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Chicken Pox Outbreak Hits School With County's Highest Vaccine Exemption Rate

Centers for Disease Control and Prevention
This 1981 electron microscope image shows varicella-zoster virions from a patient with chickenpox.

(Update: 11/29/18) The chicken pox outbreak that began at an Asheville private school in late October is far from over according to the Buncombe County Department of Health and Human Services.  The latest numbers show 37 students at the Asheville Waldorf School along with 4 people in the community have contracted the virus.  Health officials are not releasing details about the additional cates, saying only rhat they are connected to the  outbreak at the school .  

According to the Centers for Disease Control and Prevention, a chicken pox outbreak is not declared over until 42 days have passed without a new case. 

In a statement on its website, the Buncombe County Department of Health and Human Services says based on the timing of the most recent case in the community, the outbreak will continue into 2019.  The state health department says it's the largest chicken pox outbreak in the NC since the vaccine was introduced in 1995.  

The Buncombe County Department of Health and Human Services says the chicken pox outbreak at an Asheville private school has now spread to more than 30 students. (update: 11/19/2018 - 36)   And as BPR’s Helen Chickering reports,  the school has a history of high vaccine exemption rates.

“We’re definitely keep an eye when is outbreak going to end. We’re just watching and what going in school.”

That’s Buncombe County Medical Director, Dr. Jennifer Mullendore, speaking about the chicken pox outbreak at the Asheville Waldorf School. Mullendore says the private school had the highest vaccine religious exemption rate in the county last year.

“When we first became aware of the outbreak, the most recent data we have is from last school year and we recognized, just within the kindergarten class, last year’s kindergarten class, 68 percent of children had an exemption to some, to at least one required vaccine,” says Mullendore, “I would say based on this outbreak and data we found, it appears the chicken pox vaccine was one of the more commonly exempted vaccines for this school.”

Students who can’t prove immunity to the virus are required to stay home for 21 days.   While chicken pox is considered by some to be a childhood rite of passage, Dr. Mullendore says, some cases can be more severe and cause serious complications, especially in people who are immunocompromised, pregnant women and children under one.

The Asheville Waldorf School issued a statement, noting that the school is cooperating with the health department.  When asked by email about the high religious exemption rates, the school responded, “The school follows immunization requirements put in place by the state board of education, but also recognizes that a parent’s decision to immunize their children happens before they enter school.”  I’m Helen Chickering, BPR News

Hear more about the chicken pox outbreak from Dr. Jennifer Mullendore, the Buncombe County Medical Director.

During the 2016-17 school year,  57 percent of the kindergarten class at the Asheville Waldorf School (formerly Azalea Mountain School)claimed a religious exemption.  During the 2014-15 school year class the religious exemption rate was 73 percent. 

You can find the 2017-18 NC DHHS Immunization report here                                                                                Under North Carolina law, no student may attend any classes in any school without a certificate of immunization. Children must be immunized against diphtheria, tetanus, whooping cough, poliomyelitis, red measles (rubella) and rubella. However, the law allows for exemptions if a child has a medical exemption, which requires a certification from a licensed physician. It also allows for an exemption for "bona fide religious beliefs" of the child's parents or guardians. This exemption requires only a written statement of the religious beliefs.

Below is the Asheville Waldorf School media statement along with answers to questions emailed to the school by BPR news:

Media Statement

Buncombe County Health and Human Services recently requested information about instances of chicken pox at Asheville Waldorf School. Asheville Waldorf School has ensured that the Buncombe County Health Department received all the necessary information. Varicella is not classified as a dangerous disease by the state of North Carolina. Asheville Waldorf School is committed to protecting the health and safety of our community. 

BPR: Is the outbreak on one or both campuses?  If so, which campus?  Both campuses. We have many families with children at both locations. 

BPR: Any updates or info you would like to share about the status of the outbreak and how the school is responding to the outbreak? We are working in cooperation with Buncombe County Health and Human Service on the matter.

BPR: Any comment on the high religious vaccine exemption rate and this latest outbreak?    At the Asheville Waldorf School our students’ overall health is always a priority and concern. The school follows immunization requirements put in place by the North Carolina State Board of Education. We also recognize that a parent’s decision to immunize their children happens before they enter school. At Asheville Waldorf School we support our families, we love our students, we love our city and we are grateful that our community is strong during challenging times. 

Buncombe County has North Carolina’s highest rate of kindergartners who have not been immunized, with 5.7 percent of students claiming a religious exemption, compared to 1.2 percent in the rest of the state.

According to the Centers for Disease Control and Prevention, Chickenpox is a very contagious disease that causes a blister-like rash, itching, tiredness, and fever.  The rash appears first on the stomach, back and face and can spread over the entire body causing between 250 and 500 itchy blisters. The CDC says the best way to prevent it is vaccination.

Helen Chickering is a host and reporter on Blue Ridge Public Radio. She joined the station in November 2014.