Starting antiviral medications as soon as symptoms arise, within 24 to 72 hours of the first sign of a rash (the earlier, the better), can shorten the duration and severity of your illness and ease the pain of shingles. Early treatment can also reduce the risk of complications. Postherpetic neuralgia, the most common shingles complication, causes persistent pain even after the rash disappears.
While chickenpox—and, by association, shingles—used to be something that nearly everyone got at some point in their lives, both are becoming less common thanks to vaccines for each disease. Children now routinely are given the chickenpox vaccine as part of their regular shots, Dr. Adalja says, and the shingles vaccine, Zostavax, reduces the risk of developing shingles by 51 percent and postherpetic neuralgia by 67 percent, the CDC says.
The shingles virus and the chicken pox virus are one and the same – both are the varicella zoster virus. Shingles can’t be passed from one person to another, but the varicella zoster virus can, especially if you aren’t immune to it.
Transcutaneous electrical nerve stimulation (TENS): this device sends small electrical impulses through electrodes into the affected area. The TENS unit can be switched on or off depending on the level of pain experienced.
^ Beards G, Graham C, Pillay D (1998). “Investigation of vesicular rashes for HSV and VZV by PCR”. J. Med. Virol. 54 (3): 155–57. doi:10.1002/(SICI)1096-9071(199803)54:3<155::AID-JMV1>3.0.CO;2-4. PMID 9515761.
We all love travelling to new and exotic places, but unfortunately illnesses and unforeseen events can ruin the trip of a lifetime. With a little effort, take a few of these simple precautions to make…
The culprit is a germ called the varicella zoster virus (VZV), the chickenpox virus. When it first enters the body, as it does in the case of 90% of all children, it leads to chickenpox. But the body is never totally rid of VZV, which belongs to a family of viruses known as the “herpes viruses” that become latent in their host after causing the first infection. Herpes viruses manage to hide in certain types of nerve cells near the spine and brain. There they lie dormant, literally for decades, because chickenpox is a disease and shingles occurs mostly among people over 50. When the virus is reactivated it will cause shingles, not chickenpox.
Older adults are most likely to develop shingles, which is why the shingles vaccine is recommended for people age 60 and older. Zostavax is currently the only vaccine approved by the U.S. Food and Drug Administration (FDA) to prevent shingles. According to the CDC, the vaccine can reduce your risk of getting shingles by more than half, but the older you are the less effective the vaccine becomes. As a result, some people who get the vaccine may still get shingles. The ideal time for getting vaccinated is between 60 and 69 years old.
^ Han, Y; Zhang, J; Chen, N; He, L; Zhou, M; Zhu, C (Mar 28, 2013). “Corticosteroids for preventing postherpetic neuralgia”. Cochrane Database of Systematic Reviews. 3 (3): CD005582. doi:10.1002/14651858.CD005582.pub4. PMID 23543541.
Shingles symptoms appear in stages. Initial signs of infection are usually burning, stabbing, or tingling pain; skin sensitivity; or itching across a band of skin, generally on one side of the body. Some people have symptoms of a viral infection, like headache, fever, chills, fatigue, or nausea. A couple days to two weeks later, a red rash of round pocks erupts on the skin’s surface where the pain and itching occurred. Soon after, those dots become fluid-filled blisters that ooze.
While these macrophages can initiate helpful immune responses, if they’re addicted to glucose they can become incompetent at aiding the anti-viral activity of T cells – which recognise and kill virus-infected cells directly.
Cost, procrastination and a lack of insurance coverage are just a few of the reasons adults give health care providers for not getting vaccinated against shingles and other illnesses. Andrew Brookes/Getty Images/Cultura RF hide caption
Department of Health and Ageing (DOHA). National Immunisation Program Schedule. [online] Canberra, ACT: Commonwealth of Australia. 2007 [Accessed 11 Jul 2011] Available from: http://www.immunise.health.gov.au
Shingles, or herpes zoster, is a very common painful, blistering viral rash. Shingles is caused by reactivation of the chickenpox virus called varicella zoster virus (VZV). Shingles occurs in people who have previously been infected with the chickenpox virus at some point in their lives. Shingles usually occurs as a unilateral (one side of the body) pain, burning, or tingling and blistering rash extending in a local pattern in the distribution of nerves. Common areas affected by shingles include the face, abdomen, back, buttocks, and chest. Red, itchy patches form across these areas and become small blisters that may be similar in appearance to chickenpox. The rash begins to clear after the blisters break and dry into scabs within two to three weeks.
The Shingrix vaccine (whose two doses are to be given two to six months apart), according to the CDC, offers 97 percent protection in people in their 50s and 60s and roughly 91 percent protection in those in their 70s and 80s. And it appeared to retain similarly high effectiveness throughout a four-year study period and cut PHN risk by 86 percent.
All vaccines that contain live varicella virus, including ZVL, must be stored frozen at a temperature of between -50°C and -15°C (between -58°F and +5°F) until it is reconstituted. Although the manufacturer states that any freezer that has a separate sealed freezer door and reliably maintains a temperature between -50°C and -15°C is acceptable for storage of varicella-containing vaccines, CDC recommends the use of a separate stand-alone freezer to store frozen vaccines. A storage unit that is frost-free or has an automatic defrost cycle is preferred. The diluent should be stored separately at room temperature or in the refrigerator.
To prevent shingles, adults who are 60 years old and older should receive the shingles vaccine. To relieve pain, you can apply a cool washcloth to the blisters. Keep the rash covered as much as possible to avoiding spreading the varicella virus to others. Ask your doctor if you’re a candidate for anti-viral medications, which can reduce the length and intensity of the virus. You doctor can also prescribe pain medications if necessary.
Stress occurs when forces from the outside world impinge on the individual. Stress is a normal part of life. However, over-stress, can be harmful. There is now speculation, as well as some evidence, that points to the abnormal stress responses as being involved in causing various diseases or conditions.
Since 2006, we’ve had Zostavax—approved for those between 50 and 59 but recommended by the CDC for adults 60 and older—as the sole bulwark against shingles. Zostavax offers 70 percent protection against shingles for people between 50 and 59 but only 18 percent in people 80 and older, according to the Pink Sheet, which reports on the pharmaceutical industry.
If RZV is erroneously given to a child for prevention of varicella, the dose is invalid, but is there a waiting period before a valid dose of varicella vaccine can be given? Is it OK to give a dose of varicella vaccine as soon as the error is discovered?
“Anyone who has had chickenpox is at risk of getting shingles. However, because in children exposure to the chickenpox virus can have very mild symptoms, you might not even remember having had chickenpox,” Glass said.
What are some of the most common risk factors for developing shingles symptoms? These include older age, having a weak immune system or poor gut health, a history of a disease that affects the immune system, being under a lot of stress, and taking certain prescriptions, among others.
“The problem with shingles-related pain is that it’s so difficult to treat because it’s pain resulting from affected nerves that function abnormally, regular pain medications are not effective,” he said.
If you’ve had chicken pox or the immunization for chicken pox, you already have varicella zoster in your nervous system. (Even if you’re in the same room with someone with the rash, there’s no risk of further transmission.)
You have immunosuppression. That is, your immune system is not working as well as normal. This could be due to treatment (such as chemotherapy, steroids, or immunosuppressant medicines used after organ transplants or for severe arthritis) or illness (such as HIV/AIDS or certain cancers).
“The shingle attack itself is severe and painful to most people, and then there’s the possibility that the skin lesions clear up but nerve pain continues,” said Dr. Len Horovitz, a pulmonologist at Lenox Hill Hospital in New York City. “That can be really chronic, unremitting and difficult to treat.”
Several studies have investigated the efficacy of complementary and alternative medicines in reducing the pain of nerve damage left over after shingles. Alternative approaches that seem to offer hope for managing long-term pain with few side effects include:
Talk with your healthcare provider if you have questions about shingles vaccine. Shingles vaccine is available in doctor’s offices and pharmacies. To find doctor’s offices or pharmacies near you that offer the vaccine, visit Zostavax or HealthMap Vaccine Finder.
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.
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
Those who are severely allergic to any component of Shingrix should not get the vaccine, and anyone with active shingles should wait until symptoms resolve. The vaccine hasn’t been studied in pregnant or breastfeeding women.
For people who have had chickenpox, shingles is not contagious. However, if you have never had chickenpox, contact with someone who has shingles could give you chickenpox. The fluid from their open blisters is infectious. Your healthcare provider may suggest giving you the chickenpox vaccine if you are exposed to someone with shingles.