A POX ON HERPES ZOSTER

by Helen Borel,RN,PhD

I'm reaching out for any medical, neurologic or other interested individuals to provide me with information I cannot seem to locate on the internet...not even at any professional medical website...on the far-reaching ravages of Herpes zoster (hereafter referred to as H.zoster). Unfortunately, it is commonly called "Shingles," a foolish name for a vicious viral infection of the nervous system!!!

A bit of background: H.zoster, aka Varicella zoster is the virus (seemingly mild in childhood) which causes CHICKEN POX (medically known as varicella)...that itchy rash of childhood that goes away and confers immunity...or so you were told.

PHYSICIANS HAVE NOT BOTHERED TO EDUCATE AT-RISK PATIENTS ON THE SEVERITY OF HERPES ZOSTER INFECTION AND ON THE HORRIBLE PAIN THAT ACCOMPANIES IT

Sadly, until very recently, no one has bothered educating the public about its hibernation in the spinal cord for decades...only to see it emerge in vicious assaults on middle-aged and elder individuals' nervous systems, wreaking physical havoc and excrutiating pain requiring months, even years of narcotics and varied other theoretically-useful drugs like anti-epileptics, low-dose antidepressants, and other drugs thought to be helpful against what is known as "neuropathic pain".

Frequently, the viral rash, then the severe acute pain is located in the chest area, sometimes in the eye (a dangerous site) and sometimes in the brain (yet more dangerous). Although it has occured at other dermatome (nerve distribution in specific skin areas) sites, such as the arms.

Patients are often left with permanent nerve damage, such as paresthesias (pins and needles) and varied levels of pain and functional disabilities when limbs are involved. Scarring also occurs. Additionally, there is atrophy (shrinking) of affected muscle areas, such as loss of tissue in the hand muscles and compromised function of that appendage.

Given the kind of acute and severely painful viral illness this is, so painful it causes the patient to be bedridden, particularly during the weeks of acute infection and evolution of the rash...that even narcotics can't fully pierce the pain level...you would think the medical community, particularly internists, primary care physicians, family doctors, nurse practitioners, virologists, infection disease specialists, geriatricians and regional and local health departments would have long ago mounted a regular, consistent campaign warning mature Americans about the need to protect their age-related waning immune function from this onslaught by reducing stress and other prophylactic actions to ward off this viral viper.

Not only that...the subsequent chronic illness that overtakes the patient, once the acute phase has passed, is so debilitating that, again you'd think the medical community would have long ago done a compassionate job of warning the public about its risks and what to look for - because early treatment can ward off the worst of H.zoster. But no has bothered to care. This is a nightmare for the victims of H.zoster and a medically professional shame.

DESPITE AVAILABILITY OF AN ANTI-ZOSTER VACCINE IN THE PAST 3 TO 5 YEARS, RARELY HAVE AT-RISK ELDERS BEEN ROUTINELY INFORMED TO PROTECT THEMSELVES BY GETTING VACCINATED

What is more...in the past 3 to 5 years, there has been an anti-zoster vaccine available for elders and other at-risk groups (such as people with HIV and other immune-compromising conditions). Yet, it seems, physicians aren't bothering to educate their at-risk patients, nor are they informing them of the available zoster vaccine which is thought to either prevent shingles altogether, or at the very least, lessen its severity and markedly reduce the inevitable pain levels...and possibly prevent postherpetic neuralgia altogether.

CHRONIC, CRIPPLING DISABILITIES DUE TO ZOSTER-INDUCED SPINAL NERVE AND PERIPHERAL NERVE DAMAGE REQUIRE DIRE RESEARCH ATTENTION   N O W!!!

I've widely researched H.zoster (HZ) for its effects on the spinal cord and can find zero information on this subject via the online site of the National Institute of Neurologic Disorders and Stroke, and multiple other websites which liberally discuss PHN (postherpetic neuralgia), as though this were the main AND (often believed) THE ONLY complication following acute Varicella zoster/shingles affliction.

What is needed is up-to-date knowledge of HZ's long-term/chronic effects on the spinal cord and its implications for normal standing, ambulation,posture, etc.

I'm aware of cases of crippled walking, ambulation problems together with postherpetic neuralgia more than a year following the acute infection. But can't find specific, and detailed, information on spinal cord involvement after the acute H.zoster attack...nor how to treat it.

I believe it is a neurologic condition due to viral damage to the spinal cord that should be aggressively treated with some kind of physiologic therapy(ies) by a neurologist. But I can't find any online data addressing this very serious Post-Zoster complication.

Also, I must point out (despite the widespread data mentioning only certain affected sites) that Herpes Zoster infection does not only attack the chest, the trigeminals, or the eye, and sometimes the brain. IT APPARENTLY ALSO ATTACKS THE STELLATE GANGLION SITE...with resulting bilateral limb involvement (arms)...and subsequently, bilateral leg and lower back dysfunction.

Again, I am not only talking of pain, I AM TALKING ABOUT CRIPPLED POSTURE, CRIPPLED WALKING, DIFFICULTY STANDING, SITTING,etc., plus PHN pain upon these (formerly) normal functions.

If anyone reading this has a clue about this subject and is  able to provide me with detailed specifics addressing spinal cord damage due to the post-acute stages of H.zoster, I would appreciate hearing from you. Thanks in advance for any insights, experiences, knowledge, direction. If you wish, you may respond to me at medical-healthalerts@earthlink.net