Each year in Canada, there are 130,000 cases of shingles (also called herpes zoster), and 17,000 cases of associated pain that lingers afterwards, according to the College of Family Physicians of Canada. Who is at risk? Anyone who ever had chicken pox as a child. Here’s why: After you recover from the chicken pox, the virus (called varicella-zoster) lies dormant and hidden along a nerve path in your body’which could be anywhere’and can be reactivated years later when you least expect it, causing an outbreak of the painful and debilitating symptoms of shingles. While it can occur in young adults, the risk increases with age; about half of all shingles cases occur among men and women older than 60, according to the U.S. Centers for Disease Control and Prevention (CDC).
This unpleasant condition can strike anywhere on the body but most commonly occurs on the torso. Your first sign will probably be intense pain, burning, tingling or numbness somewhere on one side of your body. Symptoms often appear in the chest area, back, abdomen, arm or leg, although they may also appear in the head and neck area. This is followed by the appearance of a rash in the affected area that develops into painful blisters. Some sufferers report feeling ‘just awful’ and are plagued by fatigue, fever, weakness and headaches.
The danger with shingles is that when symptoms first appear, they are so puzzling and varied that individuals often don’t see a physician right away. Says Dr. Allison McGeer, an infectious disease specialist at Mount Sinai Hospital in Toronto, ‘The rash might start as just redness before the blisters develop, and people often don’t know that early treatment is important.’
McGeer stresses the importance of seeing a doctor as soon as you notice the symptoms. ‘It is crucial to receive immediate treatment with antiviral medication. Starting medication within 72 hours decreases the length and severity of nerve pain,’ says McGeer, who adds that approximately one third of sufferers will continue to have pain in the affected area for up to six months, long after other symptoms have disappeared. The antiviral medication’acyclovir, famciclovir or valacyclovir’can cost in the hundreds of dollars, but may be covered by your extended health plan. Non-steroidal anti-inflammatory medication and pain medication may also be prescribed.
The CDC suggests various ways you can try to relieve some of the itching that can also occur, including wet compresses, colloidal oatmeal baths or calamine lotion. The rash area should be kept clean to prevent infection. Try to stay at home and rest until the blisters dry, and if you do go out, keep the rash covered to prevent infecting those individuals who have not previously had chicken pox. In a few days, the blisters will dry up and the rash will heal over several weeks, eventually disappearing, though nerve pain may linger. In some cases, pain lingers in the affected area for months; this condition is known as post-herpetic neuralgia.
Susceptibility to shingles is increased in individuals with suppressed immune systems caused by disease, medication or severe stress. The earlier in life you had chicken pox, the more likely you are to develop shingles later in life.
Rarely, the virus will erupt along a nerve pathway in the head area and can cause one-sided facial paralysis, headache and earache. When this happens, explains McGeer, the rash is often not apparent because it is hidden inside the ear. If not treated immediately, the paralysis can become permanent, resulting in a drooping eyelid or corner of the mouth. Shingles in this form is known as Ramsay-Hunt syndrome.
With a greater number of young children receiving vaccinations against chicken pox, the incidence of shingles in the future adult population will reduce accordingly. (There is a vaccine for adults to protect against shingles; see ‘A Shot of Prevention,’ below.) Maintaining a healthy body with a strong immune system by getting enough sleep, avoiding stress and eating a balanced diet is always a good idea’but, points out McGeer, there’s no evidence this will help prevent your chances of getting shingles. That’s why it’s so important to know the signs.
A shot of prevention
To prevent shingles, McGeer recommends that anyone age 60 or over receive the prescription vaccine, called Zostavax, which will boost your body’s immunity to the disease. ‘It’s essentially the same vaccine given to children, but in a stronger concentration,’ explains McGeer. The vaccine, which costs about $200, is not recommended for individuals with severely reduced immune systems, however.