An anxious reader in Norfolk has asked about chickenpox in children. She read that a five-year-old had died in London from the disease and that this is the second death in children from chickenpox in the past few years. Should she have her young children vaccinated?

Chickenpox in children is usually trivial. It was thought of as such an unimportant rite of passage when I was at school that the trick was to scratch one or two of the spots so that they didn’t heal – it was believed that a child remained unfit for classes so long as at least one spot remained scabby.

In its initial stages chickenpox can, however, give the patient an unpleasant headache, a temperature and other symptoms similar to those of flu. The rash starts as red blotches on the skin, which soon turn into blisters and later into scabby ulcers. The varicella virus is responsible for both chickenpox and shingles. After an attack of chickenpox the signs and symptoms disappear, but the virus remains with the patient and lurks around the spinal nerve roots. From time to time when the patient’s resistance is lowered by age, intercurrent disease, stress or immune-suppressant drugs there can be a recrudescence of the symptoms, but more for sufferers of shingles than of chickenpox.

Any patient whatever their age who is immune-compromised is liable to suffer a severe attack. The two most common potentially dangerous complications of chickenpox are pneumonia and, fortunately less frequently, encephalitis – inflammation of the brain. When pneumonia complicates chickenpox it tends to be persistent.

The other group of people who have to worry about chickenpox, if they haven’t had it in childhood, are pregnant women. The association of pregnancy and chickenpox gives rise to two problems. There is a higher incidence of pneumonia and in one in 50 cases of chickenpox during pregnancy the baby may suffer abnormalities or the woman may miscarry.

The Manchester child who died a few years ago died from pneumonia. No statement was made about the cause of death in the more recent fatality in the London area.

In America, inoculations against chickenpox are routine but in this country we tend to leave acquiring immunity to it to nature. There is anxiety that widespread chickenpox immunisation could lead to an increase in shingles. If a woman knows that she has never had chickenpox in childhood and is planning pregnancy she would be well advised to have the vaccination that has been available for six years.

A reader whose brother, an office worker who rarely goes out into the sun, has recently developed a melanoma of the eye is concerned that this can be a familial problem.

Most melanomas occur in skin exposed to sunlight. Those who have been overexposed in childhood and have been burnt on three or more occasions are especially vulnerable. So the incidence of melanoma is higher in those of European stock who live in sunny climates. The incidence of melanomas is also increasing more rapidly for people living in sunny climates; for example, it quadruples every ten years in Australasia but only doubles in Northern Europe.

Not all cases of melanoma originate in areas of the skin exposed to the sun. In African and South Asian people the soles of the feet and palms of the hand are comparatively common sites for melanomas, and this is probably because these areas are less deeply pigmented than the arms, face and back. It is more difficult to account for melanomas that appear either at the back of the eye, in the perianal skin, around the lips or on the meninges, the covering of the brain. These cancers are obviously likely not to have been induced by the sun, but to have originated because of a genetic tendency unrelated to skin colouring.

There is a memorial service at 11.30am today at St. Bride’s, Fleet Street, in London, for Juliet Peck. Juliet, a former journalist, died in January from widespread metastases, which originated from melanoma in the eye. Unusually the initial secondary case appeared in the intestines – more often when this cancer recurs it has spread to the liver, lungs, skin or bones. Juliet continued to live a very active life after the initial diagnosis. Her apparent indifference to her disease was not only evident in the ten years before she had any recurrence of the trouble. Even after she had had unpleasant treatment for secondary growths in the gut, liver and lungs she continued with a multitude of interests.

Juliet was a remarkable woman who had been married to two remarkable men, Dominique Vergos and Rory Peck. Both were press photographers and both suffered violent deaths overseas when still young. They were famed for the fearlessness that they displayed when recording images of the various war zones in which they worked. Rory was Juliet’s second husband. He was killed in crossfire when covering the attempted coup against President Yeltsin in Moscow in October 1993. Among Juliet’s many responsibilities she found time to set up the Rory Peck Trust, which annually makes a substantial award to press photographers, looks after their interests when they are at work and, should they be killed or seriously injured, attends to the needs of their families or dependants.

The Rory Peck Trust, 020-7730 1411; rorypecktrust.com

Have your say and ask your questions about chickenpox. Dr Stuttaford’s answers will appear online at 1pm Wednesday