Shingles Are Preventable
By Michael P. Basista, M.D., Director, ImmediCenter Family Practice

What are shingles?
Shingles, (herpes zoster), are a painful rash, often with blisters, that affects people over fifty, or those with weakened immune systems.

About one million people come down with shingles a year in the US. Susceptibility to shingles increases with age, and about 50% of people who live to 85 years ultimately develop shingles.

Shingles are caused by the same virus that causes chickenpox (varicella zoster or HZV). Genital herpes, which is caused by a different virus, is not at all related to shingles. One can only get shingles after exposure to chickenpox, or the chickenpox vaccine. After chickenpox, usually in childhood, the HZV virus is contained in nerve cells, and stays in your body. As one ages, or if the immune system weakens, the HZV virus can escape from the nerve cells to cause shingles.

What are the symptoms of shingles?
A shingles rash usually appears on one side of the face or body and lasts two to four weeks. Pain, which is the hallmark of the disease, can be quite severe. Other symptoms can include fever, headache, chills and an upset stomach.

Very rarely, shingles can lead to pneumonia, hearing loss, blindness, brain inflammation (encephalitis) or even death.

Are shingles preventable?
Yes. A vaccine called Zostavax became available in 2006. This vaccine significantly reduces the chances of getting shingles and post-herpetic neuralgia. A single dose of shingles vaccine is indicated for adults 60 years of age and older.

Zostavax is not for everyone. You should not get vaccinated if you:
• are allergic to any of its ingredients.
• are allergic to gelatin or neomycin.
• have a weakened immune system (leukemia, lymphoma, or
• HIV/AIDS).
• take high doses of steroids by injection or by mouth.
• are pregnant or plan to get pregnant.

How is shingles contracted?
Shingles is not contagious from one person to another; however, it can cause chickenpox in someone who has never had the disease or not received the chickenpox vaccine. The HZV virus lives in the blisters of people with shingles, and the virus can be spread until the blisters are healed. Anyone with shingles should stay away from babies under 12 months and pregnant women.

What medications are effective for shingles?
Medications that can help clear up the infection and reduce the chances of getting post-herpetic neuralgia include Zovirax, Famvir or Valtrex. It is essential to get to your doctor quickly, within 3 days if possible. Your physician might also elect to use steroid medication. If the infection spreads to the eye, there are special drops your physician can prescribe.

The pain can be treated in different ways. Your doctor may recommend over-the-counters analgesics, such as Tylenol (acetaminophen), Motrin or Advil (ibuprofen), or a prescription painkiller. Aspirin should be avoided in this instance, because it might cause a rare liver problem called Reye’s syndrome.

A new vaccine, Zostavax, significantly reduces the chances of getting shingles and post-herpetic neuralgia.

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