When my sister Karen got shingles last month, she became the unofficial spokesperson for Zostavax, the shingles vaccine. Starting with her husband Marty, she has begun a one-woman campaign for getting the vaccine instead of getting shingles.
“It’s debilitating,” she emailed me recently. “This is the first time in three weeks I’ve been able to drive myself anywhere.”
Her case of shingles came on unexpectedly while she and Marty were camping in the Pacific Northwest. At first she had a pain in her back and didn’t want to spoil their camping trip so she started taking Tylenol. When the rash started, she thought it might be a side effect from the Tylenol. But two days later, the blistery rash that started on her back had spread around her torso. While she was in the campground women’s room, another camper saw her looking at the rash and said, “Honey, that looks like shingles.”
It was my sister’s good fortune that the other camper knew what shingles looked like, and her remark came at a critical moment for Karen. She was still within the 72-hour window of time that would allow her to get treated with Valtrex, or valacyclovir, one drug in a family of acyclovirs that reduces the likelihood of later complications. Reduce, but not necessarily eliminate.
First, a little about shingles
Karen’s case was pretty typical: a slight sharp pain in the back that got worse. Within 24 hours, a rash starts on the spine, then spreads around to the chest, belly and abdomen. By 48 hours, the rash is painful, oozy, and in full bloom, and remains for anywhere up to five weeks.
Shingles are caused by a re-emergence of the herpes zoster virus—the remnant of the varicella zoster virus or chicken pox. Herpes zoster virus lies dormant in the nerve and later travels along the nerve axon to nerve endings in the skin. Since nerve endings are everywhere, it’s possible to get shingles everywhere. Some of the more severe cases include facial and aural shingles that can cause hearing and vision loss.
It’s still unknown why chicken pox goes underground, so to speak, and resides in nerve endings. Even less is known about what triggers it to come out ten or twenty years later, or who it affects most, and why.
But what we do know is that the chances are greater that it will come out in people who had chicken pox when they were less than a year old, are now over 60 years old, and have impaired immune systems, according to the National Institute of Health’s U.S. Medical Library. However, not all three circumstances need apply. Shingles can occur in anyone who’s ever had chicken pox.
The good news is that you can’t pass shingles on. The bad news is that you can pass chicken pox on to children and adults who haven’t had either chicken pox or the chicken pox vaccine.
The really bad news is that even after the rash is gone, many people get postherpetic neuralgia, or a chronic nerve pain that can lasts months or even years. That’s why it’s so important to take Valtrex or one of the other acyclovirs as soon as the rash is identified. It can greatly reduce the severity of the outbreak and also reduces the risk of postherpetic neuralgia.
There’s a wealth of information online on shingles. Medline Plus, a website by the National Institute of Health’s U.S. National Library of Medicine is one of the better ones (www.nih.gov/medline).
Don’t let the name intimidate you, Medline Plus is not full of medical jargon or set up for medical researchers, but instead speaks in plain English and has great links.
Wikipedia is another great source of information. But remember, Wikipedia is interactive and can be changed by anyone. Still, it has some detailed and referenced material on shingles worth looking at.
As for me, I’ve got a doctor’s appointment to get vaccinated.