Herpes Zoster Virus Hides in Spinal Column, Shingles Symptoms and Treatment
Herpes Zoster is the medical name for shingles. The virus that causes chicken pox (varicela virus) stays in the system residing near the spine. This herpes virus is also sometimes referred to as "varicela zoster". Usually the chest, abdomen and back, and face are the areas involved. More rarely the shoulder and scalp can be involved. It is believed that this virus can become activated by triggers. If the immune system is weakened, a number of stressors could be the trigger of an outbreak. Stress, illness, and age can be contributing factors in an outbreak.
The duration of the rash and blisters is usually a few weeks. Pain and discomfort can last for months after an outbreak. Post herpetic neuralgia can last for months after the rash has gone. From Wikipedia, post herpetic neuralgia is thought to be nerve damage caused by herpes zoster. The damage causes nerves in the affected dermatomic area (a dermatome is an area of skin that is mainly supplied by a single spinal nerve. There are eight cervical nerves, twelve thoracic nerves, five lumbar nerves and five sacral nerves. Each of these nerves relays sensation (including pain) from a particular region of skin to the brain) of the skin to send abnormal electrical signals to the brain. These signals may convey excruciating pain, and may persist or recur for months, years or until death.
Symptoms of Shingles:
Tingling and pain occur at the site of a flare. If these symptoms affect the face, the patient should be checked by a physician immediately, as the virus can move to the eye and brain with severe consequences. Associated symptoms include: headache, fatigue, and fever. The pain that occurs at the site is telling. It is a pain with tingling, signs that nerves are being affected. In the literature, shingles is described as a burning or stabbing pain in most cases. I had a friend once who experienced this stabbing pain when he had an outbreak of shingles. The rash extended from the center of his back to the right all the way around to the right side of his chest. The outbreaks occur in one area, not several discontinuous spots. Along with the pain, this specificity of area is a good symptom for diagnosis. The pain is the first symptom and can be confused with lung pain or pain of the heart. Even air motion from a fan can cause pain in the rash and blistered area.
Treatment of Shingles:
Since varicela is a virus, antiviral drugs such as acyclovir can be used to shorten the duration of a flare. This means that soon after the symptoms for shingles appear, (redness and blisters, pain and numbness, fatigue, headache, and fever) the drug can be administered. I have read that the last symptoms listed can be described as "flu like". All antivirals must be prescribed by a physician. Very severe side effects can occur.
As is the case with many skin conditions, if blisters open up they are susceptible to infection. In this case antibiotics are given. Antibiotics can only be prescribed by a physician. Anesthetic topical drugs are often used for this painful condition. Over-the-counter pain relief medications and prescription analgesics are prescribed to deal with the pain. Acetaminophen, aspirin, ibuprofen, and naproxin are just some of the pain relief medications recommended. In addition to being the first symptom, the pain seems the most difficult one for the patient to deal with. Itching has been reported as another symptom but from the literature it seems to occur less frequently.
The pain comes from the virus traveling along nerves which begin at the spine. Nerves radiate from the spine (where the virus lays dormant) like ribs with these pathways running out sideways from the spine on both sides. The blisters of a shingles flare up seem to run along the areas where these nerves flow. The varicela virus, when activated, seems to move out over these areas when the body is stressed, resulting in pain, then blisters and rash.
For alternative treatments, google herbal medicine, acupuncture, psychological treatments and homeopathy for shingles.
Self care includes: rest, fluids, analgesics, baking soda baths to decrease itching (one cup to a normal bath), or oatmeal baths. Oatmeal lotion is recommended in place of soaps (which can dry the skin).
You cannot contract shingles from a person suffering an outbreak. However, a person who has never had chickenpox and is not vaccinated could contract it from contact with shingles. Most people are affected in the age range of 50 -70. There is a vaccine out that older people can take called Zostavax. This shingles vaccine is recommended for people 60 and older, particularly those suffering from debilitating disease and those having had shingles previously. This vaccine has been shown to reduce the incidence of shingles in this age group by one half. The duration of the shingles was also shortened. A physician must be consulted before this vaccine is given. Anyone showing shingles symptoms should seek a physician's care.
Have you fallen victim to painful shingles?
Herpes Zoster Located on Neck
From Federal Bureau of Prisons Clinical Practice Guideline December 2011
for Varicella Case
(when case could have been exposed to varicella)
From 21 to 10 days before onset of rash in case
for Varicella Case
(when case is able to transmit infection)
From 2 days before rash, until all lesions crusted (4-7 days after onset)
for Varicella Contacts
(when susceptible contacts are at risk for developing varicella)
From 10 days after contact with the varicella case began, until 21 days after contact ended
In 1995, a vaccine for shingles was introduced. Various studies show that that vaccine provided up to 99% effectiveness. This vaccine was attenuated - meaning that a virus was treated in such a way that it would not cause infection but would create a good immune reaction to cause immunity to shingles.
A relatively new contribution to controlling herpes zoster infections is an attenuated and higher potency vaccine called Zostavax. This vaccine was approved for older people 60 years of age and above in 2006, and was tolerated well by that population. Follow up studies showed a 61% effectiveness in preventing the disease.
2011 showed a lowering in age of the CDC recommendation for the use of Zostavax. The recommendation was that people 50-59 should get the immunization. The result was 70% efficacy.
Photos and YouTube
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© 2010 John R Wilsdon