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ShinglesShingles or Herpes ZosterShingles, or herpes zoster, is a viral disease that is caused by the reactivation of the chickenpox virus. Chickenpox is known as varicella zoster virus (VZV) The virus appears as a very painful rash in people who have previously been infected with the chickenpox virus, usually as children. The rash extends in a pattern which corresponds to the nerve endings and can cover some or all of the face, abdomen, back, buttocks, and chest in red itchy blistering patches similar, to those of chickenpox. The rash begins to clear after the blisters break and dry into scabs, usually within two or three weeks. How do you catch Herpes Zoster?After people have chickenpox, the virus lies dormant in the nerve roots at the base of the spinal cord or the facial nerve. It may never reappear, but sometimes the dormant virus flares up again as inflamation of the nerve endings, when the patient’s immune system is low or suppressed. Usually the disease only infects people once in their lives, although it is possible to have more than one occurrence of the virus.Over 60s Particulary VulnerableAlthough herpes zoster can effect any age group, susceptibility to the disease starts to increase from the age of 50. The virus is most common in people over the age of 60 or in those whose immune systems do not function effectively, such as the HIV positive and AIDS or cancer patientsSymptoms and EvolutionThe virus often makes itself known through flu-like symptoms like fever, chills, aches and pains, headaches and tiredness. The most typical symptom is a band of pain, often around the chest area, although the nerves in the face, back, abdomen can also be affected. In some cases when the nerve endings in the face are inflamed, the virus can also affect the eyes, eyelids, hearing and tastebuds.Herpes Zoster often manifests itself as a severely painful skin condition. Pain may appear in either a localized or generalized area, days or even weeks before the skin rash appears. The diagnosis is usually made when the eruption of blisters occurs in a rash which is associated with unilateral pain. Typically, an eruption occurs uniquely on one side of the body. Although in extremely rare cases the blistering rash and pain may cover the entire body. The latter complication usually occurs in patients with very low immune systems. Treatment and PreventionTreatment often includes antiviral pills with the best results occurring the earlier the tablets are started; antihistamine for the itching; and lotions, such as calamine, for the blisters. Early treatment can limit the length of the disease, but herpes zoster eventually disappears with or without treatment. Painkillers, such as analgesics, are given to treat the pain, which is the most difficult complication of the virus, and can last for months or even years.Chronic pain that persists for more than six weeks after the onset of herpes zoster is called post herpetic neuralgia (PHN). Antiviral medications including acyclovir (Zovirax), if given within the first 48-72 hours of the occurrence of symptoms, can help reduce the length and severity of post viral neuralgia. There is a vaccination called Zostavax that is recommended for people over the age of sixty. It might eventually be recommended for younger people, once testing has been extended to this age group.
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