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.
The deep pain associated with post-herpetic neuralgia is caused by damage to the nerve during the shingles attack. In these cases, the nerve can no longer send the correct signals to the brain. Signals are amplified and confused, causing the sensation of pain, even though there is no longer injury to the skin.
Shingles prevention steps include vaccination. There is a U.S. FDA-approved vaccine (Zostavax) for adults 50 years of age and older to help lessen the risk of shingles, and it is recommended for adults aged 60 and older. Zostavax is a live attenuated vaccine and therefore carries a small risk of shingles when administered. There is also a U.S. FDA-approved chickenpox vaccine called Varivax which is used primarily in a single dose for children between 12-18 months of age or older who have not had chickenpox.
^ Grahn, A; Studahl, M (September 2015). “Varicella-zoster virus infections of the central nervous system – Prognosis, diagnostics and treatment”. Journal of Infection. 71 (3): 281–93. doi:10.1016/j.jinf.2015.06.004. PMID 26073188.
There are many causes of back pain. Pain in the low back can relate to the bony lumbar spine, discs between the vertebrae, ligaments around the spine and discs, spinal cord and nerves, muscles of the low back, internal organs of the pelvis and abdomen, and the skin covering the lumbar area.
The most difficult complication of shingles tends to be the residual pain that may last in the area for months or years. Chronic pain lasting more than six weeks after the onset of shingles is called postherpetic neuralgia (PHN). Antiviral medications including acyclovir (Zovirax), if given the first 48-72 hours of the development of shingles, can help reduce the length and severity of postherpetic neuralgia. Additional treatments are available for PHN.
Shingles is a virus condition involving inflammation of sensory nerves that can result in severe pain. It causes localized pain, numbness, and itching, followed by the appearance of clustered blisters in a strip pattern on one side of the body. Sometimes the pain can persist for weeks, months, or years after the rash heals (known as postherpetic neuralgia). The term “shingles” is derived from the Latin word cingulum, meaning girdle — the idea being that shingles often girdles part of the body.
Shingles is caused by the same varicella-zoster virus that causes chickenpox. The virus can re-emerge decades after a recovery from chickenpox, often causing a painful rash that may burn or itch for weeks before it subsides.
The vaccine should be stored frozen until reconstituted. It may be refrigerated for no more than 72 hours prior to reconstitution. Once reconstituted, it should be administered within 30minutes. The vaccine must be given subcutaneously. It should not be administered at the same time as the pneumococcal vaccine as this may result in a poorer response to the vaccine. It may be administered at the same time as the influenza vaccine.
^ de Melker H, Berbers G, Hahné S, et al. (2006). “The epidemiology of varicella and herpes zoster in The Netherlands: implications for varicella zoster virus vaccination”. Vaccine. 24 (18): 3946–52. doi:10.1016/j.vaccine.2006.02.017. PMID 16564115.
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Zoster vaccine live (Zostavax) is an attenuated vaccine given to individuals age 60 or older for the prevention of shingles (herpes zoster). Side effects, warnings and precautions, pregnancy information, and complications, should be reviewed prior to taking any medication.
Every year in the United States, over 1 million people per year will be affected by the herpes zoster virus, also known as shingles. Approximately one half of shingles cases affect people at least 60 years old.
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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.
The action taken depends on why varicella vaccine was given in the first place. If it was given because the person tested negative for varicella antibody, then the next dose should be varicella vaccine. If the varicella vaccine was given in error (i.e., without serologic testing), then RZV or ZVL should be given.
“But, with time and as one gets older, there is a decline in natural immunity and the virus can flair up again, presenting as shingles,” Glass said. Consequently, the risk of shingles increases as one gets older and the likelihood of persistent pain increases dramatically after the age of 50.
The Shingles Prevention Study involved individuals age 60 years and older and found found that Zostavax significantly reduced disease in this age group. The vaccine is currently recommended for persons 60 years of age and older.
“What’s remarkable [about the new vaccine] is that the high level of immunity persists even in the very old,” says Dr. Anne Louise Oaklander, a neurologist at Harvard and Massachusetts General Hospital who studies the complications that can arise with shingles.
The rashes are irritating and can last for days or weeks. Many can begin treating their shingles pain by taking over the counter medications. Some also report finding relief with creams or antihistamines, but usually require a doctor’s care to fully heal. If you feel you are experiencing shingles rash pain, your regular doctor can prescribe you stronger medications to keep the pain at bay.
“Patients describe the pain of shingles in different ways, often as severe and excruciating. Typically it is described as a burning sensation,” said Dr Jody Pearl, a neurologist in private practice in Joburg.
“There is a strong, solid business case, but you never want to see people in that much pain and we don’t want to put the strains on caregivers and businesses and others who will be impacted,” said Morris.
A vaccine, like any medicine, could possibly cause serious problems, such as severe allergic reactions. However, the risk of a vaccine causing serious harm, or death, is extremely small. No serious problems have been identified with shingles vaccine.
Dr. Talia Swartz is an assistant professor of infectious diseases with the Icahn School of Medicine at Mount Sinai in New York City. Swartz said, “The reason for the close vote is that while Shingrix is much more effective, it is also associated with more reactions. While they are not serious reactions, they may be temporarily inconvenient, including fever and muscle pain.”
One of the key major differences between the 2 vaccines is that Shingrix is not a live vaccine. The only contraindication is anyone with a history of a severe allergic reaction to Shingrix. Redness, soreness, headache, fatigue, and some gastrointestinal upset have been identified as the most common adverse effects, but overall it is also pretty well-tolerated.
Pain medication can be used to help relieve the discomfort caused by the rash, which can sometimes be severe. For some individuals with mild shingles pain, over-the-counter analgesics such as acetaminophen (Tylenol) or the anti-inflammatory drug ibuprofen (Motrin or Advil) may be all that is needed. Individuals with more severe pain may require stronger opioid pain medication.
The National Immunisation Program (NIP) provides a free shingles vaccine at 70 years of age (from November 2016). There is also a free catch-up program for 71 to 79 year olds until the end of 2021. The shingles vaccine is available on prescription for people aged 50 to 69 years and from 80 years but it must be paid for by the patient. Vaccination is still recommended for people who have had shingles infection in the past. It is recommended to wait at least a year after recovery.
A substantial number of older Americans have suppressed immunity because they’re undergoing chemotherapy or transplants, have H.I.V. or take steroids. For them, the previous vaccine was off-limits because it was made with a weakened live virus.