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For some seniors, it can mean the difference between living independently and having to move into a long-term care facility because of its long-lasting effects, Livingstone said. Losing their independence is a huge issue for older people, she added.
^ Colebunders R, Mann JM, Francis H, et al. (1988). “Herpes zoster in African patients: a clinical predictor of human immunodeficiency virus infection”. J. Infect. Dis. 157 (2): 314–18. doi:10.1093/infdis/157.2.314. PMID 3335810.
About half of all shingles patients experience post-herpetic neuralgia. The likelihood of this condition increases with age. Post-herpetic neuralgia occurs in at least half of shingles patients over 60 and three-quarters of those over the age of 70.
The culprit is a germ called the varicella zoster virus (VZV), the chickenpox virus. When it first 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 childhood disease and shingles occurs mostly among people over 50. When the virus is reactivated it will cause shingles, not chickenpox.
According to the Centers for Disease Control and Prevention (CDC)’s Advisory Committee on Immunization Practices, Shingrix has been shown to reduce the risk of developing shingles by 97% in patients between 50 and 69 years of age, and 91% in patients ages 70 and up. Shingrix was shown to prevent post-herpetic neuralgia by 90%. Shingrix is administered intramuscularly and requires a 2-dose series, one received at baseline, with a follow-up vaccine in 2-6 months. You can find Shingrix in the refrigerator, where it can then be reconstituted prior to use. Once reconstituted, the vaccine is good for up to 6 hours.
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.
Elderly individuals, as well as people with compromised immune systems, may have a higher risk of contracting shingles from an affected individual, says WebMD. Pregnant women who are exposed to shingles can pass the virus on to their fetus. People who have received the shingles vaccine may be less likely to contract the virus.
Open sores of any kind are always susceptible to bacterial infection. To lower the possibility of a secondary infection, keep the area clean and avoid scratching. Secondary infection is also more likely if you have a weakened immune system.
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Durable, insulating and protective cedar shake shingles are gaining popularity across the USA. This material is resistant to storms and can be either 18” or 24” long. As for design, cedar shingles fade gradually from natural wood tone to a silver-like tone. Different types are available: hand-split resawn shakes, tapersplit shakes or tapersawn shakes.
Shingles is caused by the varicella zoster virus (VZV), the same virus that causes chickenpox. After a person recovers from chickenpox, the virus stays dormant (inactive) in the body. For reasons that are not fully known, the virus can reactivate years later, causing shingles.
Shingles typically causes painful skin bumps or blisters. Even before the skin lesions appear, the pain of shingles can be severe. The skin pain is often described as a burning sensation of the skin with heightened sensitivity. The rash of shingles consists of red blisters that eventually burst and ooze. The rash occurs in a band-like distribution along the path of a nerve. The blisters eventually crust over (form a scab) and heal. Sometimes, symptoms like chills, diarrhea, and headache can occur as a person develops shingles. The nearby lymph nodes may be swollen.
We have a patient with a severe allergy to vancomycin who wants to receive zoster vaccine. According to the Zostavax prescribing information, an allergy to neomycin would be a contraindication to vaccination but we are not sure about allergy to vancomycin.
Ramsay Hunt syndrome (also known as herpes zoster oticus) consists of weakness of the face due to infection with the varicella zoster virus. Five cases arise per 100,000 of the population per year in the US. It is more common among those over 60 and rare in children. Other symptoms may include severe ear pain and small blisters on the outer ear or in the mouth. Prompt diagnosis and treatment (ideally within 72 hours of the onset of symptoms) are crucial to secure the best outcomes. In cases where treatment has been started within this time period, facial weakness recovers in up to 75% of patients. Standard treatment is with antiviral therapy (most commonly acyclovir). Corticosteroids are known for their anti‐inflammatory properties and are commonly used together with antivirals to reduce the inflammation in the facial nerve. This is thought to be the cause of the facial weakness. The aim of the review was to see if corticosteroids, used at the same time as antiviral drugs, improved outcomes in patients with Ramsay Hunt syndrome. However the review found no trials matching the inclusion criteria, and no conclusions can be drawn about the effectiveness of using corticosteroids in this way. It is recommended that high‐quality randomised controlled trials be undertaken to address this issue.
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.
Southern Cross Medical Library information is necessarily of a general nature. Always seek specific medical advice for treatment appropriate to you. For more articles go to the Medical Library index page.
^ “Clinical Features of Viral Meningitis in Adults: Significant Differences in Cerebrospinal Fluid Findings among Herpes Simplex Virus, Varicella Zoster Virus, and Enterovirus Infections” (PDF). Clinical Infectious Diseases, the Infectious Diseases Society of America. 2008.
It’s important to visit a doctor right away if you think you’re developing shingles, since it can sometimes be mistaken for rashes like poison ivy, impetigo, scabies or herpes simplex virus. When pain persists, it might be mistaken for heart complications, migraines or menopausal symptoms.
ZVL may be stored at refrigerator temperature between 2°C and 8°C (between 36°F and 46°F) for up to 72 continuous hours prior to reconstitution. Vaccine stored between 2°C and 8°C that is not used within 72 hours of removal from a freezer should be discarded. ZVL should be reconstituted immediately upon removal from the freezer. Administer zoster vaccine immediately after reconstitution to minimize loss of potency. Discard reconstituted vaccine if not used within 30 minutes. Do not freeze reconstituted vaccine.
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The vaccine is not recommended for people who allergic to gelatin, the antibiotic neomycin, or any other vaccine components. People with weakened immune systems, including individuals with HIV/AIDS, leukemia, lymphoma, or other lymphatic or bone marrow cancers, or people taking immune-suppressing drugs should not get Zostavax. Neither should women who are pregnant or planning to get pregnant.
Shingles occurs only in people who have been previously infected with VZV; although it can occur at any age, approximately half of the cases in the United States occur in those aged 50 years or older. Repeated attacks of shingles are rare, and it is extremely rare for a person to have more than three recurrences.
If you have shingles you should avoid contact with anyone who hasn’t had chickenpox, especially pregnant women, people with a weak immune system and very young babies as they are at risk of catching chickenpox.
Symptoms of shingles affect the nerves and the skin and can occur in almost any part of the body. However, shingles most often affects one side of the trunk. Symptoms generally begin with sensations of itching, tingling, and/or a severe burning pain in the affected area. The pain can be severe. Several days later a rash develops in a band or patch-like shape. Other symptoms can include fever, headache, and chills.
Neuropathic pain is pain which comes from damaged nerves, spinal cord, or brain. It is different from pain messages that are carried along healthy nerves from damaged tissue (for example, a fall or cut, or arthritic knee). Neuropathic pain is treated by different medicines to those used for pain from damaged tissue. Medicines that are sometimes used to treat depression or epilepsy can be very effective in some people with neuropathic pain.
Any unusual condition, such as a severe allergic reaction or a high fever. If a severe allergic reaction occurred, it would be within a few minutes to an hour after the shot. Signs of a serious allergic reaction can include difficulty breathing, hoarseness or wheezing, swelling of the throat, hives, paleness, weakness, a fast heart beat, or dizziness.
There may be another reason to delay the booster shot. Last spring, researchers reported the results of a phase 3 trial of a new zoster vaccine — one that uses only the antigens in the virus that stimulate the immune system rather than the live attenuated virus used in Zostavax. Shingrix, as it has been named, appears to be more effective than Zostavax and the manufacturer, GlaxoSmithKline, intends to apply for F.D.A. approval of the vaccine in the second half of 2016.