What to know about shin­gles and its vac­cine

The Korea Times - - HEALTH - By Bahk Eun-ji [email protected]­re­atimes.co.kr

Her­pes zoster, also known as shin­gles, is a painful skin rash that lasts for two to four weeks.

The dis­ease is caused by the vari­cella zoster virus, the same virus that causes chick­en­pox. In most cases, chick­en­pox is a be­nign in­fec­tion with symp­toms that dis­ap­pear within 10 days.

How­ever, the vari­cella zoster virus re­mains dor­mant near the pa­tient’s spine, and the virus can be re­ac­ti­vated years later in some cases, caus­ing dif­fer­ent symp­toms.

One of the most un­pleas­ant is neu­ral­gia, or con­stant in­tense pain af­fect­ing mainly the nerves of the chest and neck or the trigem­i­nal nerve in the face and lower back.

The pain can be ac­com­pa­nied by pares­the­sia, a feel­ing of tin­gling, prick­ling, itch­ing, numb­ness, or burn­ing. A blis­ter­ing skin rash of­ten de­vel­ops.

The num­ber of shin­gles pa­tients is in­creas­ing yearly, es­pe­cially among women and peo­ple in their 50s, ac­cord­ing to data from the Health In­sur­ance Re­view and As­sess­ment Ser­vice (HIRA).

Ac­cord­ing to records from the HIRA, 725,511 peo­ple were di­ag­nosed with shin­gles in 2018, up 12.4 per­cent from 2014’s 645,624. The num­ber of fe­male pa­tients was 1.6 times higher than males, as 441,000, or 61 per­cent, were women in 2018.

About 24.5 per­cent, or 177,600 pa­tients in 2018 were in their 50s. Pa­tients in their 60s fol­lowed at 21.1 per­cent and those in their 40s at 15.7 per­cent. About 84,500 were in their 30s and 43,622 were in their 20s.

“The rea­son for shin­gles and the fre­quent out­breaks among peo­ple in their 50s is still un­clear. But it may be due to low­ered im­mu­nity to in­fec­tions,” said Jo Jung-koo, a pro­fes­sor at the anes­the­si­ol­ogy de­part­ment of the Na­tional Health In­sur­ance Ser­vice (NHIS) Il­san Hos­pi­tal.

“Shin­gles is more com­mon in older adults and in peo­ple who have weak­ened im­mune sys­tems. Se­niors are more vul­ner­a­ble to chronic dis­eases and the level of im­mu­nity drops when the body weak­ens.”

Is vari­cella zoster virus con­ta­gious?

Any per­son with shin­gles can pass the vari­cella zoster virus on to any­one who’s not im­mune to chick­en­pox. It is usu­ally trans­mit­ted through di­rect con­tact with the open sores of the shin­gles rash. Once in­fected, the per­son will de­velop chick­en­pox, not shin­gles.

How­ever, chick­en­pox can also be dan­ger­ous for some peo­ple. Shin­gles is con­ta­gious un­til the scabs of the blis­ters have healed, so pa­tients should avoid phys­i­cal con­tact with any­one who hasn’t yet had chick­en­pox or been vac­ci­nated, es­pe­cially peo­ple who have rel­a­tively weak im­mune sys­tems such as preg­nant women, young chil­dren and ba­bies.

Pre­ven­tion and treat­ment

There is no cure for shin­gles, but im­me­di­ate treat­ment with an­tivi­ral drugs can re­duce the risk of com­pli­ca­tions.

Doc­tors also rec­om­mend get­ting vac­ci­nated, es­pe­cially for those aged 60 or higher who are more vul­ner­a­ble to the dis­ease, as the vac­cine is be­lieved to re­duce the chances of the in­fec­tion by up to 50 per­cent.

Cur­rently, peo­ple look­ing to re­ceive the shin­gles vac­cine have two op­tions: Zostavax and Shin­grix.

Zostavax was ap­proved by the U.S. Food and Drug Ad­min­is­tra­tion (FDA) in 2006. It is a vac­cine that is ad­min­is­tered sub­cu­ta­neously, usu­ally in the back of the arm. It is de­signed to help peo­ple aged 50 years or older, but health au­thor­i­ties rec­om­mend peo­ple over 60 get vac­ci­nated. Ef­fi­cacy of the vac­cine goes down as the age of a per­son goes up. Ac­cord­ing to the U.S. Cen­ters for Dis­ease Con­trol and Pre­ven­tion (CDC), Zostavax is 70 per­cent ef­fec­tive for those in their 50s, and the rat de­crease from there - 64 per­cent in the 60s, 41 per­cent in the 70s, and 18 per­cent in the 80s.

Shin­grix, ap­proved by the FDA in 2017, is a pre­ferred al­ter­na­tive to Zostavax. It is said to be 97 per­cent ef­fec­tive in pre­vent­ing shin­gles for adults of ages 50 to 69, and over 90 per­cent for peo­ple in their 70s and older, CDC data showed.

Ex­perts said Shin­grix of­fers pro­tec­tion against the dis­ease for over five years. It is a non-liv­ing vac­cine made of a virus com­po­nent, and is given in two doses, with an in­ter­val of two to six months.

“It sounds typ­i­cal, but the best pre­ven­tion of shin­gles is to boost your im­mu­nity by hav­ing enough sleep, rest and reg­u­lar ex­er­cise and avoid­ing stress­ful sit­u­a­tions,” Jo said.

Get­ty­im­ages­bank

A woman is ad­min­is­tered a shin­gles vac­cine. The num­ber of shin­gles pa­tients is in­creas­ing yearly, es­pe­cially among women and peo­ple in their 50s, ac­cord­ing to data from the Health In­sur­ance Re­view and As­sess­ment Ser­vice.

Get­ty­im­ages­bank

Blis­ter­ing of the skin is one of the symp­toms of shin­gles.

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