Last time we spoke about the importance of vaccination to help prevent flu. This week we’ll discuss shingles, a condition for which a vaccine has recently become available. If you are over 50 and have had chicken pox, you need to read this …
Introduction
Shingles, which is also called herpes zoster, is a viral infection caused by the varicella zoster virus (VZV), a herpes group virus. VZV also causes chicken pox and remains in the body after recovery from chicken pox. If VZV is reactivated it leads to shingles.
Who gets shingles?
Most people who develop shingles are over 50 and all have previously had chicken pox. Everyone who’s had chicken pox is at risk of developing shingles. Around half of all people reaching the age of 85 will develop shingles and you can get shingles more than once. A rise in shingles cases has been noted globally, with experts believing this may be due to childhood vaccination programs, aging and greater use of immunosuppressive agents in medicine.
How is shingles transmitted?
Shingles itself is not transmitted from person to person. However, the virus that causes shingles (VZV) is very contagious and people with shingles can spread it to others. People who have never had chickenpox and are not vaccinated against it may develop chicken pox following exposure to VZV from someone with shingles. VZV is transmitted via droplets in air and/or contact with fluid in shingles blisters or by touching dressings, sheets or clothes soiled with herpes blister fluids.
How long is someone infectious?
A person with shingles is infectious when they have blisters. They stop being infectious after the blisters develop crusts. Keeping the rash covered and bathing as advised by a heath care professional can help reduce the risk of viral transmission.
How do I know if I have shingles?
Around 80% of people experience early signs/symptoms before shingles presents (headache, photophobia, unexplained discomfort or illness, as well as tingling, itching or severe pain usually precede appearance of a rash by a few days). Next, a rash consisting of lesions or blisters appears. The rash usually covers the torso in a band or belt like shape. Blisters erupt over a week or so and heal within two weeks. Shingles is usually diagnosed based on history and presence of shingles blisters/rash.
How is shingles treated?
Shingles is treated with antiviral medications and pain medication. People seen by a doctor within 72 hours of developing the rash are prescribed antivirals. Note that all immunocompromised people are prescribed antivirals regardless of duration of the rash. Antivirals reduce pain, duration of the rash and viral shedding (presence of virus in fluid from blisters). Viral medications reduce ophthalmic complications, however it’s not clear if they reduce post herpetic neuralgia (pain lasting after shingles has disappeared). Managing pain early and effectively may help reduce the occurrence and severity of post herpetic neuralgia. Paracetamol is recommended for pain relief.
Can shingles be prevented?
Shingles has recently become a vaccine preventable disease. Zostavax® provides protection for up to 10 years.
Should I, or a loved one, get vaccinated?
Vaccination is not recommended for people below the age of 50. For people aged 50 – 59 years, vaccination is not routinely recommended. People over the age of 60 are eligible for vaccination. People who have previously had shingles can also be vaccinated. The Australian Federal Government under the National Shingles Vaccination Program will provide free shingles vaccination to all people aged 70 years old, with a five-year catch‑up program for people aged 71-79 years old until 31 October 2021. People not eligible for a free vaccine can purchase it with a prescription from a doctor. Speak to your doctor if you would like more information about the shingles vaccine.
Further Reading
Australian Government. Department of Health. National Shingles Program Questions and Answers.
http://immunise.health.gov.au/internet/immunise/publishing.nsf/Content/shingles-Q&A.cnt [Last updated 10 March 2017] [Accessed 21 August 2017].
Victoria State Government. Better Heath Chanel. Shingles.
https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/shingles [Last Update Date Not Provided] [Accessed 21 August 2017].
Australian Government. Department of Health. The Australian Immunisation Handbook. 10th Edition. http://www.immunise.health.gov.au/internet/immunise/publishing.nsf/Content/Handbook10-home~handbook10part4~handbook10-4-24 [Last updated 1 August 2017] [Accessed 21 August 2017].