myDrReferences 1. National Health and Medical Research Council (NHMRC). The Australian Immunisation Handbook, 10th Edition. Chapter 4.24 – Zoster (Herpes zoster) [accessed Sept 2015]. Available from: http://www.immunise.health.gov.au/internet/immunise/publishing.nsf/Content/Handbook10-home~handbook10part4~handbook10-4-24
Barbara Walters’ co-hosts on The View informed viewers that Walters has been hospitalized with the chicken pox. She’s 83, and the infection, which is more common among young children, is rare among older adults. According to her co-host Whoopi Goldberg, Walters has never had chicken pox before.
There’s a strong link between the bacteria living in our intestines and virtually every disease that threatens us, since bacteria are what make up most of our immune system. Today, there’s a big emphasis on conducting research that reveals how people with certain diseases have mixes of bacteria in their intestines that are very different than those of healthier people. The belief is that a microbiome that has a greater diversity of microbes and more “good bacteria” present is better able to fight off viruses, infections and illnesses. (12) Conversely, a microbiome with less diversity and more “bad bacteria” can lead to problems, such as leaky gut syndrome, that can increase the chances of developing shingles.
There are several effective treatments for shingles. Drugs that fight viruses (antivirals), such as acyclovir (Zovirax), valacyclovir (Valtrex), or famciclovir (Famvir), can reduce the severity and duration of the rash if started early (within 72 hours of the appearance of the rash). In addition to antiviral medications, pain medications may be needed for symptom control. Both nonsteroidal anti-inflammatory medications and narcotic pain-control medications may be used for pain management in shingles.
Shingles may lead to stroke and heart attack The herpes zoster virus causes chickenpox and shingles; following shingles, there appears to be a higher risk of acute cardiovascular events such as stroke or myocardial infarction Read now
Centers for Disease Control and Prevention: “Shingles: Signs & Symptoms;” “Shingles: Transmission;” “Shingles (Herpes Zoster): Prevention and Treatment;” “Shingles Vaccination: What You Need to Know;” “Shingrix Recommendations;” and “What Everybody Should Know about Zostavax.”
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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.
Only people who have had chickenpox in the past (usually in childhood) can get shingles. The reason why the chickenpox virus reactivates as shingles is not fully understood. It is thought that the following factors influence the development of shingles:
Unfortunately even after the rash clears up after about two to four weeks, pain might still be experienced for up to several more weeks as the nerves recalibrate and recover from the virus. This is called “postherpetic neuralgia” (PHN) and is considered to be the most common complication of shingles.
Shingles may occur in the mouth if the maxillary or mandibular division of the trigeminal nerve is affected, in which the rash may appear on the mucous membrane of the upper jaw (usually the palate, sometimes the gums of the upper teeth) or the lower jaw (tongue or gums of the lower teeth) respectively. Oral involvement may occur alone or in combination with a rash on the skin over the cutaneous distribution of the same trigeminal branch. As with shingles of the skin, the lesions tend to only involve one side, distinguishing it from other oral blistering conditions. In the mouth, shingles appears initially as 1–4 mm opaque blisters (vesicles), which break down quickly to leave ulcers that heal within 10–14 days. The prodromal pain (before the rash) may be confused with toothache. Sometimes this leads to unnecessary dental treatment. Post herpetic neuralgia uncommonly is associated with shingles in the mouth. Unusual complications may occur with intra-oral shingles that are not seen elsewhere. Due to the close relationship of blood vessels to nerves, the virus can spread to involve the blood vessels and compromise the blood supply, sometimes causing ischemic necrosis. Therefore, oral involvement rarely causes complications such as osteonecrosis, tooth loss, periodontitis (gum disease), pulp calcification, pulp necrosis, periapical lesions and tooth developmental anomalies.
If the pain of shingles is very intense it may be mistaken for other problems, and occasionally people get the pain without a rash. Therefore, it is important to get a proper diagnosis in order to treat it as soon as possible.
First, the VZV vaccine, otherwise known as the chickenpox vaccine, may decrease the incidence of shingles by enhancing the immune system’s ability to fight off VZV (about 70%-90% effective) or keep this virus inactive. This vaccine is usually administered to children, but the immunity may decline in about 15-20 years. The single-dose vaccine dose is given to babies 12-18 months of age. Most vaccine side effects, if they occur, are mild and range from a rash, skin redness, and swelling to small chickenpox lesions, usually at the injection site. Boosters of this vaccine for use in adults are now being investigated and may help prevent shingles in the future.
It may also vote to recommend the vaccine on a preferential basis — in other words, suggest that doctors use the GSK vaccine over the Merck one. At a meeting of the committee in June, a CDC vaccine expert who heads a Shingrix work group, Dr. Kathleen Dooling, alerted the ACIP to the fact the work group was leaning toward proposing a preferential recommendation for the new vaccine.
ACIP does not have a recommendation to administer either zoster vaccine to people younger than 50 years with recurrent zoster episodes. However, clinicians may choose to administer a vaccine off-label, if in their clinical judgment, they think the vaccine is indicated. The patient should be informed that the use is off-label, and that the safety and efficacy of the vaccine has not been tested in people younger than 50.
^ Weaver BA (1 March 2007). “The burden of herpes zoster and postherpetic neuralgia in the United States”. J. Am. Osteopath. Assoc. 107 (3 Suppl): S2–57. PMID 17488884. Archived from the original on 13 January 2008.
Because herpes zoster can only occur in people who have already had chickenpox, neither of the shingles vaccines is intended to prevent the initial viral infection. They are, instead, intended to stimulate the immune system to resist the reactivation of existing virus. This reactivation triggers the symptoms of the disease, which include local burning, itching and rash. In addition, they help to prevent the most concerning sequela of shingles which is persistent, often severe, in the site of the reactivation. Neither vaccine provides herd immunity since adults with shingles almost never pass this virus along to others.
^ Furuta Y, Ohtani F, Mesuda Y, Fukuda S, Inuyama Y (2000). “Early diagnosis of zoster sine herpete and antiviral therapy for the treatment of facial palsy”. Neurology. 55 (5): 708–10. doi:10.1212/WNL.55.5.708. PMID 10980741.
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.
Becoming infected with chickenpox during pregnancy could cause birth defects in your unborn child. Likewise, shingles could also cause problems for your unborn child. If you are pregnant and haven’t had chickenpox, avoid exposure to infected people. Zostavax, the shingles vaccine, can reduce the incidence of shingles by half. Women should wait at least three months after receiving the vaccine before trying to get pregnant.
Shingles can affect the skin around your eyes (ophthalmic zoster). This can give you red and streaming eyes (conjunctivitis) and may damage your eyes or affect your vision. If you have shingles around your eyes you may need to see an ophthalmologist (a doctor who specialises in eye conditions).