Avoid the pox: Shingles vaccine readily available

Herpes Zoster (also known as shingles) is caused by same virus that causes chicken pox. When initially infected with chicken pox, most children develop a rash, fever and a cough. These symptoms are generally mild, last for one to two weeks and are ultimately resolved. However, despite the fact that we "get over" the disease, the virus actually lies dormant and "hides" in the nerves around our spinal cord for the rest of our lives.

Shingles is the reactivation of the chicken pox virus. It is estimated that more than 1 million people will get shingles each year in the United States. Most of the patients at risk are over age 60. Nevertheless, shingles can occur in almost any age group. Most people who develop the disease tend to have a weakened immune system, are ill or are suffering from a great deal of stress.

A patient developing shingles may first feel a buzz or an itch on the skin before a rash appears. Once the rash occurs, it will be unilateral (on one side of the body) and may appear as vesicles (fluid-filled bumps) running in a linear fashion. These can be painful, itchy or burning and may persist for days or weeks before resolving. Unfortunately, if not treated, the pain associated with the rash can last a great deal longer than the rash itself. Post-herpetic neuralgia is a result of shingles. Symptoms include severe pain at the site of the rash. The pain usually resolves after several weeks or months, but in some patients may be permanent and debilitating.

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1 in 3 adults in the United States will develop shingles.

The rash associated with shingles can appear up to 14 days after the first symptoms (tingle, itch or buzz) occur. It can affect the eyes, ears and scalp as well, making it more difficult to diagnose.

Shingles is not contagious. But the rash of shingles does contain the chicken pox virus and someone who never had chicken pox could catch it. If you have shingles you therefore should cover the rash when around individuals who have not had chicken pox. Avoid contact with infants and young children until the rash resolves.

The vaccine is recommended by the Centers for Disease Control for people over the age of 60; however those with risk factors who are over 50 might benefit from the vaccine as well.

The vaccine is only about 50 percent effective in preventing shingles, but may decrease the severity and duration for those who do develop the disease.

If treated with medication early (within the first 24 to 72 hours), the symptoms of shingles can be minimized. If you develop a painful rash, visit your doctor as soon as possible.

The vaccine is not appropriate for pregnant women, people who already have compromised immune systems (such as patients with AIDS or cancer) or those who are taking chronic steroids or medications which suppress the immune system. In addition, if you are allergic to gelatin or neomycin, you may not be able to receive the vaccination.

Most common side effects from the vaccine are pain, redness or a rash at the site of the injection, headache and fatigue. However, serious reactions such as allergic reactions, shortness of breath and swelling are quite rare.

Even if you have had shingles, you can still receive the shingles vaccine to help prevent future occurrences of the disease.

The vaccine is expensive (around $200). Medicare Part D does cover the cost of the shingles vaccine; however, Medicare Part B does not. Check with your carrier to see if the shot is covered.

Patients who have not had chicken pox are not at risk of developing shingles. However, developing chicken pox as an adult is more dangerous than acquiring the disease as a child. Therefore, patients receiving the shingles vaccine that have never had chicken pox may also benefit as it will confer immunity against the disease. A simple blood test can determine if you have ever had chicken pox.

Some patients who have had shingles describe the pain as excruciating. For these patients, the chronic discomfort adversely affects their quality of life. The shingles vaccine reduces the risk of developing the disease.

Avoid the pox! Visit your physician for more information.

Dr. Michael Schwartz is board certified in internal medicine with a private practice in Darien. For comments or questions, visit his website at www.drmichaelbschwartz.com.