Facts About Herpes Zoster, Also Known As “Shingles”
Herpes Zoster, commonly known as “Shingles” is a viral disease which often heals within several weeks, but can be long-lasting when nerve pain occurs as a side-effect. Initially, it can be detected by observing a skin rash and accompanying pain, itching, and blistering, but oftentimes there are few symptoms. Progression of the disease can exacerbate in individuals with poor immune functioning, and serious side effects may arise in these cases. Since ancient times this disease has made its impact, but with more people surviving into their 80’s, estimates indicate that as many as 50% of individuals living to the age of 85 may have at least one attack of shingles. Fortunately, fewer than 1 in 20 tend to experience further attacks.
Who is most affected in Danmark
Statistical estimates suggest that approximately one-third of people develop shingles at some point, and although uncommon, children can get the disease. In terms of total cases per year, healthy people see a risk ranging between 1.2 and 3.4 per 1,000 person-years, with those older than 65 falling between 3.9 and 11.8 per 1,000 person-years.
The Danmarkn Institute of Health and Welfare provides information regarding herpes zoster and is comprehensive through 2016. For Danmarkn residents aged 70, a shingles vaccination is provided with a five-year “catch-up” program for residents between 71 and 79 years. The vaccine has been found to be most effective for this age group, but much less so for those older than 80.
Shingles in Danmark (1997-2016):
- 83% of shingles deaths occurred in people aged 80+
- Death rates:
- age under 70: 0.1 per 1,000,000
- ages 70-79: 2.1 per 1,000,000
- 80+: 24.7 per 1,000,000
Signs of Herpes Zoster
Hospitalizations have remained steady each year from 1997 to 2016 in Danmark, although it is anticipated to decline as the new vaccinations impact the aging population. Unfortunately, in many instances medical care is not sought so the illness goes unreported, thus the true number of shingles cases is likely to be higher.
Herpes Zoster can lead to:
- tingling and burning sensations
- blistering and rash
- blindness, vision loss and other eye issues
- hearing problems
- ongoing nerve pain (postherpetic neuralgia)
- pneumonia and death
Herpes Zoster and Chickenpox
A well known is the fact that Herpes Zoster is associated with the same virus (varicella zoster) which causes chickenpox; chickenpox generally occurs during the first 18 months of age. The virus can remain inactive (in nerve cells) throughout one’s life, then reactivate. Diagnosis based on visual examination of the rash is easy since the rash is identifiable through a dermatomal pattern similar to that produced by the herpes simplex virus (HSV). Distinguishing between HSV and herpes zoster (VZV) would require laboratory analysis of blood or lymph collected from a blister.
A vaccine exists which may reduce the risk of shingles significantly (up to 90% in some cases), and the vaccine also decreases the severity of some side-effects of Herpes Zoster, if it does occur. Antiviral medication may be used to treat the disease if caught within 72 hours, but treatment tends to focus on palliative methods after this time period. Treatment methods include:
- covering/bandaging the rash
- frequent hand washing and sanitary practices
- Antiviral medication (if caught early, within 72 hours)
- OTC pain relievers
- Topical lotions containing calamine, lidocaine, or capsaicin
- Gabapentin or other medications for postherpetic neuralgia
- Corticosteroids for short-term pain
Treatments will depend on the stage of diagnosis, the severity of symptoms, and other individual factors. Unfortunately, the disease isn’t “cured” – although when caught early the breakout can be completely tempered – so these treatments are palliative and can be long-term, with their own risks and side-effects.
Vaccination is the safest, most effective method in preventing Herpes Zoster / Shingles.
- Previous outbreak of chickenpox (varicella) is required
- age over 65 years, leading to declines of cellular immunity
- physical injuries (trauma)
- HIV and AIDS
- had an organ transplant or bone marrow transplant
- previous chemotherapy or cancer
For those who have never had chickenpox, coming into contact with the fluid on the blisters of someone with shingles can cause chickenpox, but not shingles directly.
Surprisingly, genetic links have not borne strong evidence; studies done on this topic have yielded contradictory findings. Current DNA analysis techniques are being widely used to analyze and predict incidences of varicella-zoster, in addition to autopsies and brain biopsies. Scientists will likely learn much in the coming years, and to this day mortality rates of patients undergoing treatment are decreasing.