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Don’t Mingle with Shingles

female doctorCollege of DuPage Nursing Student Amanda Sigsworth shared with Healthy Lombard that according to MedicineNet (2021), Shingles is a condition caused by the varicella-zoster virus. This is the same virus that causes chickenpox. When an individual is first exposed to the varicella-zoster virus, usually in childhood, they will show signs and symptoms of chickenpox, and that will be the diagnosis. They continue on to explain that after symptoms have subsided and recovery is complete, the virus remains dormant in nerve cells located in the spine. The virus may be reactivated later in life at which time signs and symptoms of a secondary infection called Shingles occur. Finally, Shingles are always secondary to Chickenpox (MedicineNet, 2021).

 

What happens when the virus is reactivated and is it contagious?

When the virus becomes reactivated it will move along a nerve path, also known as a dermatome, and affect only one side of the body. Symptoms associated with the reactivation include stinging, tingling, itching, or a burning sensation, followed by a rash in the same location. The rash will follow along the nerve but is typically seen on the torso or face; the rash then develops into small red patches that blister, rupture, and eventually crust over. The individual is usually only contagious when the fluid or pus-filled blisters, which contain the virus, are open and not yet crusted over. People who have not been exposed at all to the zoster virus yet should stay away from the affected individual while they are contagious, whereas, those who have been previously exposed will not contract the virus.

 

What are the risk factors for this condition and are there complications?

MedicineNet (2021) describes risk factors for Shingles as; exposure to the varicella-zoster virus, increasing age, a weakened immune system, and possibly stress. Additionally, they include complications and descriptions; Postherpetic neuralgia, Ramsay Hung syndrome, bacterial skin infections, Herpes Zoster Opthalmicus, Encephalitis, and Disseminated Herpes Zoster. Postherpetic neuralgia is persistent pain or discomfort in the affected area even after the rash has healed. This pain can last for months up to several years and can be very difficult to manage. According to MedicineNet (2021) about 15%-25% of those older than 60 years who develop shingles may experience postherpetic neuralgia. MedicineNet continues to depict complications, Ramsay Hung Syndrome is an uncommon complication that involves the facial nerves which may lead to facial paralysis. The accompanying rash can involve the ear/ear canal and in some cases the mouth. Symptoms include hearing loss, ringing in the ears, and dizziness. Bacterial skin infections can occur secondary to the shingles rash. Herpes Zoster Ophthalmic can lead to blindness in the affected eye. Encephalitis or inflammation of the brain may occur and can be life-threatening. Finally, Disseminated Herpes Zoster is a potentially life-threatening condition in which the varicella-zoster virus becomes widespread in the body, potentially affecting the brain, lung, and liver.

What can an individual do to prevent getting Shingles?

            Any healthy individual over the age of 50 can receive a Shingles vaccine. However, the shingles vaccine is not indicated to prevent the initial chickenpox infection, therefore, of the estimated 1% of those over age 40 who have not been exposed to varicella-zoster, they should not receive the shingles vaccine (MedicineNet, 2021; Doerr and Stoppler, 2021). Therefore, since the majority of adults have been exposed to varicella-zoster, the vaccine is indicated to prevent the reactivation of the virus. Those who should not receive the vaccine are those who are allergic to any ingredient in the vaccine, those who currently have Shingles (these individuals should wait until after they’ve recovered to be vaccinated), and pregnant or breastfeeding women (they should wait until after their pregnancy and finished breastfeeding).

 

How does the Shingles vaccine work?

DrugTopics (2018) explains that the Shingles vaccine works like other vaccines in that it essentially teaches the body how to fight off certain bacteria or viruses so if the individual comes into contact with it again, the immune system knows what to do. The Shingrix vaccine, however, differs from past vaccines in that it is made from a weakened form of a virus. Shingrix is the first shingles vaccine to combine a non-live antigen with a specifically designed adjuvant (Longware, 2018), by introducing part of the outer shell rather than the live varicella-zoster virus. The immune system can learn to recognize the shell of the zoster virus, so the immune system can respond accordingly.

 

How effective is the Shingles vaccine?

            According to the Centers for Disease Control and Prevention (2018), adults between 50 and 69 years of age who received two doses of Shingrix demonstrated 97% effectiveness against shingles, and among those who were 70 years or older, Shingrix was 91% effective. Generally, people are very concerned about vaccine statistics and while the Shingles vaccine is not 100% effective in preventing Shingles, it reduces the chances of reactivation by nearly 100%.

 

How can an individual receive a Shingles vaccination?

            Doctor’s offices and pharmacies carry this vaccine so an individual can talk to their health care provider about scheduling an appointment, or by visiting a local pharmacy to receive Shingrix. Shingrix consists of 2 doses administered 2 to 6 months apart. Potential side effects include fatigue, muscle pain, stomach pain, or pain in the injection site, fever, or nausea. Symptoms last up to 3 days and occur from either the first or second dose or both.

 

Why is it important to spread the message about the Shingles vaccination?

It is important to spread the message about the Shingles vaccine because while reactivation of varicella zoster is not a guarantee, it is preventable.

 

Works Cited

 

Steven Doerr, M.D.; Melissa Conrad Stöppler, M.D. (2021, February 10). Shingles:

Contagious, Treatment, and Causes. Retrieved March 24, 2021, from

https://www.medicinenet.com/shingles_herpes_zoster/article.htm

 

Shingles Vaccination. (2018, January 25). Retrieved March 24, 2021, from

https://www.cdc.gov/vaccines/vpd/shingles/public/shingrix/index.html

 

Longware Duff, B. (2018, March 11). Study Reveals How Shingrix Vaccine Works. Retrieved                March 24, 2021, from

https://www

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