Bathing is generally allowed, and the affected area can be washed with soap and water. Cool compresses and anti-itching lotions such as calamine lotion may also provide relief from symptoms. An aluminum acetate solution (Burow’s or Domeboro solution, available at pharmacies) can be used to help dry up the blisters and oozing. Application of petroleum jelly can also aid in healing. Over-the-counter (OTC) antihistamines, such as diphenyydramine (Benadryl) and pain medicines can also help provide relief.
Herpes zoster virus causes shingles. No one knows for sure what causes the chickenpox virus to become reactivated to cause shingles. Some investigators suggest that the following conditions may participate in virus reactivation, since they have been associated with a higher incidence of shingles. This is a list of only some of the major conditions that may trigger reactivation but have as yet not been proven to do so:
Shingles is caused by the same virus that causes chickenpox (varicella-zoster virus or VZV), a member of the herpes family of viruses. After a person has chickenpox, the virus can live dormant in the nervous system for life. Sometimes the virus remains dormant forever, but in other cases, the virus reactivates along a nerve of sensation.
^ Enders G, Miller E, Cradock-Watson J, Bolley I, Ridehalgh M (1994). “Consequences of varicella and herpes zoster in pregnancy: prospective study of 1739 cases”. The Lancet. 343 (8912): 1548–51. doi:10.1016/S0140-6736(94)92943-2. PMID 7802767.
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?
The most commonly reported adverse events following vaccination include pain and redness at the vaccination site, and headache. There have been reports of asthma exacerbation, congestive heart failure and the development of polymyalgia rheumatic following vaccination, but these are rare.
If shingles is suspected, it should be treated as soon as possible with acyclovir/valacyclovir and adequate pain management. This reduces the duration of the episode and the risk of developing complications including PHN.
The shingles vaccine has been tested on thousands of people to ensure its efficacy and safety. Most of the time, the vaccine is safely administered without any side effects. When it does cause reactions, they’re usually mild. People have reported side effects including redness, swelling, itching, or soreness in the area of skin where they were injected. A small number of people have complained of a headache after being vaccinated.
Shingles is most commonly diagnosed and treated by a primary care physician (family practitioner, pediatrician, and internist) or an emergency medicine physician. For certain individuals who develop complications of shingles, a specialist in ophthalmology, neurology, or infectious disease may also be involved. Select patients with postherpetic neuralgia may require the care of a pain specialist.
Because the virus affects your nerves, the pain may continue after the rash has cleared, sometimes lingering for weeks, months or even years. This is called post-herpetic neuralgia. It’s more common in older people and in people who had a severe rash.
One of the biggest misconceptions about shingles is that it only affects older adults. Although people over the age of 50 are more likely to develop shingles, the disease can also affect younger people. Even children can develop shingles.
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In phase 3 trials, the vaccine was 97% effective against shingles in those 50 years and older, and it was 89.8% effective for those 70 years and older. Additionally, Shingrix was shown to be 89% effective in preventing post-herpetic neuralgia (PHN) in those 70 years and older and 91% effective in those 50 years and older.
It’s easy to ignore minor aches and pains, especially in age, but pay attention to the location. “One symptom that people might ignore is pain in a certain area even with no evidence of a rash,” says Patrick Fratellone, MD, an integrative physician and registered herbalist practicing in New York City. “There are a few patients who have shingles and no rash.” In those cases, a blood test can help with the diagnosis.
Classic textbook descriptions state that VZV reactivation in the CNS is restricted to immunocompromised individuals and the elderly, however, recent studies have found that most patients are immunocompetent, and less than 60 years old. Old references cite vesicular rash as a characteristic finding, however, recent studies have found that rash is only present in 45% of cases. In addition, systemic inflammation is not as reliable an indicator as previously thought: the mean level of C-reactive protein and mean white blood cell count are within the normal range in patients with VZV meningitis. MRI and CT scans are usually normal in cases of VZV reactivation in the CNS. CSF pleocytosis, previously thought to be a strong indicator of VZV encephalitis, was absent in half of a group of patients diagnosed with VZV encephalitis by PCR.
If the shingles rash appears around the eye or forehead, it can cause eye infections and temporary or permanent loss of vision. If the shingles virus attacks the ear, people may develop hearing or balance problems. In rare cases, the shingles virus may attack the brain or spinal cord. These complications can usually be prevented by beginning treatment for shingles as soon as possible.
And even if adults want to get their recommended shots, some lose track of which they have already received and when. Pediatricians routinely report the vaccines they provide to state or city vaccination registries that electronically collect and consolidate the information. But the registries are not widely used for adults, who are more likely to get vaccines at various locations, such as a pharmacy or at work, for example.
People 60 years of age or older should get shingles vaccine (Zostavax). They should get the vaccine whether or not they recall having had chickenpox, which is caused by the same virus as shingles. Studies show that more than 99% of Americans aged 40 and older have had chickenpox, even if they don’t remember getting the disease. There is no maximum age for getting shingles vaccine.
By comparison, Shingrix is a non-live, subunit vaccine that works by introducing only an essential subunit of the actual microbe. The intention of using part rather than the whole pathogen is to reduce the possibility of the body having an adverse reaction.
The Centers for Disease Control and Prevention (CDC) recommend that people over 60 years old are vaccinated with the shingles vaccine at least once. The varicella-zoster shot, known as Zostavax, or VZV, is approved by the Food and Drug Administration (FDA) for those over 50 years old.
Hello, Bob, Data from clinical trials indicates that side effects from the vaccine may include pain and swelling at the injection site (most common), and body aches, fever, and headaches. See the GSK press release about the ACIP meeting at which the vaccine was recommended.
If you have shingles, there are antiviral drugs your healthcare provider can give you to help reduce the severity and shorten the time you have it. They include acyclovir (Zovirax), valacyclovir (Valtrex), and famciclovir (Famvir).
This is a serious vaccine administration error. The event should be documented and reported to either the Vaccine Adverse Event Reporting System (VAERS) or the manufacturer. Procedures should put in place to prevent this from happening again. ZVL contains about 14 times as much varicella vaccine virus as varicella vaccine. However, no specific medical action needs to be taken in response to this vaccine administration error. If this was the child’s first dose of varicella-containing vaccine he/she will still need the second dose of varicella-containing vaccine on schedule.