I was in a makeshift clinic in a mud brick building and a
child was brought in by his mother for a rash which was the classic “dew drop
on a rose petal” of chicken pox. He was not particularly ill and everything
else was normal and I discussed with his mother through the interpreter what to
expect as the illness ran its course.
It was not until they were gone that I realized the Zambians
I was working with were surprised (appalled?) at my nonchalance. In their
context, without routine vaccination, chicken pox remains a formidable foe.
Because many folks lack easy access to clean water, they are more likely to see
skin lesions which have become secondarily infected with bacteria. And due to
limited transportation and access to medical care, the secondary infections can
become severe before they come to medical attention. So they typically treat aggressively with a combination of an antiviral called acyclovir and antibiotics such as dicloxacillin to prevent secondary skin infections. While this type of treatment would seem excessive in our context, it was a good reminder that chicken pox is not always a benign disease. Prior to the introduction of the vaccine, about 100 children died of chicken pox complications in the United States each year.
When an illness becomes a sort of historical footnote, it is easy to forget the misery it caused in the past, even if you saw some of that misery first-hand 25 years ago. And remaining pockets of diphtheria, polio and measles remind us that without continued vigilance, these diseases could jump out of history right back into our present.
