Shaking the Shingles

YOU MAY HAVE noticed numerous advertisements recently for the shingles vaccine. Or you may know someone unlucky, probably an older relative or friend, who developed the virus. If you’re wondering whether you should get vaccinated or if you’re at risk, the simple answers are yes and yes.

Shingles, also known as herpes zoster, is a reactivation of the chickenpox virus in anyone who was previously infected with chickenpox. According to the Centers for Disease Control and Prevention (CDC), studies show that more than 99 percent of Americans age 40 and older have had chickenpox, even if they didn’t remember getting it. Nearly one out of three people in the United States will develop shingles, with half of the estimated 1 million cases each year occurring in men and women age 60 and older. Shingles can appear anywhere on the body; however, it is most commonly found on the skin of the abdomen underneath the ribs, leading toward the navel. Other commonly affected areas are the vaginal tissues and the inside of the mouth. The varicella-zoster infection spreads to the very ends of the nerves, causing them to send impulses to the brain that are interpreted as severe pain, itching, or burning and rendering the overlying skin much more sensitive than usual. An attack of shingles is often preceded by three or four days of chills, fever, achy feelings as well as the pain in the affected area.

“It takes up latency in the nervous system and your normal immunity will hold it in check. As we get older, or in certain people who are immune-suppressed, by illness or medication, that virus is just ready to jump back out and cause the second illness,” explains Dr. Anne Louise Oaklander, associate professor of neurology at Massachusetts GeneralHospital in Boston and a preeminent expert on shingles.

 Conditions

The most obvious sign of shingles: a painful or burning rash that begins on the back or torso on one side of the body (see “Signs & symptoms,” below). Less often, the rash begins on the face or head, and in mild cases a rash might not appear at all. If you experience a band of inexplicable pain, itch or unusual sensation, Oaklander suggests contacting your doctor immediately.

Shingles itself can’t be transmitted from person to person. However, in rare cases shingles can cause chickenpox in young people who haven’t had chickenpox or been immunized for that disease.

 Complications

The shingles vaccine, approved by the Food and Drug Administration (FDA) in 2006, reduces the likelihood of getting shingles by 50 to 70 percent. It also reduces the severity of shingles-related complications. Having shingles is bad enough itself, says Oaklander, but the complications are also dreadful.

Chronic nerve pain known as post herpetic neuralgia, or PHN, remains the most common complication of a shingles eruption, occurring in half or more of untreated people age 60 and older.  PHN is more likely to occur in older people. Some folks experience post herpetic itch at the site of the rash. The skin of many people with PHN becomes so sensitive that they cannot tolerate wearing clothing or even feeling a light breeze on the affected area. Described as agonizing, excruciating, and burning, the pain can have severe impact on daily living, leading to a loss of independence and, ultimately, to depression and isolation. Also, for people with immune deficiencies, shingles and its aftermath can be devastating. The disease is capable with affecting the internal organs, attacking even the lungs, kidneys, and liver. It can cause permanent injury including blindness, deafness, or paralysis if it goes unchecked. Though rare, shingles can lead to encephalitis, stroke, spinal cord damage, vision and/or hearing loss, and even death.

Death can occur as the result of a secondary bacterial infection or viral pneumonia brought on by shingles.

It can take up to a month to fully recover from shingles. Antiviral medications help shorten the length and severity of the illness, and are most effective when started as soon as shingles is suspected – pain or itching often precedes the rash.

Treatment

Treatment for PHN includes various topical analgesics, such as capsaicin or menthol creams, and lidocaine patches, as well as anti seizure and opioid medication. Tricyclic anti-depressants have been shown to relieve pain in up to two-thirds of those suffering from PHN and shorten the duration of the chronic condition by half.

Experts don’t know why some folks get shingles and others don’t, but the chances of getting shingles, and developing PHN, increase with age. CDC recommends that healthy individuals over age 60, regardless of their previous exposure to chickenpox receive the shingles vaccine for adults age 50 and up.

“It’s a simple and safe way for preventing a potentially devastating neurological illness,” says Oaklander.

For more on shingles, visit www.cdc.gov/shingles.

Signs & Symptoms

Rash on back of the body

According to the CDC, shingles usually starts as a painful rash on one side of the face or body. The rash forms blisters that typically scab over in 7 to 10 days and clears up within two to four weeks.

Before the rash develops, there is often pain, itching or tingling in the area where the rash will develop. This may happen anywhere from one to five days before the rash appears.

Rash on front of the body

Most commonly, the rash occurs in a single strip around either the left or the right side of the body. In other cases, the rash occurs on one side of the face. In rare cases (usually among people with weakened immune systems), the rash may be more widespread and look similar to chickenpox rash. Shingles can affect the eyes and cause loss of vision.

Other symptoms of shingles can include:

  •  Fever
  • Upset stomach
  • Chills
  • Headache

The Costco Connection:

The shingles vaccine is available at most Costco pharmacies. Vaccines vary per location; inquire at your local warehouse pharmacy.

References:

Gerontological Nursing by: Adrianne Dill Linton and Helen W. Lach

Costco Connection: October issue 2012

Prescription for Nutritional Healing Third Edition by: Phyllis A. Balach, CNC,

and James F. Balch, M.D,

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Mirjana Goforth writes and shares information on health, wellness and safety issues. Please check out the web page www.premiercarenurses.com  for other useful health information. If you like to reach her directly please call her at (561) 317-9233.

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