In a journalistic career spanning more than 50 years, Barbara Walters has traveled the world to confront presidents, despots and war criminals. But last week the worldly 83-year-old journalist was hospitalized by a bug that more typically disrupts kindergarten schedules: chickenpox.
Walters' illness has many people in middle age and beyond asking if they, too, could be susceptible to chickenpox or shingles – which is caused by the same virus – as well as mumps, measles and other childhood illnesses that can be particularly uncomfortable for older adults.
Are You at Risk?
Many of us don't remember if we had chickenpox or the mumps when we were little, and if our parents aren't around to ask, we can't confirm it one way or the other. But the experts say that for most of us, there's little cause for alarm: Studies of chickenpox antibodies in public blood samples, for example, have found that 98 percent of Americans over age 40 have already had the disease, says medical epidemiologist Stephanie Bialek of the federal Centers for Disease Control and Prevention.
Chickenpox infections in people over 60 are extraordinarily rare. It's possible that Walters is one of the 2 percent of adults who somehow managed to escape previous infection, Bialek says. She may have come down with chickenpox as a result of exposure to someone who had shingles.
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The good news for the rest of us is that such childhood illnesses are far less common today because of widespread vaccination. For example, before 1995, when the varicella zoster vaccine (which combats the virus causing both chickenpox and shingles) became available, 4 million Americans contracted chickenpox every year. Today, only about 250,000 people do. About 15 percent of Americans who get chickenpox today are over 20, but they are six times more likely than children to be hospitalized with complications of the disease, like dehydration, pneumonia and bacterial skin infections, Bialek says.
If you had chickenpox as a child, you cannot get it again, but the virus can lie dormant in nerve cells for decades, only to reactivate as shingles for reasons not totally clear to epidemiologists. Shingles, which can cause pain and discomfort for many weeks, usually appear as a single cluster of blisters in a specific area. Sometimes, though, the blisters are widespread like chickenpox, in which case it can be tricky to tell the two apart, Bialek says.
About 20 percent of people who had chickenpox earlier in life will come down with shingles when they get older. Our vulnerability to shingles increases as we age; people with compromised immune systems because of cancer, HIV infection or similar concerns are also at higher risk.
The CDC recommends that all adults 60 and older get the shingles vaccine, which is essentially a larger dose of the chickenpox vaccine given to children. (If you've never had chickenpox, the shingles vaccine will protect against it as well.) Adults over 60 who never get the shingles vaccine run about a 1-in-3 chance of developing the condition over time.
If you're under 60 and can't remember whether you've had chickenpox, ask your doctor if a vaccination for it makes sense. A simple blood test can determine whether you already have antibodies to varicella zoster, an almost-certain sign that you did have chickenpox.
"There are situations where it may be more prudent just to go ahead and vaccinate" for chickenpox, Bialek says, such as if you're traveling to a country that doesn't immunize against it or if you've recently had a close encounter with a child who has since developed the disease. (Kids can be infectious up to three weeks before symptoms appear.) Getting vaccinated even after you've already been exposed can help prevent you from getting sick or at least limit the symptoms.
Measles and Mumps: Rare, but Still Out There
There has been a single vaccine for measles, mumps and rubella for more than 40 years. The CDC generally considers everyone born before 1957 to be immune to those diseases today, says Dr. Carolyn Bridges, a medical epidemiologist who serves as associate director for adult immunizations at the agency. Before the original measles vaccine was licensed in 1963, the nation faced about 3.5 million cases each year. In 2012, there were only 55 reported cases nationwide.
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Many of us may think we never had the mumps as a kid, but we're probably wrong. Only 30 to 40 percent of people ever infected with the mumps actually develop the condition's trademark swelling, Bridges says. About half of all infected people experience only respiratory symptoms, like a cough. For the rest, the infection passes with no symptoms at all.
That doesn't mean we're entirely in the clear. The virus that causes mumps can also lead to orchitis, an inflammation of the testicles, in as many as 4 out of 10 men who contract it after puberty, Bridges says. Men over 45 are at the greatest risk for this uncomfortable and sometimes painful complication. Still, only a few hundred cases of mumps were reported in the United States last year, although many more likely went undetected because the symptoms were so mild.
As with chickenpox, if you're unsure whether you had mumps or measles, a blood test can check for antibodies. But the procedure isn't foolproof, Bridges says. If you're traveling to a country that has had outbreaks or if you're a health-care worker who might infect sick patients, you should probably get immunized.