At least 18 school-age children and teenagers in seven Northwest Arkansas-area school districts have recently contracted chickenpox, school district officials have reported.
Their illnesses have led some of their non-vaccinated classmates to also miss school.
“Those students who have not been immunized, they are excluded from school,” said Dr. Jennifer Dillaha, medical director for immunizations for the Arkansas Department of Health. “If they have been infected, it will take 21 days to develop the disease. They cannot come back to school until after that 21 days have passed and they are free of chickenpox.”
New state health regulations in effect this school year require all school-age children to receive two doses of the chickenpox, or varicella, vaccine. State health officials have directed school officials to have students remain out of school if they were in close contact with children who had chickenpox and either were exempt from being vaccinated or had not received their second vaccination within a few days of exposure.
The vaccination regulations apply to all children attending child care facilities, public schools and private schools unless they provide proof of immunity from a medical professional or receive a medical, religious or philosophical exemption from the state Department of Health.
In Arkansas, children had 30 days after the beginning of school to receive second doses of the chickenpox vaccine, which would have been around Sept. 16 in most districts, Dillaha said.
The Booneville, Rogers, Siloam Springs and Van Buren school districts each had one student become ill with chickenpox this month, school officials reported. Also, the Kingston campus of the Jasper School District reported such an illness.
In Booneville, seven students were given until Monday of this week to receive vaccinations, and Superintendent John Parrish, who was out of the office Tuesday, said he did not know if any of those students have now been excluded from school.
In Siloam Springs, after the chickenpox case was detected, about 20 children were found to have not received their second doses of the vaccine,said Jody Wiggins, assistant superintendent for the district. All of them have since received those second doses, she said, and one child who had an exemption ultimately did get vaccinated. So no students are being kept out of school for not following the vaccinations policy.
Since Sept. 15, eight confirmed cases of chickenpox have occurred among Bentonville children in elementary and middle school, spokesman Paul Stolt said. That district has a small number of children who are exempt from being vaccinated, he said, but he did not know Tuesday whether any students were being kept out of school because of lacking vaccinations.
Fayetteville School District officials learned last week that five students had confirmed cases chickenpox, said Melissa Thomas, director of nursing for Fayetteville Public Schools.
The Fayetteville and Van Buren districts each excluded about 10 students from school, officials in the districts said.
State health officials began receiving reports of chickenpox cases when school started, which was Aug. 18 for most districts, Health Department spokesman Kerry Krell said. The department is aware of chickenpox cases in Northwest Arkansas and is investigating possible cases in southwest and central Arkansas.
In Fayetteville, state health officials instructed workers at the high school to identify all students who were in classes with the infected students or who were involved with them in extracurricular activities, Thomas said. The district called each of the 180 students identified and placed automated phone calls to alert other families.
Those who did not receive the vaccinations by Sept. 17 or had exemptions will be held out of school until Oct. 1 in the Fayetteville district, she said.
“Since it was circumstances outside of their control, the school won’t count them absent for final exams and absenteeism,” Thomas said. “The school will work diligently to help them make up their schoolwork.”
The new requirement of receiving two doses of varicella vaccine primarily affects older students because previous state regulations required two doses only for children entering kindergarten, Thomas said. High school students had entered kindergarten when the state required only one dose.
One dose of the vaccine is 85 percent protective, while two doses are 98 percent protective, said Jessica Leung, an epidemiologist who specializes in chickenpox at the federal Centers for Disease Control and Prevention.
Many adults remember chickenpox as a common childhood illness, she said. It is characterized by fever and an itchy rash, and the illness can be severe, Leung said.
“It’s highly contagious,” she said. “It’s possible you can get very sick from it.”
Arkansas recorded 1,213 cases of chickenpox in 2006, the first full year that the state Health Department tracked the viral infection, Krell said. The number of cases fell to between 220 and 321 annually from 2010-13. The department has recorded 88 cases so far this year.
The U.S. Food and Drug Administration approved the first varicella vaccine for use in the United States in 1995. The CDC began recommending it as part of routine childhood immunizations in 1996. The recommendation for a two-dose series was issued in 2006, according to the CDC.
Arkansas’s Board of Health required all kindergarteners to receive single vaccinations against the illness starting with the 2000-01 school year. The Board of Health changed the requirement to two doses for children entering kindergarten in 2009, and one dose for children ages 15 months to 18 months who were attending preschool or enrolled in day care, Dillaha said.
New regulations that went into effect Sept. 1, now require children in the first through 12th grades to get two doses of the vaccine, Dillaha said. The new regulations are in line with recommendations from the CDC Advisory Committee on Immunization Practices.
Nationwide, the vaccine is credited for a decline in chickenpox cases. There were about 4 million cases annually before the vaccinations were instituted and 350,000 cases in 2010, Leung said. Before the vaccine was used, chickenpox complications led to 10,000 hospitalizations annually. By 2010, the number of hospitalizations dropped to 1,700. The number of chickenpox-related deaths fell from more than 100 annually before the vaccine to fewer than 20 in 2010.
Between 2000 and 2006, about 40 percent of the hospitalizations for chickenpox occurred in children ages infant to 4 years old, and another 40 percent occurred in adults who were at least 20 years old, Leung said.
In 2010, all chickenpox-related deaths were adults who were at least 20 years old, and in most cases, the deaths were adults who had not been vaccinated, Leung said.
Severe reactions to the vaccine are rare, but they can include seizures and pneumonia, Leung said. Since 1995, 140 million doses of chickenpox vaccine have been administered.