More Than Half of Chickenpox Diagnoses Are Wrong, Study Finds (arstechnica.com) 52
An anonymous reader shares a report: Thanks to the vaccination program that began in 1995, chickenpox is now relatively rare. Cases of the miserable, itchy condition have fallen more than 97 percent. But, while children have largely put the oatmeal baths and oven mitts behind them, doctors have apparently let their diagnostic skills get a little crusty. According to a study published Thursday, public health researchers in Minnesota found that 55 percent of people diagnosed with chickenpox based on their symptoms were actually negative for the varicella-zoster virus, the virus that causes chickenpox. The study noted that the people were all diagnosed in person by health care providers in medical facilities. But, instead of chickenpox, lab testing showed that some of the patients were actually infected with an enterovirus, which can cause a rash, or the herpes simplex virus 1, which causes cold sores.
The study, published in the Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report, supports expanding laboratory testing for suspected chickenpox cases in the state's program and highlights that diagnoses based on symptoms are "unreliable." For one thing, doctors simply see far fewer chickenpox cases these days because of the protection from vaccines. While chickenpox cases in the US previously reached 4 million each year, with 10,500 to 13,500 hospitalizations and 100 to 150 deaths, there are now fewer than 150,000 cases,1,400 hospitalizations, and 30 deaths each year, the CDC reports. Vaccination is more than 90 percent effective at preventing the disease. In the rare cases where a vaccinated person contracts chickenpox, the muted rashes are challenging to identify by eye. But even in unvaccinated children, chickenpox can be tricky to pick out; it can easily be confused with measles, insect bites, enterovirus, skin infections such as scabies and impetigo, herpes viruses, and hand, foot, and mouth disease.
The study, published in the Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report, supports expanding laboratory testing for suspected chickenpox cases in the state's program and highlights that diagnoses based on symptoms are "unreliable." For one thing, doctors simply see far fewer chickenpox cases these days because of the protection from vaccines. While chickenpox cases in the US previously reached 4 million each year, with 10,500 to 13,500 hospitalizations and 100 to 150 deaths, there are now fewer than 150,000 cases,1,400 hospitalizations, and 30 deaths each year, the CDC reports. Vaccination is more than 90 percent effective at preventing the disease. In the rare cases where a vaccinated person contracts chickenpox, the muted rashes are challenging to identify by eye. But even in unvaccinated children, chickenpox can be tricky to pick out; it can easily be confused with measles, insect bites, enterovirus, skin infections such as scabies and impetigo, herpes viruses, and hand, foot, and mouth disease.
chickenpox in my 20s (Score:3)
I was an adult by the time the chickenpox vaccine came out. I got chickenpox in my 20s, never had it as a kid, it was quite miserable as an adult. Poison Oak is worse though.
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When I got chickenpox as a kid I didn't feel bad in any way at all, but I got to stay home from school. I thought chickenpox was the best thing ever.
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I had it as a kid and it was wretched. I still have traumatic memories of getting some of the pox on my little pecker lol. I was absolutely coated on the damn sores and ran a fairly brutal temperature. I dont remember much of it other than the unfortunately placed pox, but my mother apparently was genuinely concerned about my fever.
worse with age (Score:2)
My youngest brother got it at pre-school. Some of the mothers up the street wanted to send their kids to play so as to catch it (this was the late 70s). He basically had some spots and had to stay home.
It spread to may sister, who was first grade or so. Her case wasn't as mild, but was still basically a two week vacation.
She gave it to my 7th grade brother and 9th grade me. And *those* were another story.
My mother told me to stop complaining, because I could have it as bad as he did.
And the next day I w
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the mothers up the street wanted to send their kids to play so as to catch it
It used to be common to have "chicken pox parties" where the neighborhood kids would all play and infect each other.
It was believed better to "get it over with" when the kids are young and the symptoms are mild.
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Whether poison oak is worse is highly variable. I have had only mild reactions to poison oak. And some people have REALLY bad reactions to chicken pox.
That said, this diagnosis problem is just to be expected. When something that was common becomes rare, the false positive percentage increases dramatically even without any change in skills.
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Whether poison oak is worse is highly variable. I have had only mild reactions to poison oak. And some people have REALLY bad reactions to chicken pox.
Chickenpox is an all-over experience from the start while the extent of poison oak/ivy (usually) depends on how soon you discover you've been exposed before you've spread it all over yourself. I had chickenpox when I was young and poison oak (or more likely ivy) as an adult after climbing up a tree to retrieve something (and, stupidly, not noticing the stuff). I needed calamine lotion for the chickenpox but oral steroids for the poison oak/ivy -- the latter treatment worked better than the former btw.
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We can use an ML classifier to diagnose poxes, rashes, and other skin disorders.
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I got it when I was 32, and I gave it to my infant son. Luckily for me, my case was mild. But it got its revenge when I got Shingles 10 years later.
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I got it when I was 32, and I gave it to my infant son. Luckily for me, my case was mild. But it got its revenge when I got Shingles 10 years later.
I had an outbreak of shingles about 17 months ago and I'm still suffering the after effects. Look up "post herpetic neuralgia". There are antiviral drugs for shingles which should be started ideally within 3 - 4 days of the outbreak. There are also two expensive but worthwhile vaccines for shingles which are a good idea, especially if you're over 50 and are self employed, because you will be of work if you get a bad case.
Conspiracy (Score:5, Funny)
This is just what Big Chicken Pox wants you to believe
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Subliminal whispers: "Buy more Calamine lotion... Buy more Calamine lotion..."
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We gotta stop the Deep Chicken!
Or was that Deep Fried Chicken?
Had chickenpox (Score:2)
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And since I've had chickenpox, now I'm liable to get shingles as an adult, which is very painful, I hear.
There's a vaccine for that, too, you know. It's highly recommended as you get older.
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Recommended for anyone over 50, but also anyone 18 or older who is at increased risk [shingrixhcp.com].
Which is to say, unless you have a reason not to, it's available if you're 18 or older. It's only a matter of whether or not your insurance will pay for it if you're not withing the recommendation. And according to the manufacturer's web site [shingrix.com], "96% of privately insured people pay $0."
Your best source of information is either your doctor (or, rather, your doctor's office manager, who deals with insurance and can definitely c
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Isn't it the same vaccine? Just a boost to your immune system so it stays properly suppressed?
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Isn't it the same vaccine? Just a boost to your immune system so it stays properly suppressed?
No. The chickenpox vaccine is a live virus. The shingles vaccine is a single protein. https://www.precisionvaccinati... [precisionv...ations.com]
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bit more research [cdc.gov], it seems that there was a live shingles vaccine available until 2020.
It was indeed the same vaccine:
* A shingles vaccine called zoster vaccine live (Zostavax) is no longer available for use in the United States, as of November 18, 2020. If you had Zostavax in the past, you should still get Shingrix. Talk to your healthcare provider to determine the best time to get Shingrix.
Zostavax, shingle vaccine. In your article, the chicken pox vaccine is called Zostavax.
So it appears that you are indeed correct - it's just that my information was old.
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for that matter, if you had the single shot vaccine as a kid, you should go in for a second shot (it's now done as two).
As an over 50 who had a bad case of chickenpox as a child, they gave me the two shot sequence a year or so ago.
hawk
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Chickenpox vs Vaccine Unclear (Score:2)
And since I've had chickenpox, now I'm liable to get shingles as an adult
Yes, but you are less likely to get shingles having had chicken pox than you are if you have never had chickenpox since you have immunity for life. Unfortunately, the longevity of immunity from the chicken pox vaccine is only 10-20 years which means that if you have the vaccine, unless you get a booster regularly, you are at risk of getting shingles by the time the immunity wears out and shingles is a lot more dangerous than chicken pox.
In fact, the rate of shingles cases is rising and this may be relat
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Oddly enough, one reason we here more about the shingles vaccine is that in the past occasional exposure to kids with chickenpox acted a bit as an immune booster in adults. Now with the kids vaccinated against it, older adults need a vaccine to boost their immunity back up.
Trained to look for sometihing that isn't there (Score:2)
This is not at all surprising for doctors trained in an era when chickenpox was common. Symptoms are always at least somewhat ambiguous so doctors have to filter into probability buckets. If one of the likely suspects is no longer likely, it is going to over diagnosed. It doesn't mean the doctors no longer know chickenpox well. Almost the opposite. They need to detrain the selection for chickenpox and increase training for diseases with similar symptoms that are still common.
What would indicate doctors
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I had Chickenpox in the 1980's (Score:2)
Accurate (Score:1)
Yeah this sounds right. GPs are useless, and getting more useless every day. All they do is shrug and refer you to a dermatologist. I actually look forward to the day when medical diagnoses can be made by AI.
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This is also something of an America thing where we see less Primary Care doctors and rely more on Urgent care and ER visits. Compared to the OECD Americans don't as often have a "regular doctor" and those doctors tend to me more swamped with the stupid insurance system(s) we have in the US combined with a doctor shortage so even just having a regular GP can feel like a luxury, and the fact that the feeling you are describing is absolutely real which I would also put some blame on our litigious nature mak
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Re: Accurate (Score:2)
Where the hell do you get that information? If you go for a doctor visit (which is paid for in the US by either the government or insurance at least yearly) then a doctor sees you. If you go to an urgent care, it is possible that if you really didnâ(TM)t need to be there (all you needed was a band aid) then a nurse will see you but a doctor will still review your case. In all other cases, legal liability issues dictate that a doctor checks on you.
We've found the Problem (Score:2)
"Health Care Provider"
Being a doctor is a binary state. It's like pregnancy. Either you are or you are not.
If you are not a doctor and you are diagnosing patients you are breaking the law. Practicing medicine without a license is a crime in all 50 states.
This story is one of the many reasons.
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No, there are also Nurse Practitioners and Physician Assistants, both of whom can legally see patients, diagnose, and create prescriptions. My Primary Care person is an NP, and she's great.
"Health Care Provider" is not the problem.
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Like I said, we've found the problem. Health care provider IS the problem because they are WRONG.
Let me guess, nurse practitioners and physician assistants are cheaper?
Chernobyl was cheaper too. How did that work out?
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Welcome to American Healthcare where we don't have enough doctors because:
1. The AMA caps residencies to keep doctor salaries high so that's already stupid
2. They keep salaries high partly because we burden doctors with 6 figures of school debt
3. Which also means the high burden of medical school will drive more students into specialties than Primary Care
4. Once they are doctors not only do they have to pay their loans but also huge amounts of insurance money and
5. Have to hire tons of staff to deal with mu
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The problem with health care in this country is very simple: There are three parasites for every organism.
Get the parasites out, starting with the government, and the organisms will function properly.
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Are you saying the best healthcare system is a totally free market one? Despite the fact that healthcare does not and cannot follow rational market conditions?
Where in history or today is that working? The US is the most "Free market" of any OECD countries system and we pay way more for less and worse outcomes.
Why is every other country on some sort of system like the Beveridge or Bismarck, Single-Payer or national model? Why would countries like Taiwan and Korea go through decade long transitions just to e
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Other countries are on national models because they don't have a constitution that forbids their government from involving itself in every last nook and cranny of its citizens' lives. The federal government has not the slightest mote of legal authority to govern health care.
One would think the $600 million non-functional web site would have cured Americans of the delusion that government would improve health care.
The government and all the other parasites interfere because they want money and control. Healt
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The federal government has not the slightest mote of legal authority to govern health care.
Well be sure to get a Supreme Court case against Medicare, Medicaid and the VA then.
One would think the $600 million non-functional web site would have cured Americans of the delusion that government would improve health care.
The website is the silliest thing to argue about. Firstly the ACA did in fact improve healthcare on several fronts. Ask anyone if they think we should get rid of the Maximum out Of Pocket or the rule on Pre-existing conditions, two reforms that are wildly popular. What also would have really made a difference is if the Public Option wasn't axed from it at the last minute.
Health care should be just like the legal profession: between a doctor and patient. Period.
because the government certainly has involvement on
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We've had numerous cases against Medicare. The government has not a shred of involvement in the relationship between people and their lawyers. See "attorney client privilege."
Doctors should be paid by their patients. If we allow the federal government into the relationship, then we will get the medical equivalent of student loans: astronomical prices, political chaos and nationwide incompetence.
So a monopoly in addition to an unconstitutional and parasitic legal frame
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So you advocate to abolish the DEA and make all drugs OTC? I suppose you also advocate abolishing the licensing of medical practice entirely? Unless or until those answers are yes, you are interfering with the free market.
Naturally, the FDA would become just a division of the FTC.
Most people can see a giant can of worms in that, including most of the right. I don't even see Libertarians advocating for the abolition of licensing and prescriptions anymore. especially the few that have actually managed to be e
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The federal government has no legal authority to establish a DEA because they had no authority to outlaw narcotics in the first place.
The best evidence we have they are off the reservation is the fact the modern government presumed to outlaw a plant with a simple act of Congress.105 years ago when they outlawed alcohol, they had to amend the Constitution because they knew they had no authority otherwise.
Then, having realized their mistake, they un-outlawed alcohol. Then they proceeded to forget everything w
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And prescriptions?
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that';s exactly the problem. it's cheap and it's great until you have something rare or serious that gets missed, the good news is your loved ones will get a decent settlement check
And the attorneys that handled your case will probably get an even bigger check than your loved ones.
Re: We've found the Problem (Score:2)
PA are practically speaking doctors, they have similar but shorter education and both NP and PA work under supervision of a fully licensed medical doctor, meaning a fully licensed doctor is available when the PA/NP has a question. An NP on the other hand has a focus more on the patient than the disease itself.
The largest difference is when it comes to surgery and supervision. It has nothing to do with their skills and knowledge, both NP, PA and MD must have a similar base. Basically youâ(TM)re comparin
An Almost Inevitable Result of Success (Score:2)
If we suppose that there is an underlying error rate in classifying pox-like rashes as chicken pox then when true chicken pox cases become very rare reported cases that are misclassifications will naturally dominate. Then too, with true cases very rare any given physician is going to have little experience in observing and correctly identifying it, so the error rate should be expected to go up.
wonna spill the blood of a hippy (Score:2)
Unless you live with the hippies in Nimbin,
idiot anti-vaxers