Medical science still doesn’t know why the shingles virus may reactivate in one person with certain risk factors and not in another with the same risk factors
By: Harpeet Sidhu, M.D.
Just as an earthquake can have an aftershock, chicken pox a disease that strikes most people in their childhood can have an aftershock later on in life in the form of shingles, also known as herpes zoster.
While the symptoms of chicken pox heal in children afflicted with the varicella-zoster virus that causes the disease, the virus remains in the body for life, hiding out in the nervous system, usually in the spine. Unlike the flu virus, which can be killed off by our bodies, the virus that causes shingles simply becomes inactive.
Shingles is very common, striking half a million people in the United States each year. Though it can happen at any age, it most frequently affects adults between the ages of 60 to 80. The virus can reactivate, traveling through nerve fibers, from the spine and out to the skin, causing this painful skin disease.
According to the National Institute of Allergy and Infectious Diseases, half of all Americans will have had shingles by the time they are 80.
Who is most likely to develop shingles? The single biggest risk factor is a history of having had chicken pox. In fact, 1 out of every 5 people who have had chicken pox is likely to get shingles.
Another significant risk factor is aging, which takes away the body’s ability to protect itself against the infection that can remain latent in the body for years, just waiting for the natural immunity to break down to give it an opportunity to resurface.
Other risk factors include other immune-deficiency conditions that create a vulnerability to reactivating the virus that causes shingles. These conditions include HIV infection, radiation treatments for cancer, or a transplant operation. People who have suffered a stressful event also have a heightened chance of suffering from shingles.
Medical science still doesn’t know why the virus may reactivate in one person with certain risk factors and not in another with the same risk factors.
Shingles typically develops in three stages, first as severe pain or tingling in the skin, on the back, chest, the rib cage or the waist. Within two to three days, a red, itchy rash develops, very often on one side of the body or the other, following a single nerve path. This stage is followed by small blisters that look like chicken pox.
However, unlike chicken pox, which is scattered all over the body, shingles blisters tend to cluster in one specific area. The blisters then erupt into open sores that crust over in about a week or two.
The burning and itching of the blisters is often accompanied by shooting pains that can be severe and last for months, even years, causing a condition called postherpetic neuralgia, which can disrupt sleep and interfere with basic life functions. Roughly 1 in 5 who are diagnosed with shingles will develop this condition.
If the rash is on the face and affects the cornea of the eye, vision problems, even blindness, can result.
It is important to keep the fingernails well-trimmed, as the itching and scratching can cause secondary bacterial infections to the afflicted area. Such an infection can lead to scarring or in a small number of cases, more serious complications, including toxic shock syndrome.
In the past, not much could be done to prevent a person from getting shingles. But that is changing. Just last year, the United States Food and Drug Administration approved a shingles vaccine to boost the immune system in older adults. It is targeted to people age 60 and over who have had chicken pox but have not had shingles.
Another strong boost to shingles prevention came in 1995 with the introduction of the chicken pox vaccine, which has been successful in preventing chicken pox in 70 to 90 percent of those vaccinated. Only people who have had chicken pox can get shingles, so fewer people getting chicken pox as children means fewer people getting shingles as adults.
Whether or not you have had chicken pox also affects how you might be affected by contact with someone who has shingles. If you have had chicken pox, shingles is not contagious, unless you come in direct contact with the blisters before they have scabbed over.
However, if you have not had chicken pox, you could come down with chicken pox if you have contact with someone who has shingles, since it is caused by the same virus.
There is no cure for shingles, as the disease has to run its course, but an early diagnosis is helpful to a speedier recovery so consult your physician at the first sign of the tell-tale rash. An antiviral medication within 72 hours of the initial outbreak can reduce the severity of the pain and help the healing process.
To find a physician with Princeton HealthCare System, visit www.princetonhcs.org or call 888-742-7496.