05 August 2013

No, You Don't Want Shingles

If you have not had chickenpox, you have no worry about having shingles or herpes zoster. If you are one of the people that has had chickenpox, then please consider obtaining the vaccination for herpes zoster if your are age 60 or older. Anyone that has recovered from chickenpox may develop shingles; even children can get shingles. However, the risk of disease increases as a person gets older. About half of all cases occur among men and women 60 years old or older.

People who have medical conditions that keep their immune systems from working properly, such as certain cancers, including leukemia and lymphoma, and human immunodeficiency virus (HIV), and people who receive immunosuppressive drugs, such as steroids and drugs given after organ transplantation are at greater risk of getting shingles. People who develop shingles typically have only one episode in their lifetime. In rare cases, however, a person can have a second or even a third episode.

Shingles occurs when the virus that causes chickenpox starts up again in your body. After you get better from chickenpox, the virus is dormant in your nerve roots. In some people, it stays dormant forever. In others, the virus "wakes up" when disease, stress, or aging weakens the immune system. Some medicines may trigger the virus to wake up and cause a shingles rash. It is not clear why this happens, but after the virus becomes active again, it can only cause shingles, not chickenpox.

Shingles is only contagious during the time when the rash is in the blister-phase. A person is not infectious before blisters appear. Once the rash has developed crusts, the person is no longer contagious. You are unable to catch shingles from someone that has shingles. They can only spread the virus to another person who has never had chickenpox and who has not had the chickenpox vaccination.

Often the rash occurs in a single stripe around either the left or right side of the body. The rash can occur on one side of the face. Less often, the rash may be more widespread and look similar to a chickenpox rash (normally among people with a weakened immune system). The dangerous part of shingles is when it affects the eye and this can cause loss of vision.

Other symptoms of shingles can include fever, headache, chills, and upset stomach. If you have shingles, keep the rash covered, do not touch or scratch the rash, and wash your hands often to prevent the spread of the varicella zoster virus. Until your rash has developed crusts, avoid contact with pregnant women who have never had chickenpox or varicella zoster virus. Also, avoid contact with all children and anyone having a condition in the second paragraph above.

If shingles develops a complication, this is called postherpetic neuralgia (PHN). People with PHN have severe pain in the areas where they had the shingles rash, even after the rash clears up. This pain from PHN may be severe and debilitating, but it usually resolves in a few weeks or months in most patients. PHN can, however, persists for many years in some persons. The older you become the more likely you are to develop PHN. Occasionally shingles can lead to pneumonia, hearing problems, blindness, brain inflammation, or death.

This is a good reason to have the shingles vaccine (Zostavax®). This was recommended by the Advisory Committee on Immunization Practices (ACIP) in 2006 to reduce the risk of shingles and its associated pain in people age 60 years and older.
Your risk for developing shingles increases as you age. The vaccine is currently recommended for persons 60 years of age and older. Even people who have had shingles can receive the vaccine to help prevent future occurrences of the disease.

Shingles vaccine is available in pharmacies and doctor's offices. Talk with your healthcare provider if you have questions about shingles vaccine.

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