Shingles or Herpes Zoster as it is officially known, is caused by the same viral disease as chickenpox. This very painful condition which attacks the dorsal root nerve ganglia is seen mostly in adults over 50, producing blisters in areas of the skin innervated by the effected nerves.
Most people only ever have one attack but the pain can persist for months. The Shingles virus is nowhere near as contagious as chickenpox but it can be passed on through contact for about a week after the appearance of the rash.
As long as the rash does not spread to the brain it is not particularly dangerous to healthy individuals but those with immune deficiencies such as HIV patients or those being treated for cancers can be at great risk.
Most people only ever have one attack but the pain can persist for months. The Shingles virus is nowhere near as contagious as chickenpox but it can be passed on through contact for about a week after the appearance of the rash.
As long as the rash does not spread to the brain it is not particularly dangerous to healthy individuals but those with immune deficiencies such as HIV patients or those being treated for cancers can be at great risk.
Causes of Shingles
Shingles results from reactivation of the Varicella virus which has lain dormant and can occur years after an initial chickenpox infection. It is uncertain why the virus reactivates but stress, trauma, drugs or immuno-suppressant diseases are the most likely triggers.
Signs and Symptoms of Shingles
Patients may feel unwell and have a fever for a few days, this can be accompanied by localized pain before the characteristic rash appears.
The rash first appears as red spots which very quickly turn into intensely painful and itchy blisters. Occasionally they appear on the arms and legs but most times the rash is on one side of the trunk. Hypersensitivity of the skin may also be present. The spots will eventually erupt and begin to dry out forming scabs which can cause scarring.
Shingles pain is usually present for one to four weeks but occasionally it can go for months and turn into Postpherpetic neuralgia. In fairly rare cases the virus may effect the head and neck and can involve the face and eyes. In this case patients should seek immediate medical attention in order to prevent serious complications.
Diagnosis of Shingles
The early symptoms of shingles can mimic the pain of such conditions as pleurisy or appendicitis, so a definitive diagnosis is not really possible until the characteristic nodules appear. To differentiate the causal virus Herpes Zoster from Herpes Simplex requires the examination of stained antibodies from vesicular fluid.
Treatment of Shingles
Topical antiviral ointments can help if the disease is treated in the early stages but antiviral treatment with drugs such as Acyclovir is the mainstay of treatment. Symptomatic treatment with antipruritic creams such as Calamine lotion and pain killers such as Aspirin or Codeine are used to relieve pain.
If Postherpetic neuralgia develops, the current methods of treatment are Capsacain, transcutaneous electrical nerve stimulation and the tricyclic antidepressant amitryptyline to help with combating the effect of the relentless pain.
If there are signs of infection, systemic antibiotics are added to the treatment regime. Hygiene is important both to prevent spreading the disease through contact and to prevent potentially serious infections at least until the rash has completely scabbed over when it is no longer contagious.
Complications of Shingles
Prognosis is normally very good but in rare cases where the infection spreads to the eyes and brain, corneal damage and blindness are possible.
Prevention of Shingles
As with everything, a healthy lifestyle and attention to dietary requirements is the main weapon against compromising the immune system. In recent years a vaccine has become available and administration is recommended for people over 60.
