Monday, 30 May 2016

Cultural Attitudes to Chicken Pox Around the World

A few weeks ago spots suddenly appeared on my youngest son's neck and chest. There was a pox on our house, and it didn't come or leave quietly. In fact, he was really sick and his entire body was covered in chicken pox, including inside his mouth and even in his throat. At the end of last week my middle son developed the uncomfortable rash too and as I write he is home from school. Interestingly enough, I soon learnt that the Dutch have a different attitude to chicken pox than some other nations.

When your child gets ill, Google becomes the source of medical advice. Most parents can't help themselves. We all know we shouldn't do it, but we do, we consult the internet to answer our medical queries.

At first I wanted to cram on the symptoms. And then on how infectious my son was, for how long, and when. To start with he was feeling physically okay, and had only a few spots on his face and torso. In trying to establish whether it was okay to take him out and about that weekend I came across this on the UK National Health Service website:

"To prevent spreading the infection, keep children off nursery or school until all their spots have crusted over. 

If your child has chickenpox, try to keep them away from public areas........."
UK NHS Website 

Well, clear. He stays home. Out of the way of others.

But wait, what do the Dutch think about all this?

"Als uw kind zich goed voelt, mag het naar school of naar het kinderdagverblijf. Het kan zijn dat de school of het kinderdagverblijf daar andere afspraken over heeft.
Meld de besmetting op school of op het kinderdagverblijf zodat andere ouders gewaarschuwd kunnen worden over een mogelijke besmetting."

In short, this states that if your child feels okay they can go to school (or day care) unless the school has another policy. Let the school or day care know so that they can let other parents know about the possibility of infection.

The problem with chicken pox is that a child is infectious before the spots appear. It's also highly infectious so once a child has the rash it's likely that half the class has already been infected. Most parents have first hand experience about what a breeding ground for germs most infant classrooms are......

In the majority of cases it is a harmless childhood disease that most children get at one time or another. Chicken pox is much more dangerous for pregnant women, new borns and older people whose immune systems are compromised. Hence, the NHS advice to avoid public places with an infected person.

However, the Dutch view is this: the risks associated with chicken pox are small and by the time the population reaches adulthood 97% has already had chicken pox, making the chances of serious complications in others small. In fact, 95% of children have had chicken pox by the age of 12.

My youngest, within a few days, was so sick that we called the out of hours doctor (it was a Bank holiday) and having described the symptoms they asked that he was brought in to the hospital (where the doctor's post is). He was whisked straight into an isolation room (recently created because of the ebola virus) and seen by a paediatrician, who said she hadn't seen a worse case of chicken pox before. So, my little guy had it bad.

A family member in the United States enquired about whether or not there was a chicken pox vaccination in the Netherlands. I knew for sure that if there was my sons had never had it, and I certainly hadn't been vaccinated as a child in England. It turns out that children are routinely vaccinated against chicken pox in the US and have been for a decade. It certainly explains the horror reactions you get from American parents when there is an outbreak of chicken pox here. It's something completely new. Faced with the very laid back attitude of Dutch parents to chicken pox, some American expats are perplexed. The cultural differences in attitude towards the childhood disease couldn't be further apart.

So, curious, I asked in the Multicultual Kid Blogs group about how chicken pox is dealt with in countries they are familiar with.

"We had chicken pox parties growing up across Europe in the 90s. No chicken pox vaccines back then. Now, back home in Australia, vaccination schedules have gone to include almost every fart & of course chicken pox also - pushing it out into adulthood. No one would take a chicken pox kid out & about."

Children are vaccinated.

Children are usually vaccinated but it is not obligatory and you pay yourself or the vaccine. If infected you must stay home and can only return to school with a doctor's note.

The view is the younger the child is when it gets CP the better. It is not a standard vaccine, but anyone can buy it from the pharmacy.

Children are not vaccinated and parents try to get their children 'contaminated' as soon as possible.

"Both in Poland and Germany kids are vaccinated against chicken pox as a part of the routine vaccination schedule. In the NL, however, I was told that this vaccine doesn't exist (????) The problem with the Dutch approach to chicken pox is this: I always know when the chicken pox season is on because the daycare is empty. As in only 4 kids in a group and they have to pull groups together to have enough kids. Everyone else is home with the chicken pox. I don't see this with any other diseases, not even with the common cold. What that means is that because kids are not vaccinated, the parents have to take time off work which means they're losing money and because the kids are regularly brought to daycare with the chicken pox it means that more and more kids get infected and more and more parents have to stay at home with them. Seriously I simply don't get it. It'd be a much cheaper solution to vaccinate and then it wouldn't be a problem."
The European Mama

Children are quarantined.

Children are not vaccinated.

Children are not vaccinated but are quarantined when they have chicken pox.

The vaccination exists but is not obligatory. Those infected are kept home until given the all clear by an attending doctor who comes to the house.

Vaccines are given to children at high risk (those 12 years and over who have not yet had chicken pox) Children can go to daycares as soon as the fever is over and as long as the child feels okay.

Children weren't vaccinated when I was growing up and it's not a standard vaccination now.
Parents don't send their children to school with chicken pox, but sending your kids around to a friend with chicken pox so that children catch it earlier rather than later is not unheard of!

Children are routinely vaccinated.

So there you go. I don't want a discussion about vaccinations; everyone has their view and approach, but it is fascinating to learn how much a childhood disease is treated differently from country to country.


  1. There was no vax when I was a kid and I of course had chicken pox like everyone else in Australia in the 1970's. A few months ago I went to hospital due to a persistent 4 day headache that was not responding to migraine drugs. Long story short, I had encephalitis caused by having had chicken pox as a child and spent 2 weeks in deutsch hospital on a drip. Not fun.

    1. What?? I assume that's rare right? That's not something you'd think of: oh I have a terrible headache because I had chicken pox once😳. Sorry to hear you went through this!

  2. Your poor boy, such cases are so rare but that is no comfort when it happens to you. I had to keep mine off school when they caught it in the UK and it was a pain, Miss EE caught it at the last possible moment from Master EE and incubated it for a long time so I had to take weeks off work. A vaccine would have been so much better. I don't know if they vaccinate here in KSA but will check it out for Mini EE. I would be hesitant to send a child to school without informing them incase there was an immunocompromised parent, teacher or child or a pregnant and not immune parent or teacher regularly attending the setting.

    In KZ children were kept home but let out once the spots were crusted over. Funnily enough the lotion they used in place of calomine was bright green so all the children looked like little aliens.