Casually Contagious: Being Sick in France is Different Than Being Sick in America
The French won't let something like the chickenpox or stomach virus keep them from living life to the fullest
One of the things about not being great at French and living in France with kids is the shock and awe of getting health alerts from your kids’ schools and then having to translate a new contagious vocabulary word with which my kid may have been exposed.
Here are the top two alerts and vocabulary words for elementary-age kids:
“La présence de poux nous a été signalée dans l'école.” Poux means lice.
“Des cas de varicelle nous sont encore signalés dans l'école.” Varicelle means chickenpox.
CHICKENPOX.
As a geriatric millennial I was one of the last batch of Americans to enjoy the ritual of childhood chickenpox. It wasn’t until 1995 when American doctors began universally recommending the chickenpox vaccine to children. In the 1980s my parents made sure I got it when my sister did (Spoon sharing!!! Insanity.) and we passed the itchy days with popsicles, oatmeal baths and whatever daytime television had to offer on four TV channels.1
My younger siblings and children are all vaccinated so it’s been almost 30 years since I’ve seen someone with the distinctive pox. I almost forgot the virus existed. So imagine my surprise when we moved to France and I started seeing kids with chickenpox… everywhere.
I wouldn’t be surprised if a couple of these kids had chickenpox… photo by Regina Sinsky-Crosby
According to some very detail-oriented doctors the chickenpox rash causes 250 to 500 fluid-filled blisters that burst open and eventually scab over. It’s usually accompanied by a very high fever and so. much. itching.
As an American who hasn’t seen 250-500 fluid-filled blisters on anyone in almost 30 years I actually shouted “WHOA!” when I walked into our favorite restaurant and the owner’s 5 year-old daughter, who happens to be in my son’s class, was casually sitting at a table coloring with full-on chickenpox. In a restaurant. Later that week eight more kids would catch the virus at a birthday party. I told the host our kids were vaccinated against it.
“There’s a vaccine for varicelle?” she asked. “Stop it. You are making me feel like France is like a developing country without vaccines.”
France is not a developing country and it has world-famous healthcare. The chemist and microbiologist who laid the groundwork for modern vaccination, Louis Pasteur, was French (he also invented pasteurization). Our kids’ public schools and activities are strict about children receiving 11 vaccinations to participate. There is no opt-out. But the chickenpox vaccine is not systematically recommended in France for infants. Instead the vaccine is only recommended to adults over 70 who never had chickenpox as children (and usually only adults with other underlying health issues).
It’s interesting that French vaccine skepticism “is less against the vaccine itself than those promoting it, reflecting a distrust of politicians.” The Guardian has a fantastic article on French vaccine skepticism which points out that around the time America started mandating Chickenpox vaccines a 1990s French campaign to vaccinate children against hepatitis B “coincided with a jump in multiple sclerosis cases, though studies never found a convincing link between the two.” In 1991 several French health authorities were charged with manslaughter for knowingly distributing blood products contaminated with HIV to hemophiliacs in the 1980s. The 1990s weren’t an ideal time for French lawmakers and politicians to mandate a new vaccine for children.
So French children don’t get the chickenpox vaccine and they get sick. According to la Santé Publique there are around 700,000 cases of chickenpox in France annually with 90% of cases happening before the age of 15.2
Last May when we had the local chickenpox outbreak I saw more than a dozen kids at parks, restaurants and shops with pox. Our town felt like a 1980s chickenpox party.
This virus revealed one of the biggest cultural differences between France and the U.S.: Americans are advised to stay home with even moderate symptoms of any given illness. The French believe that if one is well enough to walk and feels okay one can go about normal activities.
A French friend in San Diego warned me about this cultural difference.
“When you’re sick in France you still go out,” she told me. “I had a dinner party in Paris with couples who clearly had the flu. It was normal.”
The famous French bisous was put on hold during the height of Covid but it has made a comeback. I will casually double kiss a friend and learn they have a cold or their kid is sick. Honestly it’s worth the risk of infection because bisous are the best.
I recently invited one of my favorite new friends and her family to our house for cocktails. She arrived with two out of three kids, explaining, after the kids had hand-picked charcuterie plates, that her other child was at home vomiting. American parents, even pre-Covid, would at least send a heads-up text asking if it was still cool to come. But whatever! Bisous !
My most harrowing experience with French casualness around sickness was my daughter’s classe de neige, a 4th grade tradition of going on a multi-night ski trip, when 27 out of 42 kids got a gastro-intestinal illness. I was one of two chaperones who got it, too. I won’t go into details (honestly I am still traumatized) but the thing that stood out to me the most was the casualness of the teachers and staff. When it was just 10 sick kids I was ready to go into an isolation chamber and cancel the rest of the trip but they continued ski lessons and group meals. Once 27 kids were sick they finally alerted the parents who mostly replied some variation of “at least it isn’t Covid!”
Not one parent came to get their kid. I made my husband come get me. The only one who went home. My daughter somehow didn’t get sick and just kept on skiing and dining with kids who were violently ill only hours before.
Being casual about illness is one of the greatest examples of c’est la vie, the French mantra that most things in life are inévitable. Sure le gastro and chickenpox aren’t fun for kids but they probably won’t die. Unlike viruses like measles, polio and R.S.V. that can be fatal and ruin children’s lives the chickenpox seems innocent (to children, see footnote 2 on shingles).
"If you don't get vaccinated [and live in a country with good healthcare], you're still less likely to catch that infection,” explains Imran Khan, a representative for Wellcome which conducted the world's biggest survey on public attitudes toward health and science. “If you do get infected, you might not become as unwell or might not die, because we've got quite good healthcare systems in place."
When we are sick in France we can call our wonderful home nurse or even have a doctor do a same-day home visit. We can walk into pharmacies and get professional guidance and inexpensive over-the-counter medicine. My husband had a major surgery here last month and I had a minor biopsy. Both surgeries were less than 1/2 the cost of the same surgeries in the U.S. If we were French they would have been free. Affordable access to healthcare means that everyone is more likely to partake in preventative medicine. Sure you get sick in France but the help you need is affordable and accessible.
I think about how my kids won’t have chickenpox scars like mine and then I see their little friends with new scars (you know the one everyone seems to get between their eyebrows?!) and I wonder if they aren’t missing out on something cultural. But then again we’re still in a global pandemic and I'm sick and tired of sick days and sick kids so I’m taking any and every vaccine I can get my hands on.3
Today I am writing this post in bed. I have some sort of chest cold. I almost went out but I’m not yet culturally acclimated to that concept. I will abstain from bisous for a few days. I will be well soon because I live in France.
Fun Fact: I got chickenpox TWICE. The first time was super mild and then I got it again years later as a pre-teen. The second time around I scored because we finally had a Blockbuster in town.
Some of you are probably wondering about shingles. Here’s a very formal paper based on clinical studies of the shingles vaccine in France. My take away is that the concern is more about the strain of shingles on public healthcare costs than the individual health risks of shingles.
Even our dog has had all the vaccines. See my earlier post on how to get a dog to France.