Nasty Infectious Diseases You Want To Avoid - Shingles
This is a painful, red blistering viral infection of the nerves that supply certain areas of the skin, caused by reactivation of the Varicella-zoster virus (VZV), the same culprit that causes childhood chicken pox.
Shingles is a common illness that strikes one in five Americans. The name comes from the Latin word cingulum, meaning "belt" or "girdle." By age 85, people have a 50-50 chance of developing shingles if they haven't already had them.
Cause - After an episode of chickenpox, the virus lie dormant in sensory nerves along the spine for many years. When the immune system efficiency is weakened, the virus reemerges and migrates along the sensory nerve, breaking out at its receptor ends in the skin. Each year, shingles affects several hundred patients per 100,000 in the United States, usually over age 50. Scientists suspect that a decline in the activity of white blood cells may allow the virus to reemerge. This idea is bolstered by the fact that shingles also appears in children with leukemia, cancer patients undergoing chemotherapy, and organ transplant patients. The virus often affects a nerve that has had previous trauma.
Symptoms - The first sign is excessive sensitivity in an area of skin, followed by pain; after about five days the rash appears, turning into tense blisters that turn yellow within three more days. The blisters then dry out and crust over, gradually dropping off (leaving small pitted scars behind). Because the nerves have been damaged after the virus attack, after the blisters heal the nerves constantly produce strong pain impulses that may last for months or years. The older the patient and more severe the rash, the more likely the pain will persist. Shingles often affects a strip of skin over the ribs on one side; sometimes it affects the lower part of the body or the upper half of the face on one side. It can occur in any area of the body.
Treatment - There is little that can be done either for the rash or the pain afterward, but prompt use of antiviral drugs such as acyclovir, famcyclovir, or valacyclovir can shorten the rash stage and lessen the chance of pain later. Therefore, patients should seek medical help at the first signs of shingles. Acyclovir slows reproduction of the virus and shortens the course of the infection, although it doesn't prevent the nerve pain following a shingles attack. Some experts maintain that steroid drugs such as prednisone can prevent this pain. Valacyclovir is a chemical cousin of the widely used acyclovir. For severe pain from shingles, experts occasionally recommend injecting a nerve block in the appropriate place to block the sympathetic nerves supplying the area of pain. This block typically relieves pain for hours in up to 80 percent of patients. An over-the-counter product called Zostrix or Valtrex (active ingredient: capsaicin, a red pepper derivative used to make chili powder) may help relieve the post-herpetic shingles pain, once all the blisters have disappeared. Experts believe that capsaicin blocks the production of a chemical necessary for pain impulse transmission between nerve cells. Do not apply Zostrix to active shingles blisters. As a counterirritant, Zostrix is designed to be used on unbroken, healed skin with a pain sensation, not for open oozing infections.
Complications - Almost half of the 600,000 patients who get shingles each year suffer from agonizing pain that may last from days to years. If the pain lasts long after the rash, it is known as postherpetic neuralgia. It can also lead to bizarre sensations that can linger for years, including phantom feelings. Sufferers complain that a light touch can feel like torture and a drop of water feels like a third-degree burn. Even the softest clothing can be unbearable to these patients. Postherpetic neuralgia is treated with a variety of medications from amitriptyline to opioids.
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