Shingles: What you need to know about avoiding and treating the shingles virus

Monday, July 2, 2012
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A person can acquire the herpes zoster virus -- more commonly known as shingles -- after getting chickenpox as a child. Research suggests that about 50 percent of people who live to age 85 will have at least one episode of shingles in their lifetime, says Dr. Cheree Wheeler-Duke, a primary care physician at Southeast Primary Care in Cape Girardeau.

"Although the chickenpox virus symptoms are short-lived, the virus itself does not die and actually goes dormant within the nervous system of the body," she explains. "Years later the virus can become reactivated and cause a viral skin eruption in the pattern of nerve distribution for that region of the body."

Shingles starts like many other illnesses, with a headache, fever and fatigue. What it's known for, though, is a burning sensation and rash on isolated spots of the body, says Wheeler-Duke.

Dr. Victoria Adjovu, an internal medicine physician at Cape Primary Care, says shingles often appears as a band of rashes, and it may itch, burn and cause a tingling sensation. The rash looks like hives at first but changes to a blistered appearance as the virus progresses, says Wheeler-Duke.

The most common shingles complication is postherpetic neuralgia: Pain persisting beyond four months from the start of the rash, says Adjovu. Other complications include numbness at the affected areas, eye and ear infections and bacterial infections.

Shingles is treated by antiviral medications, pain relievers and steroids. Antiviral medications are most effective if given within 72 hours, says Wheeler-Duke, so it's important to notify your doctor at the first symptoms.

"Pain medications are often required because of the intense pain associated with the affected nerve roots," she says. "If possible, keep the affected area covered and avoid having direct skin-to-skin contact with other individuals."

The virus can also be spread via air transmission or aerosolization from skin lesions, says Adjovu.

"People who have never had chickenpox who are exposed to someone with shingles are at risk for developing chickenpox," she adds.

Shingles can surface in any person with a history of chickenpox, but it most often occurs in older adults. In younger people, it may surface due to a weakened immune system: High stress levels and recent illness have been linked to suppression of the immune system and ensuing episodes of shingles. Patients with HIV, a history of transplant or autoimmune diseases may also be at risk, says Wheeler-Duke.

Zostavax is a one-time shingles vaccine approved for adults ages 50 and up but recommended for those ages 60 and up. It's also recommended for those with chronic medical conditions like COPD and diabetes, and anyone living in a nursing home or long-term care facility, says Wheeler-Duke.

"It decreases the chances of you developing shingles and will causemilder forms of shingles should you develop it," says Adjovu.

Charlotte Craig, director of the Cape Girardeau County Public Health Center, says the only downside of the shingles vaccine is that each one costs the health department $180, and that's what patients must pay. It's a fragile vaccine that must be kept frozen, says Craig, and many doctors' offices don't keep it in stock because of the cost.

Even after a bout of shingles, the virus remains dormant in the nerve roots, says Wheeler-Duke. The vaccine works to prevent the virus from reactivating, whether for the first time or for additional occurrences.

"Even if you've had shingles before, they're saying do still go ahead and get that vaccine. Shingles is a hard disease, and very debilitating," says Craig.

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