Shingles also known as Herpes Zoster or Nagin. It is a painful, localized blistering skin rash, that typically develops on one side of the body or face. It is caused by the same varicella zoster virus which causes chicken pox. You cannot get shingles from someone who has shingles. The word Herpes Zoster came from Greek. Herpes means “creep” and Zoster means waist or circle. The word Shingles came from Latin which means waist belt. Probably the way shingles erupts is the basis for the nomineclature.
After a person got infected with chicken pox, usually in the childhood, the virus stays in the body and remains in an inactive or dormant form for several years or decades. Later, the in-active virus gets re-activated, if it gets favorable conditions, and causes Shingles. Most people who develop shingles only have it one time during their life time, however some immune deficient people may get recurrent shingles. A person with shingles can spread varicella -zoster virus to others.
It is a sporadic disease and most patients have no history of recent exposure to other individuals with Chicken Pox. Recurrent Shingles is exceedingly rare except in hosts with poor and weakened immune system especially in HIV & AIDS patients, lymphoma like cancers and bone marrow transplant recipients.
Let us know how common is Shingles?
Shingles can occur in all ages but it incidence is highest in fifth decade of life and very highest among more than 80 years. 90% of adults above 50 years of age already have the virus in their bodies in an inactive form. In this group, in every 1 out of 3 persons, the dormant virus re-activates and can cause Shingles in onetime or other in their life time. Diabetics will have 40% higher risk and similarly patients suffering and taking treatment forweb rheumatoid arthritis, psoriatic arthritis, lupus will have higher risk of getting shingles. Immuno-compromised persons like AIDS patients, people who are on immune-suppressant mediacations for malignancies, after liver, kidney, heart, lung and bone marrow transplants are more prone to get shingles. Female sex is having increased risk to get shingles than their counterparts. Not only adults, occasionally children also get shingles. Stress can weaken the immune system and may trigger shingles. In India about 10 lakh people suffer from Shingles annually.
Coming to the signs and symptoms of Shingles?
Shingles produce a painful rash erupting in a stripe of blisters that most typically wraps around either side of the chest or waist along the nerve distribution paths. It also appears in other areas such as face and some times involving the eye called “Herpes Zoster Ophthalmicus”. It begins with pain followed by rash in 48 to 72 hours, evolves rapidly into painful, burning and itchy blisters. Some times fever, chills, stomach upset and headache may also seen. Sometimes cold sores caused by Herpes Simplex , Rickettsial Pox, Monkey Pox may confuse with Shingles. The total duration of the disease is usually 7 to 10 days, however it may take as long as 2 to 4 weeks to return to normal.
Shingles causes excruciating pain in the affected area. The pain feels like as if one receives electric shocks, nail piercing pain, burning feeling caused by fall of boiling water. The agonising pain last for weeks, sometimes even for months. It is said that the herpetic pains are more severe than labor pains.
What is the treatment for Shingles?
Besides the physical measures like applying soothing and cleansing lotions like aluminium acetate soaks, antiviral medications like Acyclovir, Famciclovir, Valacyclovir and Foscornate may be given by your doctor.
Why Shingles is serious and what are the possible complications of Shingles?
In most people Shingles eventually resolves with treatment. However, in about 10-18% of patients it causes post-herpetic neuralgia, a type of cruciating nerve pain that can last for months and years even after the rash healed. PHN risk increases with age more after 70 years. In about 25% the rash occurs on the face or around eyes. This can lead to swelling of the eye and in rare cases the vision may get lost. It may also cause skin scarring, stroke, meningitis, myelitis, GBS, facial palsy, heart attacks, pneumonia liver failure, muscle weaknesses, hearing loss, tinnitus and vertigo.
The pain and complications due to Shingles can be severe enough to impact work efficiency, productivity, sleep, ability to enjoy daily activities such as quality of time spending with family and friends.
There is no cure for shingles. In prevention of Shingles and it’s complications, vaccination plays a. crucial role. Shringrex vaccine is a non-live recombinant adjuvented vaccine given as 2 doses with a gap of 2 to 6 months. It works with more than 97% efficacy across all age groups above 50. Vaccine offers protection for about 10 years. Vaccine can be given to those who had shingles in the past, it prevents future occurrences. It is almost safe but may cause some minor side effects like pain, redness and swelling at injection site as like any other vaccine. Fever, muscle pains and headaches if at all develops, stays for a couple of days.
Looking at the pain and suffering, it is advisable to protect yourself from Shingles with Shingrex vaccine. A cost of little more than ten thousand rupees per dose may be equivalent to a family get together meals at a restaurant or a piece of jewellery. Wouldn’t you think that protecting yourself from Shingles is equally or even far more important?
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