A southern Manitoba community near Winkler has found itself with cases of chickenpox (the varicella virus) on its hands. For Dr. Mahmoud Khodaveisi, the medical officer for Southern Health-Santé Sud, the developing situation has the potential to grow into something more concerning, but at the moment, the data does not support the presence of an outbreak.
How an outbreak is defined
In order for a collection of cases to be considered an outbreak, there must be enough clinical cases recorded to show a trend. According to Dr. Khodaveisi, while there have been a few clinical cases lately, most information about the cluster of chickenpox cases is anecdotal.
“I can't say that there is not anything happening, but if the physician or other primary care provider observes an increase of cases, they notify us,” he says. “[We] haven't heard anything about cases [from physicians], but [in] one community . . . close to the Winkler area, we've heard that there were a couple of cases [from residents].”
Vulnerable community members
What does this mean for the community? Ultimately, there are cases of chickenpox in the area, which means that to avoid the possibility of an outbreak, it’s best to be cautious, especially for the sake of the vulnerable portions of the population.
“In healthy young children, [the illness is] usually self-recovered but some people . . . show severe symptoms and also may have a higher risk for complications,” he says. “When someone is immunocompromised, . . . varicella could [cause] infection of the lung, inflammation of the brain, et cetera.”
Pregnant people are also at risk when it comes to the varicella virus. The illness can be passed on to the fetus. Further, because the vaccination for chickenpox is only recommended for children over the age of one, infants are also vulnerable. Something else to consider is that the sickness is often worse for adults who catch it. The government of Canada reports that the highest fatality rate of complications from chickenpox is among adults.
Dr. Khodaveisi says that the recommended course of action to avoid chickenpox is a two-dose vaccination.
“If someone has one dose, that person is more [likely to] get chicken pox than someone who got two doses,” he says. “I can say that most people who get the varicella vaccine will not get chickenpox and even if they do get [it], it’s a very mild illness.”
According to Dr. Khodaveisi, while the traditional symptoms of chickenpox are fever and tell-tale blisters, those who get the illness after vaccinations may not even develop a fever, and they are not at risk for serious complications.
A vaccine success story
Dr. Khodaveisi says that he looked into the data that Health Canada has collected about the chickenpox vaccine.
“Those who received two doses of varicella vaccine [were] followed over a 10-year period. [Health Canada] says the vaccine was effective in preventing varicella 98 per cent [of the time],” he says. “It’s very effective.”
Another reason to consider the vaccine is that it also prevents shingles later in life.
“Once people are infected by the [chickenpox] virus, it can stay in their body, [and then] when immunity is waning, the virus can be activated,” says Dr. Khodaveisi. “It causes shingles.”
Shingles is a painful condition that can cause itchy rashes, malaise, fevers, chills, and body aches, among other symptoms.
For those who have already had chickenpox, there is also a vaccine to prevent shingles in the future. As for the chickenpox vaccine, Dr. Khodaveisi considers it the ideal route for the health of the community.
“Immunization is the best way to protect children against chickenpox. If the children are immunized, they also help protect other people,” he says. “In the community, there are [immunocompromised and vulnerable groups] that cannot get the vaccine, so it's our responsibility to protect them, not transmit the infection to them.”
Dr. Khodaveisi adds that vaccinations are recommended for those who aren’t sure if they have had chickenpox as well as children who have had the illness as an infant. He says that because varicella is contagious up to two days before its onset, being vaccinated is an important protection against it.
While chickenpox was once a widespread illness with which many people became infected, Dr. Khodaveisi says that the effectiveness of the varicella vaccine is to thank for the reduced numbers that the country now experiences.
More information about the varicella immunization can be found on Manitoba’s fact sheet about the vaccine.
~With files from Robyn Wiebe~