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Stop shingles with fast action, vaccination

Chicken pox relative has long-term consequences

January 9, 2014
By DAN ROBLEE - DMG writer (droblee@mininggazette.com) , The Daily Mining Gazette

HOUGHTON - When Karl Rundman of Atlantic Mine got his first case of shingles over a decade ago, he and his wife suspected what the rash might be and got to the doctor fast. He was treated with the anti-viral drug Valtrex, and the rash and discomfort receded within a week.

"I was very fortunate," he said. "The reason I was proactive is because I saw what happened with my mother. You never forget that."

His mother developed shingles about 35 years ago, he remembered, while she was battling cancer and undergoing chemotherapy, and before modern treatment was available.

"There was a bad outbreak on her head, her immune system was weakened and it ended up taking her left eye," he said. "Then she had this pain from the shingles which lasted the rest of her life. Rundman went through two more outbreaks, one on his head and another on his body, but each time a quick response and medication curbed the problem before the intense neural pain that debilitates some sufferers ever had time to develop.

Finally, about a year ago, he was vaccinated against the virus, and hasn't had an outbreak since. He would have done so sooner, he said, but the vaccine hadn't been available.

Shingles is a manifestation of the herpes zoster virus that usually occurs later in life. That's the same virus that causes chicken pox, and the childhood disease is the first indicator of whether a person is at risk for shingles.

"If you've never had chicken pox, you don't have to worry," said Jessica Bessner, director of pharmacy at Aspirus Keweenaw.

If the virus is lying latent in someone's system, it's most likely to emerge after the age of 60. It usually happens when the immune system is weakened by physical or emotional stress, or an already existing illness.

In rare instances the rash will emerge earlier in life, though a younger immune system will usually fight it off more effectively before long-term nerve pain sets in.

"I had a mild case at age 27," Bessner said. "The physician I saw said you basically need to chill out; you're under a lot of stress at work and you're not managing it effectively."

According to Sue Ingram, Registered Nurses supervisor at the Baraga County Memorial Hospital Physician Group, shingles first shows up as a painful, often blistering skin rash, usually on just one side of the body or head. If unchecked, it will tend to wrap around the body or head, still remaining on the same side.

As opposed to a rash that's just uncomfortable or itchy, "most people can't stand the pain," Ingram said.

"It hurts to have clothing on or for somebody to touch it," she added.

Left unchecked, the rash can spread, and if it reaches the eyes it can cause temporary blindness.

Usually, if left untreated, the rash will last from two to four weeks, Ingram said.

Also, intense internal pain in the nerves at and around the area of the rash, called post-herpetic neuralgia, can set in. If left untreated, or if treatment is administered too late or the body's immune system isn't able to help with the fight, this pain can last for months or even years.

If someone suspects a rash might be shingles, the key is to follow Rundman's lead.

"Get in to the doctor right away," Ingram said.

The anti-viral drugs don't eliminate the virus from the nerves themselves, but they do alleviate the symptoms and usually prevent the long-term pain, she said.

The best alternative, of course, is not to get shingles at all.

The shingles vaccine, Zostavax, went on the market in 2006. It's recommended for all people 60 and over by the federal Centers for Disease Control, and approved for those 50 and up. People that have previously had shingles should still get the vaccine.

Pregnant women, those with weakened immune systems and those with allergies to gelatin or the antibiotic Neomycin should not, however, Ingram said. Any concerns that the vaccine will actually cause the disease are unfounded.

"You will not develop shingles from the vaccine," she said.

According to the CDC website, the vaccine reduces the occurrence of a shingles outbreak by about half, and the occurrence of post-herpetic neuralgia, the long-term nerve pain, by 67 percent.

Bessner said Aspirus has administered about 800 doses of the shingles vaccines locally since 2009. She said the subcutaneous injection - much less painful than an intramuscular injection - often causes a mild rash due to a common allergic reaction. That's not a sign of shingles, she said, and usually goes away within 24 hours.

The only disadvantage to the vaccine, according to Bessner, is the cost, which can run up to $200. Insurance coverage varies, she said, though it is covered under Medicaid Part D.

Aspirus keeps the vaccine on hand, Bessner said, but not all pharmacies do.

Ingram recommended working with your doctor to set up a vaccination, to make sure the serum is on hand when needed and not brought out of storage too soon.

To learn more about shingles, go to www.cdc.gov/shingles.

 
 

 

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