MORE HELP ON CPOX FRONT PLEASE - Are NHS Direct talking out of backside? my dd has chickenpox, my immune brother was in contact with her and NHS Direct has told my other sister that if he visits her he could pass on the virus to dsis's breastfed 4-we...

[ExterminAitch]

(actually it's two sisters but i thought brother made it less confusing in the title. let's go with the truth from here and forget i mentioned a brother).

my sister (elder of the two) is going to visit my new niece and younger sis etc in her home, but told other sis about contact with poxy dd.

so my youngest sister phoned NHS line to ask if her niece being in contact with my other sis could be a problem. both sisters of mine are immune, have been for yonks. youngest sis is bfing her wee girl.

nhs said.

1 if dd is still infectious (she isn't imo, it's 5 days after first spots and is all scabby) then oldersis, despite being immune herself, could carry the virus on her body. apparently, it takes only 15 mins contact to pass the virus across.

(no answer from nhs on how long virus survives on a resistant host. it would be a gap of about 4 days before she'd visit new niece, surely it can't live that long?

also no idea how 15 mins comes into play, from what i've read it's spread by snot, saliva and burst pox. what does 15 mins have to do with anything? a full-on toddler snog from an infectious child could take seconds but presumably pass it on?)

1. youngest sis is bfing. she was told, however, that this makes no difference because it takes 5 weeks to be immune to cpox if bfing. that, surely, is crap? it's certainly contrary to what i was told when dd was 10 days old and exposed to infectious child, which was only 2.5 years ago.

anyway, can anyone help? poor older sister is about to cancel her plans to go and stay with younger sister for a few days, has taken days off work specially.

personally, i don't think that dd is still infectious but i can see that it's not something we can be completely unequivocal about so i do understand why she checked. but this thing about cpox hanging around on clothes... must be bollocks.

sounds like bollox to me [not helpful given i am not a doctor, sorry]

Sounds like bolloxs to me too. Dd and DS1 both had CP in March but 15mo still bf ds2 didn't get it and I am immune so I'm assuming he was still getting my anti bodies.

For a fully bf baby I'd doubt it would matter.

They do come out with some shit, don;t they?

Sounds like standard fare NHS direct shite.

Firstly, it is unlikely that your dd is still infectious from what you say.

I've never heard of an immune person carrying CP into a non-immune person without being infected themselves. CP is spread by water vapour droplets (breathing, coughung, sneezing, etc) and I've never heard of it being transmitted by clothing.

If baby is being breastfed and its mum is immune to CP, then even if baby were exposed directly to an infected person, it is unlikely to be affected. CP is rare in children under 6 months. This is because the baby still has a lot of its mother's antibodies and immunity to infection. This is even more true if the baby is being BF.

The incubation period (the time from exposure to developing symptoms) for CP is 14-21 days, not 5 weeks.

In my opinion, your sister should stick to her plans.

Well, when my dd was 8 weeks old, my SIL had my nephew i left my dd with my mum to go and visit SIL in hospital, my SIL friend was there with her 6 yr old and this child was just starting with CP (but the spots hadn't come out yet), now i had CP when i was a child so therefore immune but yet i MUST have been a carrier as my dd got CP within a week.

If you understood that then you deserve a medal. Obviously slightly different circumstances but thought i would add my experience anyhow. So the gist is, i must have passed on the CP virus even though i was immune.

BTW i only sat near to the child with CP, didn't touch her or anything, didn't know her that well tbh, but too much of a coincidence, it must have been that what happened.

NHS direst are a pain in the ass as the amount of time we have contacted them they have said see a doctor is unbelievable (by the way we are not always ill). We have gone to see the doctor and they have told us we are okay, antibiotics. If you think you or child is ill....seriously ill go to A+E if really unwell or if in the right area call outside hours surgery, cos a nurse or doc will contact you to tell you if they think it is urgent or not. I am not saying NHS are crap because they are not...but if you are very worried, call your surgey and they should suggest an alternative to care.

but pucca, i take it that you didn't wait three days and change your clothes and shower etc before seeing your daughter again? i get the thing about the carrier, it's how long the virus can survive in a resistant host that interests me (and dsis).

NHS covering their arses as usual, but CP is very misunderstood and a contentious subject amongst doctors.

It is air borne so anyone in the near vicinity of someone with CP is at risk of catching it. Coughs and sneezes heighten the risk as do immunity levels, but it is perfectly possible for someone on the other side of the room with no direct contact to be infected. It is possible to carry a virus even if you have personal immunity to it (it can lodge in the mucus membranes of the nose for example)

Have your sisters had their immunity checked or are they assuming because they have had CP before?

BF should offer immunity to baby (assuming mum's immunity level is high) but may not be immediate .

New borns are at risk of complications from CP so of higher concern than say, a healthy toddler.

It really is a case of balancing all the risk factors. From what you have said, I would think the risk level is pretty low.

Ditto Emma1997.

When I saw your op my immediate thought was "Is the breastfeeding mum immune?" Given that the answer is yes then her immunity will have been passed on to her dd and should be protective; now clearly you might still think twice about letting her hug a rampantly poxy child but given the other factors in this case the risks of the four week old being infected by third party contact via an immune adult after a period of several days from contact with your dd are negligible at best imo.

It can survive in the mucus membranes for quite a long time I think Aitch.

I am trying to recall details from various discussions with my then boss (virologist) but it was a long time ago.

CP has this weird dormancy thing as well.

And immunity is not as simple as having had it before (I gave up counting the 7th time I had it)

what are the effects of cp on a young baby?
when dd was exposed to a properly infectious child at ten days we were told by docs that if she had it at all it would be very mild, maybe two spots and a temperature, so it wouldn't be the end of the world.

btw cheers for all the responses. seems that there is a risk, but it's not likely... not my call tho.

At ten days immunity level would be building from the breastfeeding.

Various complications such as varicella pneumonia or encephalitis are risks for anyone with low immunity. The main risk for newborns though is something called disseminated varicella infection which means the infection spreads to the internal organs.

That is why CP is a worry on maternity wards - 5 days pre-birth to 3 days post is the highest risk period.

but she's not a neonate, is she? i think i said 4 weeks but my other sis says she thinks she's six weeks...

which sounds chippy, i now realise. when what i perhaps should have said was 'how long does the period defined as neonatal last?'

Don't know abotu immunity.

But, my friend's baby (breasfed) caught it at about 5 months old, and was really quite ill. She ended up on abs as the spots didn't scab and she was poorly.

my bf pfb caught it at about 6m, from another wee boy of about 5m... i was surprised at how ill he was tbh, v unhappy little fella. and scars from bashing at the spots too.

My 6yo DD got the pox when DS was three months old - he was still entirely bf at this point and in spite of massive amounts of contact before we knew she had pox (obv. tried to limit it a bit as soon as we knew and until spots had scabbed) didn't come down with it.

Unfortunately DP also caught impetigo in the same week so I was doing all child-care for both kids, and definitely wasn't changing clothes after every cuddle, although was scrupulous about hand-washing and separate towels, etc.

I had chicken-pox as a child - unfortunately also had shingles as a teen, don't know what if anything that says about my own levels of immunity.

No she isn't a neonate Aitch if she is 6 wks old, I was just drowning you in information, sorry . I was of trying to explain why NHS peeps are covering their arses because they know the worst case scenarios.

IMO the risk level in this situation is extremely low:

3rd party transfer
time period between contact with virus and contact with baby is long
baby's age
baby is BF

The definition of neonate is birth to 28 days, but the extremely high risk period in this example is only the first few days after birth before the immunity starts kicking in.

FWIW,I woouldn't take any risks at all with a newborn (or newish born) and cp. Ds1 nearly died with cp. This was when he was a newborn. He twice turned blue and had to be rescuscitated.

May be very different once they're a few weeks older though.

A risk Kerry yes, but I would think a low one. Assuming ds2 wasn't coughing, sneezing or breathing directly into the boy's face.

Good idea to prevent direct contact though as not only was the boy at risk but his pregnant mum too.

Please note, I am not medically trained. All my info is based on working with virologists/microbiologists for 6 years and the fact that I am one of the unlucky folk who has no immunity to CP. I have masses of personal experience of multiple infections and that made me read up on the subject a lot BUT I am not an expert.

If you are worried, suggest she speaks to her midwife. As long as the midwife/hospital are aware that she has had potential exposure to CP they can be prepared. The baby can be given something called immunoglobulin as soon as it is born if they think the risk warrants it.