:

A. Stupid, but not illegal

B. Illegal, but only if the mail crosses state lines

C. Illegal regardless of where it is mailed.

For answer, discussion, and another question, please click here.

[[{"type":"media","view_mode":"media_crop","fid":"41246","attributes":{"alt":"","class":"media-image media-image-right","id":"media_crop_9838015363769","media_crop_h":"0","media_crop_image_style":"-1","media_crop_instance":"4319","media_crop_rotate":"0","media_crop_scale_h":"0","media_crop_scale_w":"0","media_crop_w":"0","media_crop_x":"0","media_crop_y":"0","style":"height: 177px; width: 265px; float: right;","title":"©Sergey Ryzhovck.com","typeof":"foaf:Image"}}]]Answer: C. Illegal regardless of where it is mailed.

It is illegal for several reasons. Sending a virus or disease through the US mail is against the law as is sending any adulterated foodstuff.

 

2. The likelihood of the infected lollipop causing disease in another child after being mailed is:A. Very unlikely since infection from varicella is airborne rather than oral.

B. Very unlikely since the virus is extremely labile and unlikely to “survive” the mailing

C.  Both A and B are true

D. Low to moderate; the varicella virus is extremely contagious, but transport would reduce the number of infectious particles.

For answer and discussion, please click here.                             

Answer: C. Both A and B are true.

There is no reliable evidence that the varicella zoster virus is spread by fomites and infection is through the upper respiratory tract and conjunctiva. Why am I not surprised that these antivaxxers are not very good at science. 

Dare I wish a “pox on their house?”

References:

Ghianni T. Swapping chicken pox-infected lollipops illegal. Reuters. Sat Nov 12, 2011. 3:06pm EST. NASHVILLE

RED BOOK 2015. pg 846

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