What is Shingles (Herpes Zoster?)
Shingles is an infection that occurs when the varicella virus (chicken pox) is reactivated from it’s latent or dormant phase in the body. Subsequently if an individual has NOT had chicken pox they cannot get shingles. Chicken Pox and Shingles are caused by the herpes virus, specifically the herpes virus type 3. Chicken Pox is the acute phase of the illness and Shingles is the reactivation of that virus. It is more common in the immuno-compromised and elderly; however this author has seen it in teenagers and young adults. There is no clear answers to why and when. Some feel that stress can exacerbate this reactivation, however that has not been proven. The virus lays dormant along the nerve fibers and reactivates causing symptoms pf pain.
What are the symptoms of Shingles ( Herpes Zoster?)
A common pro-drome phase of burning pain with muscles aching on one side of the body. This phase usually happens two to three days before the development of the rash itself. This can be a time the patient presents and a mis-diagnosis is not uncommon. The common rash itself is described as crops or patches of a rash on one side of the body. They are usually raised small bumps on a red base and then usually turn into vesicles or blisters. These blisters are painful and last around three to five days. Secondary infections are not uncommon and at this point an antibiotic would be in order.
What is Postherpetic Neuralgia?
This is an ongoing painful experience that can last for years. In most cases this involves the nerve of the face (trigeminal);however it can effect all areas of the body where the rash was present. Not all patients have postherpetic neuralgia. Of those that do, it seems much more prevalent in the elderly.
What is the treatment of Shingles, ( Herpes Zoster?)
Treatment, like most viral disorders is much more effective when given in the first 48 hours. The treatment does not resolve the symptoms but does shave one or two days off the duration of the illness and decreases the severity of the symptoms. Cool wash cloths are also helpful to decrease the burning pain. Over the counter Callydryl is worthless, and does not resolve the symptoms. Narcotics are very helpful to resolve the pain and will make one much more comfortable.Corticosteroids also help with postherpetic neuralgia and have been found to help reduce inflammation. Pain management, and allowing this illness to run it’s course is the best treatment at our disposal right now.
What is the vaccine for Shingles (Herpes Zoster?)\
The vaccine for Herpes Zoster is “Zostavax” and is showing to have excellent results. Although it is pricey and most primary care providers do not stock it. It has been found to reduce the incidence by about fifty-one percent. The vaccine is recommended after the age of sixty. Local reactions from the vaccine are minor. They are redness at the injection site, mild pain and possibly a low grade fever for twenty four hours. Peace and healing highly recommends the vaccine due to the serious complications that the elderly can get from Herpes Zoster.