The Backward Logic of Chickenpox Parties

Anyone who has had chickenpox shares one distinct memory: the relentless, all-consuming itch. Ciara DiVita was only 3 years old when she caught the virus, but she remembers it well—along with the oven mitts she was made to wear to stop herself scratching. She also recalls being taken to hang out with her cousin while covered in blisters, in the hopes of deliberately infecting them. DiVita, now 30, was actually the second in the chain, having been taken by her parents to catch chickenpox from an infectious friend. “I imagine the chain continued and my cousin gave it to someone else at a chickenpox play date,” she says. A lot has changed over the past three decades, most notably the development of a chickenpox vaccine, meaning the virus is no longer the childhood rite of passage it once was. Thanks to the vaccine’s success, children today are much less likely to be exposed to the infection at school or on the playground. Chickenpox parties are also largely considered a relic of the past—a strategy many Gen X and millennial children were subjected to before vaccines became routine. But much like the virus itself—latent, opportunistic—they haven’t disappeared entirely. Before a vaccine existed, chickenpox, which is caused by the varicella-zoster virus, felt unavoidable. In temperate countries like the UK and the US, around 90 percent of children caught the virus before adolescence (in tropical countries the average age of infection is higher). It’s nothing to do with chickens. The splotchy, scratchy, highly contagious disease is possibly named after the French word for chickpea, pois chiche, according to one theory, because the round bumps caused by the virus resemble their size and shape. While most infant cases are mild, adolescents and adults are more likely to develop severe complications. This is where the idea of “getting it over and done with” emerged from, according to Maureen Tierney, associate dean of clinical research and public health at Creighton University in Omaha, Nebraska. “You were trying to have your child get the disease when they were at the greatest chance of not having complications,” Tierney says, explaining that, generally speaking, the older the patient, the more severe the infection can be. While varicella-zoster is usually a mild, self-limiting disease in children, it can be much more severe—and sometimes life-threatening—in adults. “I had an otherwise healthy adult patient who died of chickenpox pneumonia when I was first practicing,” Tierney says. “You never forget those scenarios.” The virus spreads rapidly through respiratory droplets and contact with fluid from its characteristic blisters, meaning if one child contracts it, siblings and classmates are likely to be next, if unvaccinated. Before the existence of social media, the idea that children should deliberately infect each other spread just as rapidly around communities—in conversations in the school yard, church groups, and pediatric waiting rooms—leading to the popularity of so-called chickenpox parties. Parents swapped advice about oatmeal baths and calamine lotion and arranged to bring children together when one was thought to be infectious—despite the practice never being an official medical recommendation. “They thought, well, if it's going to happen to my kid anyway, it might as well happen in a controlled environment,” says Monica Abdelnour, a pediatric infectious disease specialist at Phoenix Children’s Hospital. “The families were ready to encounter this infection, deal with it, and then move on.” While the majority of children who develop chickenpox feel well again within a week or two, around three in every 1,000 infected experience a severe complication such as pneumonia, serious bacterial skin infections, encephalitis (inflammation of the brain), or meningitis.