Did you know shingles can strike more than once? I recently read a most interesting article about this dreaded disease. I have received the shingles vaccine, but I can pass along some good information to you youngsters. Consider this Shingles 101. Skip it if you find this is n/a or upsetting.
1. One in three Americans will have shingles in their lifetimes.
2. There are one million new cases a year.
3. It only strikes people who have had chicken pox.
4. Risks and complications increase with age.
5. Symptoms include both nerve pain and blistery rash.
6. Shingles can cause both vision and hearing damage.
7. The shingles vaccine cuts risk by about half.
Most of you know someone who has had this terrible disease. It was none other than the famed Mayo Clinic who determined shingles can strike more than once. It starts with minor symptoms like itching, tingling, or numbness. Then it progresses into a painful rash that causes blisters. It most likely strikes the elderly and those already suffering from other illness or trauma. The residual nerve pain can last for months.
The Center for Disease Control (CDC) says more than half of cases occur in people over age 60. Likewise, risks of complications are increased with age. But women are slightly more likely to get shingles than the weaker sex! The CDC strongly urges all Americans over 60 to get the shingles vaccine. The bad news is that the vaccine is in short supply right now. Supply problems have plagued Merck since the vaccine was introduced in 2006.
What is shingles? It is a virus caused by Varicella zoster (VZV), the same virus that causes chicken pox. It only strikes people who have had chicken pox. Worse, the virus never fully leaves the patient’s body. It lays dormant for decades in the nerve roots of the spinal column. I then suddenly replicates and traverses down the nerves to cause shingles. Commonly, a striped rash appears, following the nerve pattern on the chest or back. Nobody seems to know what causes the virus to awaken. It seems the most likely scenario revolves around age, illness, chemotherapy, and emotional stress.
Another bit of bad news, for patients whose pain lasted more than 30 days with their first episode were most likely to have a recurrence. Fortunately, some shingles cases are mild. But many have such pain that they cannot be touched, and often require topical narcotic analgesics. Nerve pain that lasts more than a month is called postherpetic neuralgia (PHN). It can last for years in some patients.
On the medication front, antivirals generally only shorten the duration, and sometimes the severity of the episode. In severe cases, the blisters become infected. And as I have seen in some cases, the virus can spread into the eyes, sometimes permanently. An ear rash causes a complication called Ramsey Hunt Syndrome, which can result in permanent deafness and weakness of facial muscles.
It is not known if children who have received the chicken pox vaccine will be protected from shingles. The vaccine was approved in 1996, and it will be decades before this generation of widely vaccinated children reach typical shingles years. Most experts predict a decrease in the incidence of shingles. But the vaccine does not prevent 100% of cases, and even mild cases can be subclinical before vaccination.
The adult shingles vaccine cuts the risk of shingles by half in the over 60 age group. But at least the cases in this population tend to be milder. Less than 11% of Americans over 60 have been vaccinated. Cost is a factor, as charges range from $140 to $400. The web site at Zostavax.com provides availability information. Bottom line is that public health experts strongly urge Americans to get the vaccine at 60!
