The burden of illness from shingles and post-herpatic neuralgia in Australia is high with the incidence and severity increasing for seniors and people with weakened immune systems. According to a study published in the February 2011 issue of Mayo Clinic Proceedings (Herpes Zoster recurrences more frequent tha previously reported), recurring bouts of shingles may be more prevalent than previously thought at more than 6 percent. The study also found that women, who are more likely than men to have shingles, were also more likely to experience a recurrence of the virus.
Shingles is caused by the same virus as chickenpox. Once you've had chickenpox, the virus stays in the body and can reactivate as shingles (herpes zoster) later in life.
Shingles is associated with pain and an outbreak of a rash or blisters on the skin, in a band, on one side of the body. These symptoms may be accompanied by: headache and fever, tingling, burning and stabbing pain followed by an itchy skin rash and blisters. Shingles follows the nerve fibres it has laid dormant in, in the face and back. The pain of shingles can be felt without a rash or blisters developing.
Is shingles contagious?
A person with shingles can transmit the virus to anyone who hasn't had chickenpox which is transmitted through direct contact with the open sores. Once infected, the person will develop chickenpox but not shingles. Chickenpox can be hazardous for some groups of people, such as:
- Individuals with a weak immune system
- Pregnant women
Although Shingles is not a fatal condition, complications can be extremely serious or life threatening, especially in elderly patients.
Post-herpetic neuralgia (PHN) is the most frequent incapacitating complication of shingles. It is a neuropathic pain syndrome that persists after the rash has healed. By definition, PHN is established when pain persists for longer than 3 months. PHN occurs when damaged nerves send distorted and exaggerated messages of pain from the skin to the brain. The skin can feel pain from very light touch eg a bed sheet and also burning and severe pain at the shingles site, even though the shingles infection has healed. Analgesic medication, antidepressants or anticonvulsant medications can provide pain relief.
Other complications may occur depending on the site of virus and which nerves are affected. These include:
- Vision loss from Shingles in or around an eye (ophthalmic shingles).
- Neurological problems eg encephalitis (inflammation of the brain)
- Hearing problems and altered balance
Antiviral therapy is most effective when prescribed within three days of the rash showing and can reduce the severity and duration of shingles and may reduce the risk of developing PHN. However, PHN may persist for many years and not respond well to treatment.
- Corticosteroids are be used in conjuction with antiviral medication to reduce the symptoms of shingles
- Analgesics work best if given early and regular follow up (every few days) may be necessary until the pain is controlled
Seeing your GP early to have shingles treated is the key to best outcomes. According to the study, people with shingles who had endured pain for more than thirty days following the initial onset of shingles were more liable to have a recurrence.