Healthy Aging

healthy aging

Herpes Zoster (Shingles) - Prevent It

If you or a loved one have had shingles (herpes zoster), you know how unpleasant it is.  If you have not had it, please try to prevent it.  As we age, we are more likely to have this outbreak of a viral infection that is the result of us having chickenpox as a child.  Yes, it is the very same virus that has stayed dormant or inactive in us since we were a child.

What is Shingles?

The term shingles is derived from the Latin and French words meaning belt or band, and this perfectly describes the distribution of herpes zoster.  The virus that we contracted from others infected with chickenpox as a child causing us to also have chicken pox (many of us still have some tiny scars from it), has been in our bodies since we first contracted the viral illness.  It remains in the nerves close to the spine or in the head.  As we age our cellular immune responses are less effective in combating the dormant virus.  The virus begins a renewed expansive invasion along the nerve that causes the breakout in the distribution of the nerve.  Since nerves run from the spine or base of the skull to the skin that the nerve serves, this is where the virus breaks out in the skin.  It is usually only in one nerve distribution, and seems like a belt or band on half our abdomen or chest or face.

Symptoms

The symptoms of herpes zoster are very different than those of chickenpox, even though it is the very same virus.  Shingles begins by tingling or pain in the affected nerve distribution, usually in the chest area, but can be elsewhere as mentioned above.  Soon (usually within 72 hours) after the onset of the tingling or pain there are red areas on the skin that become vesicles (blisters or bubble-like areas under the skin) and finally the vesicles burst and a crusty dry lesion replaces them.  All along the affected area there is some pain and itching.  The "rash" lasts about three weeks and in some unfortunate people the pain can remain as postherpetic neuralgia (prolonged pain).  Other symptoms can be fever and chills, pain, swollen lymph glands, difficulty moving some muscles, and issues with hearing or vision (if in the head).

Epidemiology

Who and when is likely to have herpes zoster?  Anyone who harbors the virus can have shingles, in other words anyone who has had chickenpox is a candidate for a breakout of shingles.  Age is a very important factor: the incidence is increased three to four times if you are older than 65.  The incidence in this group is reported to vary from about four to 12 out of 1000 people per year.  That means in any year there is almost a one percent chance of having shingles if you are over 65.  Half the cases in the U.S. occur in people over 50 and the incidence increases the older you are.  Other factors that can lead to herpes zoster are immunosuppression from medicines or illnesses including some cancer and prolonged stress.  There is no apparent gender preference for the disease nor seasonal outbreak - it strikes men and women equally any time of year.

Treatment

There are treatments for this most discomforting and temporarily disfiguring disease.  Like most medical problems the sooner it is diagnosed the more effective the treatment and the shorter the disease process.  If you believe you have the early (or late) symptoms of shingles, call your doctor immediately and see her/him that day.  Your physician will make the diagnosis and if it is herpes zoster, likely will prescribe high doses of one of several anti-viral medications.  These have been proven to reduce the severity of the outbreak and potential for development of postherpetic neuralgia.  Thus, the importance in treating it immediately is evident.  There are other symptomatic treatments for pain and itching that may also be prescribed or recommended for over the counter medicines.  The outbreak usually is self-limited (three to four weeks) even without treatment, but treatment is advised if detected early enough.  It is also important while the skin is still weeping to avoid others who are not vaccinated against chickenpox or pregnant women, since the virus can be easily spread at this stage of the disease.

Prevention

The great news is that there is a vaccine that your physician can give you any time to help prevent the outbreak of shingles.  The vaccine can reduce the incidence of herpes zoster by 50 percent and the development of dreaded postherpetic neuralgia by 66 percent.  This means that the vaccine is effective and that older adults should ask their physician to be immunized, if not already done.  It has also been shown that eating fresh fruits seems to reduce the disease so there are two things that you can do to prevent herpes zoster: get immunized against it and eat plenty of fresh fruit.  Do it today.

Health Information Library: Shingles (herpes zoster)

Podcast: Chickenpox and Fifth Disease During Pregnancy



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