Understanding Shingles

Have you seen the latest TV ad promo called, “Shingles is Sleeping”? The awareness campaign was launched to inform Canadians of the risks of developing this disease after a recent study indicated that many Canadians underestimate their risk of shingles. As an example, three of my friends developed shingles within the past few years. Each told me it is extremely painful. One friend said she walked around her home at night crying due to the intense pain.

Shingles is a red blistering painful skin rash caused by the varicella-zoster virus, the same virus that causes chickenpox, which can lie dormant in the body for years. In many people who have had chickenpox, the virus becomes active again later in life and causes shingles.

According to the Canadian National Advisory Committee on Immunization (NACI), 90 per cent of Canadians have had chickenpox and are at risk of developing shingles. The odds of developing this rash are one in three if you are 50 and older but rises to one in two if you are 85 or older.

Canadian NHL hockey legend Denis Savard said that he was “laid up for a month” and the pain was “unbearable” when he experienced shingles. These comments from a man who played hockey and endured hard hits from opponents illustrate the intense suffering experienced by people with shingles.

As you age, your immune system weakens, and the virus can be activated and travel from nerve-to-nerve cells, causing a painful blistering skin rash. The first sign you have developed shingles is pain, burning, itching, or tingling in your body. You may experience chills and fever. Then, in several days, you develop a rash of reddish fluid-filled blisters that usually appear on the chest, back or stomach but can be on the neck or face.

The major complication (although if you have shingles, the rash and pain will seem major) is the risk of developing further nerve damage, referred to as Postherpetic Neuralgia (PHN). After the rash heals, this condition will endure for weeks, months or possibly years.

The complications include neurological difficulties, vision loss and joint pain. Outbreaks on the face near the eye can cause blindness if the cornea is affected. Bacterial infections from scratching can develop and lead to scarring. The pain, loss of sleep and difficulties with daily activities can cause depression. Some people are susceptible to pneumonia.

According to the Public Health Agency of Canada, risk factors include having chickenpox as a child, a weakened immune system, certain medications, such as corticosteroids that weaken the immune system, radiation treatment and having cancer, particularly Hodgkin’s Disease or lymphoma.

Having HIV/AIDS, even if you are younger than 50, also puts you at risk due to a weakened immune system. A study published in the Journal of Allergy and Clinical Immunology linked asthma in childhood with an increase in developing shingles as an adult. It is thought that the suppression of the immune system may escalate the reactivation of the herpes zoster virus. Consideration should be given to immunizing adults aged 50 years and older with asthma.

For seniors with these risks, prevention can be vital. According to the Public Health Agency of Canada, vaccination reduces your chances of developing shingles. Currently, there are only two vaccines authorized by Canada. Shingrix and Zostavax provide powerful protection against shingles and PHN. In adults, a vaccine is more than 90 per cent effective at preventing shingles and PHN. Immunity lasts for at least seven years. In those with weakened immune systems, the vaccine is 68-91 per cent effective in preventing shingles.

Immunize Canada recommends vaccination to prevent shingles and the complications that could arise from this disease. The organization recommends that adults aged 50 and older, as well as adults 19 years and older with weakened immune systems because of illness or therapy, receive the vaccine as they risk getting shingles and related complications.

Studies show that the vaccines are safe and create a strong defense against shingles. However, temporary side effects from getting the shots are likely to last two to three days. Most people have a sore arm with mild or moderate pain, and some also experience redness and swelling at the injection site. Others feel tired and have muscle pain, headache, shivering, fever, stomach pain or nausea.

If you experience side effects, you may take over-the-counter pain medicine such as ibuprofen or acetaminophen. To determine if you are a candidate for the vaccine, consult your physician.

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