HEALTH: How to beat shingles, a skin disease

Herpes zoster or shingles is a skin condition that causes excruciating pain to most sufferers, to the point where performing daily tasks becomes impossible.   
It will often start as tingling pain localized in one area and develop into a swathe of red, swollen rashes that will normally attack one side of the body.
According to the Centres for Disease Control, (CDC), shingles is a painful rash that develops on one side of the face or body.

The rash consists of blisters that typically scab over in 7 to 10 days and fully clears up within 2 to 4 weeks.
Before the rash appears, people mostly experience pain, itching, or tingling in the area where it will develop.

This may happen several days before the rash appears.
Most commonly, the rash occurs in a single swath or stripe around either the left or the right side of the body.
In other cases, the rash occurs on one side of the face.

Shingles on the face can affect the eye and cause vision loss in a condition known as herpes zoster opthalmicus.
In rare cases, which occur in individuals with compromised or weakened immune systems, the rash may be more widespread on the body and look similar to a chickenpox rash.
According to the US National Center for Immunization and Respiratory Diseases, Division of Viral Diseases, other symptoms of shingles can include an upset stomach, headache, fever or chills.
Shingles is caused by varicella zoster virus (VZV), which is the same virus that causes chickenpox. 

The virus stays inactive or dormant in a person’s body after they have recovered from chickenpox.

As the person gets older, the virus can reactivate later, causing shingles. 

Triggers for the condition include stress, a weakened immune system, HIV/AIDS, fatigue, cancer, radiation treatments or injury. 
In very rare cases, shingles can also lead to pneumonia, hearing problems, brain inflammation or encephalitis, and death.
Several antiviral medicines, such as acyclovir, valacyclovir, and famciclovir are used to treat shingles. 

These medications shorten the length and severity of the illness.
CDC says these medicines are most effective “if you start taking them as soon as possible after the rash appears”.
“If you think you have shingles, contact your healthcare provider as soon as possible to discuss treatment,” CDC recommends.
An additional consequence in between one to two of every five shingles sufferers is postherpetic neuralgia (PHN).

PHN is nerve pain caused by vial damage to the nerves in the areas where the shingles rash was located, and persists even after the rash is gone.
It can last for months or years after the rash has cleared, causing severe pain that can interfere with daily activities.
About 10 to 18 percent of people who get shingles will experience PHN, with about one third getting symptoms for three months, and a fifth being in pain for a year or longer.
Our risk of PHN increases with age. 

An older adult with shingles is more likely to develop PHN and experience longer lasting and more severe pain than a younger person with shingles.

People younger than 40 rarely experience PHN.
Treatment for PHN includes lidocaine skin patches on affected areas, Capsaicin skin patches, anticonvulsants, severe pain or opioid medication like tramadol, oxycodone, Ultram and morphine, as well as low doses of antidepressants.
Care should be taken while using opioids so as to avoid getting the patient addicted to the drugs.
Pain medicine purchased at your local chemist or a prescription from your doctor can also help relieve shingles-related pain.
Using wet cloths or compresses or calamine lotion may help reduce the itching associated with the condition.
If you have shingles, direct contact with the fluid from your rash blisters can spread VZV to people who have never had chickenpox or never got the chickenpox jab. 

Should they get infected, they will develop chickenpox and not shingles.

They could then develop shingles later in life.
The risk of spreading VZV to others is low if you cover the shingles rash.

People with shingles cannot spread the virus before their rash blisters appear or after the rash develops crusts.
People with chickenpox are more likely to spread VZV than people with shingles.
Notes to remember:
l It is vital to remember that you cannot get shingles from someone who has shingles.
You can get chickenpox from someone who has shingles if you have never had chickenpox or never received the chickenpox vaccine
To avoid transmitting VZV to others, ensure you cover the rash.

Avoid touching or scratching the rash. Wash your hands often.
Avoid contact with the following people until your rash forms crusts or scabs:
Pregnant women who have never had chickenpox or the chickenpox vaccine, premature or low birth weight infants, people with weakened immune system, such as people receiving immunosuppressive medications or undergoing chemotherapy, organ transplant recipients, and people with human immunodeficiency virus (HIV) infection.
Some people have a higher risk of getting shingles, including those with medical conditions receiving treatment that suppresses their immune system functions.
These include certain cancers like leukemia and lymphoma, and human immunodeficiency virus (HIV), as well as drugs such as steroids and drugs that are given after organ transplants.
In Kenya, this high risk group includes the 1.5 million people currently living with HIV.
Although rashes and itchy skin are listed among Astra Zeneca vaccine side effects, there is no link to shingles reported yet.

An Israeli research paper published in the Rheumatology journal on May 3, 2021, examined the potential association between vaccination against COVID-19 and herpes zoster (HZ) reactivation in patients with stable autoimmune inflammatory rheumatic diseases (AIIRD).

The study involved 590 people in Medics at the Tel Aviv Sourasky Medical Center and Carmel Medical Center in Haifa.

It found a shingles or herpes zoster reactivation prevalence rate of 1.2 percent for peope with AIIRD
According to Dr Victoria Furer, who is a rheumatologist at Tel Aviv Sourasky Medical Center, the report cannot authoritatively identify the vaccine as the cause of the shingles.

In an interview with the The Jerusalem Post, she said there could be an association between autoimmune disease and the vaccine in the development of shingles:

“We can say it might be a trigger in some patients. That is why we reported on it. It seems that the reason is that there is some association,” she said.

“We should not scare people. The overall message is to get vaccinated. It is just important to be aware,” added the medic.

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