By Dr. David Rideout, M.D.
Many people remember a common childhood illness from their past; chickenpox. Chickenpox is caused by the varicella-zoster virus and comes in the form of a characteristic itchy, weepy rash that appears on the face, trunk, and limbs. Although having chickenpox may be a distant memory, the virus that causes the disease remains dormant in your nervous system and can be reactivated later in life. The illness that results from the reappearance of the virus is known as shingles. It is unclear why the latent varicella-zoster virus is reactivated; but what is clear is that the resulting infection is painful and can last for weeks.
Symptoms:
Usually the first symptom of shingles to appear is pain or a burning sensation sometimes with numbness or tingling on one side of the body, often on the torso. The pain can be very severe. A red rash begins a few days after the onset of the pain, and then fluid filled blisters form from the rash. You may also have fever, headache, fatigue, and sometimes sensitivity to light. Because shingles is caused by the same virus as chickenpox, exposure to shingles can result in transmission of chickenpox to others. Persons with the shingles infection should keep the rash covered, and wash their hands frequently to prevent the spread of the virus. Until the rash has crusted, patients with an active shingles infection should avoid contact with individuals who have never had chickenpox or the varicella vaccine. Groups of greatest concern are pregnant women, infants, and people who have compromised immune systems.
  When to See a Doctor:
If you suspect shingles you should be seen by a physician. It is especially important to see your doctor promptly if the pain and rash are on your face or near an eye. This is because if not treated, the infection can lead to permanent eye damage. Also, you should seek medical help right away if you are 70 or older because you are at a greater risk for complications from the illness. Your physician will examine you and might take a culture of the blisters from the rash for laboratory examination. Your doctor will probably prescribe anti-viral medications to speed your healing and lower your risk of complications. Pain medications may also be prescribed. Shingles infections last from two to six weeks, and early treatment can help shorten the duration.
The Herpes-zoster Vaccine
There is a vaccination for the Herpes-zoster infection called Zostavax which has been approved by the Food and Drug Administration for adults over 50. The vaccination results in a decreased risk of developing shingles. Also, the vaccine can be safely administered to patients with a prior history of shingles. Like the chicken-pox vaccine, the shingles vaccine doesn’t guarantee that you won’t get shingles. It will, however, help to reduce the severity and duration of the disease.
Dr. David Rideout is the lead physician at Doctors Express in the Saugus Center, one of 15 Massachusetts offices, offering seven-day walk-in urgent medical care. For more information visit www.DoctorsExpressBoston.com. Archives of articles from previous issues can be read at www.fiftyplusadvocate.com.
