The Sleeping Virus that Can Cause Nerve Damage Protect Yourself with a Recently Developed Vaccine

While everybody is worrying about Swine flu, another painful and debilitating infection struck a million Americans in 2008, and continues to hit more people every year. Unfortunately, those at risk are often unaware of it. Even those who have heard of it don’t realize how serious it can be, or what complications can develop if treatment is delayed—including lasting pain, nerve damage, and even death.

What is this serious and difficult infection? Shingles. Considering the recent outbreak of shingles in New York, we asked we asked Brooklyn- based doctor Victoria Aleksandrovich to tell us more.

WHAT ARE SHINGLES?
Shingles come from the same virus that causes childhood chickenpox—the herpes zoster, or zoster virus (VZV). (VZV is not the same virus that causes genital herpes.) After an individual recovers from chickenpox, the virus stays in the body, dormant, and usually causes no more problems. However, as people age beyond 50 years, the virus can become active again—because of an illness, a weakened immune system, or immunosuppressive drugs— causing shingles. 
Shingles usually start out as pain, itching, or tingling on one side of the face or body. Within a few days, a rash will develop in that same area, then progress into blisters that scab over after 3–5 days. Within 2–4 weeks the blisters will clear away. In most cases, a person will experience only one episode of shingles, but sometimes a second or third episode may occur. In more severe cases, residual nerve pain can last for years.

WHY ARE CASES OF SHINGLES ON THE RISE?
The Centers for Disease Control estimate that about 1 million Americans get shingles every year, and that the number of cases is increasing. Scientists aren’t sure why, but some factors could be the increasing population of seniors, and the development of the childhood chickenpox vaccine. As more children are vaccinated for chickenpox, adult exposure to the virus is reduced. Some researchers theorize that adult exposure to chickenpox in children boosts adult immune defenses against the virus, so as fewer children contract the infection, fewer adults get the “booster” exposure, and thereby may be more likely to contract shingles later in life.

HOW DO I KNOW I HAVE SHINGLES?
Pain is often the first symptom of shingles, typically on one side of the body. Other symptoms may include fever, headache, shoulder or back pain, and a general feeling of malaise. Most people experience one-two days of numbness, itching, and stabbing pain in the area where the rash eventually appears. Shingles look like the blisterlike sores that chicken pox creates, only smaller. If you suspect you may have shingles, get to your doctor right away. A blood test (or sample of a shingles sore) can show the presence of virus, and early treatment can mean the difference between a short outburst and longer-lasting pain.

ARE THERE CASES THAT ARE ATYPICAL?
Some people struggle from pain and itching, but don’t have the rash. If you’re suffering from something like this and other treatments haven’t helped, ask your doctor for a blood test. We had a patient once who experienced back pain for many years and was treated by injections that failed to bring relief. He came into our office because of problems with his tongue. As it turned out, it was herpes zoster on his tongue. After treatment for the virus, his back pain disappeared.

WHAT ARE THE TREATMENTS FOR SHINGLES?
Herpes zoster can be cured with antiviral medicines. Usually the full course of treatment takes 10-14 days. If started within 72 hours of the onset of the rash, antivirals can limit nerve damage and shorten the duration of the illness. For faster relief we recommend ointments created in our center (in collaboration with infectious disease specialists) as well as injections.

IS THERE ANY PROTECTION FROM THE VIRUS?
There is a vaccine called Zostavax that was FDA-approved in 2006 for adults age 60 years and older. One injection reduces the incidence of herpes zoster by 51 percent. Medicare will cover the cost of the vaccine. However, it’s important to get this vaccine before the disease develops, as once you have shingles, the vaccine won’t help.

Dr. Victoria Aleksandrovich
3080 West 1st St., Ste. 102
Brooklyn, NY 11224
(718) 207-7071