The Backward Logic of Chickenpox Parties

水痘派对的荒谬逻辑

Anyone who has had chickenpox shares one distinct memory: the relentless, all-consuming itch. Ciara DiVita was only 3 years old when she caught the virus, but she remembers it well—along with the oven mitts she was made to wear to stop herself scratching. She also recalls being taken to hang out with her cousin while covered in blisters, in the hopes of deliberately infecting them. 每一个得过水痘的人都有一个共同的记忆：那种无休止、令人抓狂的瘙痒。Ciara DiVita 在 3 岁时感染了这种病毒，她对此记忆犹新——还记得为了防止抓挠，她被迫戴上烤箱手套。她还记得自己浑身长满水疱时被带去和表亲玩耍，希望能故意传染给对方。

DiVita, now 30, was actually the second in the chain, having been taken by her parents to catch chickenpox from an infectious friend. “I imagine the chain continued and my cousin gave it to someone else at a chickenpox play date,” she says. 现年 30 岁的 DiVita 其实是这条传染链上的第二环，她的父母当时带她去从一个患病的朋友那里感染水痘。“我想这条链条还在继续，我的表亲后来又在水痘聚会上把它传给了别人，”她说。

A lot has changed over the past three decades, most notably the development of a chickenpox vaccine, meaning the virus is no longer the childhood rite of passage it once was. Thanks to the vaccine’s success, children today are much less likely to be exposed to the infection at school or on the playground. 过去三十年里，很多事情发生了变化，最显著的就是水痘疫苗的研发，这意味着这种病毒不再是曾经那种童年的“必经之路”。得益于疫苗的成功，今天的孩子在学校或操场上接触到这种感染的可能性大大降低了。

Chickenpox parties are also largely considered a relic of the past—a strategy many Gen X and millennial children were subjected to before vaccines became routine. But much like the virus itself—latent, opportunistic—they haven’t disappeared entirely. 水痘派对在很大程度上也被视为过去时代的遗物——这是许多 X 世代和千禧一代在疫苗普及前所经历的一种策略。但就像病毒本身一样——潜伏且伺机而动——它们并没有完全消失。

Before a vaccine existed, chickenpox, which is caused by the varicella-zoster virus, felt unavoidable. In temperate countries like the UK and the US, around 90 percent of children caught the virus before adolescence (in tropical countries the average age of infection is higher). 在疫苗出现之前，由水痘-带状疱疹病毒引起的水痘似乎是不可避免的。在英国和美国等温带国家，约 90% 的儿童在青春期前就感染了这种病毒（在热带国家，平均感染年龄较高）。

It’s nothing to do with chickens. The splotchy, scratchy, highly contagious disease is possibly named after the French word for chickpea, pois chiche, according to one theory, because the round bumps caused by the virus resemble their size and shape. While most infant cases are mild, adolescents and adults are more likely to develop severe complications. 它与鸡（chicken）毫无关系。根据一种理论，这种斑驳、瘙痒且极具传染性的疾病可能得名于法语单词“鹰嘴豆”（pois chiche），因为病毒引起的圆形肿块在大小和形状上与鹰嘴豆相似。虽然大多数婴儿病例症状较轻，但青少年和成年人更容易出现严重的并发症。

This is where the idea of “getting it over and done with” emerged from, according to Maureen Tierney, associate dean of clinical research and public health at Creighton University in Omaha, Nebraska. “You were trying to have your child get the disease when they were at the greatest chance of not having complications,” Tierney says, explaining that, generally speaking, the older the patient, the more severe the infection can be. 内布拉斯加州奥马哈市克雷顿大学临床研究与公共卫生副院长 Maureen Tierney 表示，这就是“早得早好”这一观念的由来。“你试图让孩子在最不容易出现并发症的时候感染这种疾病，”Tierney 说。她解释道，一般来说，患者年龄越大，感染可能就越严重。

While varicella-zoster is usually a mild, self-limiting disease in children, it can be much more severe—and sometimes life-threatening—in adults. “I had an otherwise healthy adult patient who died of chickenpox pneumonia when I was first practicing,” Tierney says. “You never forget those scenarios.” 虽然水痘-带状疱疹病毒在儿童中通常是一种轻微的、自限性的疾病，但在成年人中却可能严重得多，有时甚至会危及生命。“我刚开始行医时，曾有一位原本健康的成年患者死于水痘肺炎，”Tierney 说，“你永远不会忘记那种场景。”

The virus spreads rapidly through respiratory droplets and contact with fluid from its characteristic blisters, meaning if one child contracts it, siblings and classmates are likely to be next, if unvaccinated. 这种病毒通过呼吸道飞沫和接触其特有的水疱液体迅速传播，这意味着如果一个孩子感染了，在未接种疫苗的情况下，其兄弟姐妹和同学很可能也会紧随其后被感染。

Before the existence of social media, the idea that children should deliberately infect each other spread just as rapidly around communities—in conversations in the school yard, church groups, and pediatric waiting rooms—leading to the popularity of so-called chickenpox parties. 在社交媒体出现之前，让孩子们故意互相传染的想法在社区中传播得同样迅速——通过校园、教会团体和儿科候诊室里的交谈——从而导致了所谓“水痘派对”的流行。

Parents swapped advice about oatmeal baths and calamine lotion and arranged to bring children together when one was thought to be infectious—despite the practice never being an official medical recommendation. “They thought, well, if it’s going to happen to my kid anyway, it might as well happen in a controlled environment,” says Monica Abdelnour, a pediatric infectious disease specialist at Phoenix Children’s Hospital. “The families were ready to encounter this infection, deal with it, and then move on.” 家长们交换关于燕麦浴和炉甘石洗剂的建议，并安排在某个孩子被认为具有传染性时让孩子们聚在一起——尽管这种做法从未成为官方的医疗建议。“他们认为，反正我的孩子迟早会得，不如在一个可控的环境中发生，”凤凰城儿童医院的儿科传染病专家 Monica Abdelnour 说，“这些家庭已经准备好面对这种感染，处理它，然后继续生活。”

While the majority of children who develop chickenpox feel well again within a week or two, around three in every 1,000 infected experience a severe complication such as pneumonia, serious bacterial skin infections, encephalitis (inflammation of the brain), or meningitis. 虽然大多数患水痘的儿童在一两周内就会康复，但每 1,000 名感染者中约有 3 人会出现严重的并发症，如肺炎、严重的细菌性皮肤感染、脑炎（大脑炎症）或脑膜炎。

“Some kids get really, really sick,” says Jill Morgan, a professor at the University of Maryland School of Pharmacy and an expert in pediatric health. “The problem is, if you had these parties, you didn’t know which kids would get over it and be OK, and which kids would end up in the hospital.” “有些孩子会病得非常非常重，”马里兰大学药学院教授、儿科健康专家 Jill Morgan 说，“问题在于，如果你举办这些派对，你根本不知道哪些孩子能挺过去并安然无恙，而哪些孩子最终会被送进医院。”

Chickenpox parties faded into obscurity once routine vaccination began to take hold in many parts of the world; a 2018 analysis of global vaccination trends and infection rates shows cases decreased dramatically in countries such as the US, Germany, and Australia, where universal childhood vaccination programs have already been rolled out. 一旦常规疫苗接种在世界许多地方开始普及，水痘派对就逐渐销声匿迹了；一份 2018 年关于全球疫苗接种趋势和感染率的分析显示，在美国、德国和澳大利亚等已经实施全民儿童疫苗接种计划的国家，病例数量大幅下降。

In the US, the vaccine has been associated with a roughly 97 percent drop in reported cases since its introduction, according to data published by the Centers for Disease Control and Prevention. Global data show similarly steep declines in hospitalization rates following the adoption of universal programs elsewhere: Uruguay saw a 94 percent reduction among young children, Canada a 93 percent drop, and Spain more than 80 percent. 根据美国疾病控制与预防中心发布的数据，自疫苗引入以来，美国报告的病例数下降了约 97%。全球数据也显示，在其他地区采用全民接种计划后，住院率出现了类似的急剧下降：乌拉圭幼儿住院率下降了 94%，加拿大下降了 93%，西班牙下降了超过 80%。

While immunologists hope that, just like smallpox, the disease might one day be eradicated thanks to widespread vaccination, chickenpox has far from disappeared—and for immunocompromised people who can’t be vaccinated, the disease remains a severe risk. The virus can also lie dormant for decades before resurfacing as shingles, which can be painful and also lead to potentially very serious complications, including chronic, long-lasting nerve pain and higher risk of heart attack and stroke. 虽然免疫学家希望像天花一样，这种疾病有朝一日能通过广泛的疫苗接种被根除，但水痘远未消失——对于无法接种疫苗的免疫功能低下者来说，这种疾病仍然是一个严重的风险。该病毒还可能潜伏数十年，然后以带状疱疹的形式复发，这不仅会带来剧痛，还可能导致潜在的非常严重的并发症，包括慢性的、长期的神经痛，以及更高的心脏病发作和中风风险。

Recent efforts to increase vaccination against shingles in older generations have been even more successful than anticipated: emerging research suggests people who receive the shingles vaccine—which targets the same varicella-zoster virus—may experience slower aging and a lower risk of dementia. “By vaccinating patients, we protect the people who can’t get the vaccine,” says Morgan. 最近在老年群体中推广带状疱疹疫苗接种的努力比预期的还要成功：新兴研究表明，接种带状疱疹疫苗（针对同一种水痘-带状疱疹病毒）的人可能会经历更缓慢的衰老，并降低患痴呆症的风险。“通过为患者接种疫苗，我们保护了那些无法接种疫苗的人，”Morgan 说。

“Hey mamas,” TikTok creator Hannah Grabau Kugel joked about a post she’d seen on social media. “Any other grass-fed, free-range mamas interested in hosting a chickenpox party with me?” Her tone was ironic, but the… “嘿，各位妈妈们，”TikTok 创作者 Hannah Grabau Kugel 在谈到她在社交媒体上看到的一篇帖子时开玩笑说，“还有哪位‘草饲、散养’的妈妈有兴趣和我一起举办水痘派对吗？”她的语气带有讽刺意味，但……