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Doc Talk Doc Talk: One shot can prevent the pain of shingles

  • Published Monday, Dec. 3, 2012, at 10:25 p.m.

If you know anyone who has had shingles, you know that you don’t want to get it yourself. You should know that a vaccine is now available to prevent this very painful and sometimes debilitating disease.

Shingles can occur — sometimes more than once — in anyone who has had chickenpox. After causing chickenpox, the varicella zoster virus remains in the body permanently, but is usually dormant until a person is 50 or older. The risk for reactivation of the virus increases as we get older. Fifty percent of people will have had shingles by age 85. One million cases occur annually in the United States.

The first symptom is usually an uncomfortable pain in the skin along the path of one to three nerves. Often it occurs on one side of the body, affecting the chest, abdomen or back. Shingles gets its name from this typical path, from the Latin word “cingulus,” which means belt or girdle. However, shingles can occur anywhere on the body. The pain has been described as a burning, tingling, throbbing, stabbing or intense itching. Pain is worsened by things that normally don’t cause pain. For example, clothing or bed sheets brushing against the rash may be painful. Tiredness and headaches may also occur.

Within a few days, a rash with red and round bumps appears. The bumps fill with fluid and pus that contain the virus, then become open sores. Complete healing occurs in two to four weeks. In some cases, the pain continues after the rash has healed; this pain is called postherpetic neuralgia. The pain can be debilitating and affect overall quality of life.

When shingles is identified early (within the first 72 hours), your physician can prescribe antiviral medications to decrease severity and duration of the pain, promote rapid healing of the rash, and prevent postherpetic neuralgia. Over-the-counter medications such as ibuprofen and acetaminophen can be used to treat the pain. For severe pain, your doctor may need to prescribe stronger painkillers. If shingles occurs on the face, it is especially important to see your doctor immediately, as infection of the eye can lead to blindness.

During the first seven to 10 days, the herpes zoster virus can spread to others through contact with the rash and blisters. The virus can cause chickenpox in someone who has not had the infection. For this reason, it’s best to stay home until the sores have crusted over. If you have shingles, avoid pregnant women who have not had chickenpox or the chickenpox vaccine, premature infants, and people who have weakened immune systems.

All this misery can be avoided by getting a shingles vaccination. The vaccine is recommended for people 60 and older, including those who have previously had shingles. The vaccine reduces the incidence of shingles by 51 percent and postherpetic neuralgia by 67 percent. Side effects of the vaccine are mild and may include redness, tenderness, swelling and itchiness at the injection site, as well as headache.

Most health insurance policies pay a portion of the vaccine’s cost for people who are 60, and some policies pay for the shot at age 50. Since 2008 the vaccine has been covered under Medicare Part D. The shingles vaccine can be given whether you know you have had chickenpox or not. Ninety-nine percent of people over age 40 born in the United States have had chickenpox. The vaccine is used for prevention and not for the treatment of active shingles. This vaccine should not be given to pregnant women, people allergic to gelatin or neomycin, and people with weakened immune systems.

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