There is a vaccine against the varicella virus which has been used routinely in the USA since 1996 to protect children against chickenpox. It is not given routinely in the UK but is available for prescription on the NHS if the doctor thinks it is needed. The vaccine has reduced the incidence of chickenpox in the USA. If fewer people get chickenpox, then fewer people will get shingles later in life.
Chickenpox can be dangerous for some people. Until your shingles blisters scab over, you are contagious and should avoid physical contact with anyone who hasn’t yet had chickenpox or the chickenpox vaccine, especially people with weakened immune systems, pregnant women and newborns.
The CDC states that many people describe the intense pain from shingles as being “excruciating, aching, burning, stabbing, and shock-like … It has been compared to the pain of childbirth or kidney stones.”
Varicella zoster virus is not “curable” because the virus stays dormant in the body for life. Once someone is initially exposed to the varicella virus, immunity develops that generally prevents a second bout of typical chickenpox. However, this immunity may fade over time, making older adults more prone to a later onset of a limited recurrence of the chickenpox virus as shingles.
In 2006, Merck’s vaccine, Zostavax, was approved by the FDA to prevent shingles and related complications in adults starting at 50 years old. Zostavax was shown to reduce the risk of developing shingles by 51% and post-herpetic neuralgia by 67%. The vaccine provides protection from shingles that lasts for about 5 years. Patients could receive a one-time dose of the vaccine either at their doctor’s office or pharmacy. The vaccine was to be kept frozen until use, where it was then reconstituted, requiring the immunization to be administered within 30 minutes of preparation.
Although shingles (also sometimes called herpes zoster) is caused by carrying a virus, certain risk factors make people more susceptible to its effects. Having the virus alone doesn’t guarantee that shingles will develop, and even if it does, certain preventative measures can help keep it from returning once it’s cleared up.
Risk factors for shingles are common, and the majority of people have at least one or more risk factors. For example, anyone who has had the chickenpox infection or chickenpox vaccine (live attenuated virus) may carry the herpes zoster virus that causes shingles. Older people (over 50 years of age), those with cancer, HIV, or organ transplant, or people who have a decreased ability to fight off infection due to stress or immune deficiency have a greater chance of getting shingles.
Shingles is more likely to affect adults, but it could affect children as well. Though people usually develop shingles once in a lifetime, in rare cases, shingles may recur. People with a compromised immune system are definitely more likely to get affected.
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It’s estimated that more than 90 percent of adults in the U.S. carry VZV and are therefore at risk for the development of shingles. (2) As you get older, your risk goes up, since studies show that most people (over half) who develop shingles are over the age of 60. This is why adults 60 or older are often advised to get vaccinated against the shingles virus — although as you’ll learn, this isn’t always necessary and shingles natural treatment approaches (like using antiviral herbs) can also be effective for prevention.
The first symptom is often sensitivity, tingling, itching or pain in a band on one side of the body. Any part of the body can be affected although most commonly the trunk, face and even eyes. The rash then appears on the area of skin supplied by the affected nerve. You may also experience a headache, fever and feel generally unwell.
Antiviral medicines, usually taken as tablets, can help to control the symptoms of shingles if you take them in the early stages of the illness. They help control the rash and minimise damage to your nerves; this reduces the likelihood post-herpetic neuralgia.
Tests aren’t usually needed to diagnose shingles, because the type and location of the rash is very easy to spot. However, sometimes scrapings may be taken from a blister and analysed under a microscope, or you may need a blood test to identify the virus and confirm the diagnosis.
Yes, but not in the way you may think. Your shingles rash will not trigger an outbreak of shingles in another person, but it can sometimes cause chickenpox in a child. People who’ve never had chickenpox, or the vaccine to prevent it, can pick up the virus by direct contact with the open sores of shingles. So keep a shingles rash covered and avoid contact with infants, as well as pregnant women who have never had chickenpox or the varicella vaccine.
Postherpetic neuralgia: This is the most common complication of shingles. This condition is characterized by persistent pain and discomfort in the area affected by shingles. The pain can last for months to several years after the rash has cleared up. This complication is thought to occur because of damage to the affected nerves. The pain can sometimes be severe and difficult to control, and the likelihood of developing postherpetic neuralgia increases with age. This chronic post-herpetic pain can sometimes lead to depression and disability. In people 60 years of age and older with shingles, postherpetic neuralgia will develop in approximately 15%-25% of cases. It rarely occurs in people under 40 years of age. Timely treatment with antiviral medication during a shingles outbreak may help reduce the incidence of developing postherpetic neuralgia. If postherpetic neuralgia develops, there are various treatment options available including topical creams such as capsaicin (Zostrix), topical anesthetic lidocaine patches (Lidoderm), antiseizure medications such as gabapentin (Neurontin), pregabalin (Lyrica), tricyclic antidepressant medications, and opioid pain medications. Intrathecal glucocorticoid injections may be useful for select patients with postherpetic neuralgia who do not respond to conventional medications and treatment measures.
Individuals who never have had chickenpox and have not received the vaccine for chickenpox are susceptible to shingles virus infection. Consequently, shingles disease is contagious for chickenpox by transmission of the varicella-zoster virus (VZV) to these individuals. However, the shingles rash is not contagious in that a rash from one individual is unable to spread to another individual so the disease, shingles itself, is not directly contagious. Nevertheless, the disease of shingles can pass the virus from its active rash blisters directly to another individual (an adult, child, or baby) who can become infected with the varicella-zoster virus if the individual is not immune to VZV and develop chickenpox. The chickenpox infection can cause shingles in some individuals later in their life. Shingles, in this manner, may be considered to be indirectly contagious. Moreover, because varicella-zoster virus infection is commonly contagious in the form of chickenpox, and this infection can eventually lead to shingles development in some patients, it is fair for some researchers to say that shingles is indirectly contagious by the spread of chickenpox.
The shingles rash can be a distinctive cluster of fluid-filled blisters — often in a band around one side of the waist. This explains the term “shingles,” which comes from the Latin word for belt. The next most common location is on one side of the forehead or around one eye. But shingles blisters can occur anywhere on the body.
Do not scratch the skin where the rash is located. This may increase the risk of secondary bacterial infection and scarring. Over-the-counter (OTC) antihistamines (Benadryl) and topical creams (Lidocaine cream) can relieve the itching.
Previous Stanford University research had shown that macrophages — immune cells essential to tackling infections and repairing injured tissue — in patients with coronary artery disease have excessive numbers of molecules involved in the uptake of glucose, forcing accelerated metabolism of the sugar.
People looking to receive the shingles vaccine now have two options. The Food and Drug Administration in 2017 approved Shingrix as the preferred alternative to Zostavax, which was approved in 2006. Both vaccines are approved for adults age 50 and older for the prevention of shingles and related complications, whether they’ve already had shingles or not.
The Zostavax package insert says that clinicians should consider administering live zoster vaccine and pneumococcal polysaccharide vaccine (PPSV) at least 4 weeks apart. What does ACIP say about this?
Slate shingles are also called slate tiles, the usual name outside the US. Slate roof shingles are relatively expensive to install but can last 80 to 400 years depending on the quality of the slate used, and how well they are maintained. The material itself does not deteriorate, and may be recycled from one building to another.
It’s uncommon (though not unheard of) for shingles to affect the external area around the vagina, called the vulva. It’s very unusual for shingles to affect the inside of the vagina itself, but it can occur.
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