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What You Should Know About Shingles

Tribune photo by VICTOR JUNCO

Shingles is a painful skin rash caused by the varicella-zoster virus, the same virus that causes chickenpox.

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By JANIS D. FROELICH

The Tampa Tribune

Published: June 20, 2008

I was near the back row of my Jazzercise class, making up a little ditty like I normally do, when the instructor went into high-kick mode.

"I beat the shingles. I beat the shingles," I sang to myself, exercising in pure Rockette style.

Sure, I'd been down and out for about two weeks with a painful rash caused by the varicella-zoster virus, the same virus that causes chicken pox. That nasty virus, it turns out, had lain dormant for years in my nerve tissue, until one day, after a bout with bronchitis that left me feeling rundown, shingles wrapped my right leg in a cluster of blisters.

I was bedridden for a few days in a sweaty collapse, like some poor peripheral character in an old English novel. I missed a week of work recovering.

But I bounced back, thanks to a good antiviral medicine. It also helped that I could wear skirts and shorts as the painful scabs healed. A prescribed topical cream helped a lot; there was no scarring.

So about two weeks later, there I was, doing heel-toe jumps in Jazzercise.

And that should have been the end of it. But it wasn't.

The next day, I had an unnerving numbness from my waist and down the right side to my foot. So, I ran (on my good foot) to my doctor. She took one look at me, asked me to walk a short distance and when she saw I was slightly dragging my foot, she called a neurosurgeon.

It's the aftermath of shingles, he declared. Pain after shingles, called post-herpetic neuralgia, is common. The older you are, the more likely you are to have post-herpetic neuralgia, and it's more likely it will be severe.

The numbness will work itself out in about six weeks, the consulting doctor said. His medical advice: Don't fall over yourself.

That was two years ago, but shingles Part I and shingles Part II left an impression.

I looked for information on the Internet, but nowhere could I find a chatty first-person story that I could relate to, a comforting "I-survived-this-and-you-will-too" tale. Surprising, as there are an estimated 1 million cases of shingles - also called herpes zoster - in the United States each year.

Anyone who has recovered from the chicken pox can develop shingles, even children, but it's more common in people 50 years old and older. People who have a medical condition that keeps the immune system from working properly (cancer, leukemia, lymphoma), or who have received immunosuppressive drugs are also at greater risk.

Shingles can be difficult to diagnose. Sometimes the rash is not so robust; and many skin conditions resemble shingles and could be confused for it.

The rash usually starts on one side of the face or body. The blisters will scab over after a few days, and will clear up within two to four weeks.

The U.S. Food and Drug Administration recommends getting treatment 72 hours after the blisters appear, said spokeswoman Rita Chappelle. Check out the agency's Web site, www.fda.gov, keyword: shingles, to find lots of information.

The risk of spreading shingles is low if you keep the rash covered. Once the rash has developed a crust, the person is no longer contagious. And getting treatment quickly will shorten the length and severity, the Centers for Disease Control and Prevention advises.

The good news: According to the CDC, a second or third case of shingles is rare.

And you may be able to avoid it altogether.

Have you seen those advertisements with a miserable-looking older lady and the headline "Avoid Shingles Pain?" It's for Zostavax, a vaccine the FDA licensed right around the time I got shingles. The ad says a shot of Zostavax reduces the risk of shingles in people age 60 or older.

According to the National Institute of Neurological Disorders and Stroke Web site, Zostavax cuts the expected number of cases of shingles in half. And for those who still get shingles despite immunization, the case is usually mild.

But the shingles vaccine isn't cheap or easy to get. Danita Kessner, a manager for Belleair Bluffs-based First Link Medical and Preventmed Direct, the people behind the shingles ad, says many doctors are choosing not to stock Zostavax because it is expensive ($250 to $400 per shot), and not all private health insurers cover the cost.

Kessner said her mother had shingles, and her son got it when he was 8. She used an aloe-based soap and gel and said that seemed to help heal the scabs.

My late father had shingles on his chest, so it was difficult for him to wear shirts for a few weeks. And right around the time I had shingles, an elderly neighbor had a bout. He disappeared indoors for the longest time. I saw him in early fall at our polling site, and the shingles scabs were very close to one eye. The poor man winced in pain as we chatted.

People hear horror stories about shingles from friends and family, Kessner said, but they don't necessarily know what it is when they get it and they wait too long for treatment. I went to the doctor within a few days of noticing my blisters, and I got the first dose of my antiviral medicine right on the spot.

Exercise also helped me through. I knew I had to continue building myself up. Lying in bed ill is not the fun it was as a kid when missing school was involved.

SHINGLES FAQs

What is shingles?

Shingles, also called herpes zoster or zoster, is a painful skin rash caused by the varicella-zoster virus, the same virus that causes chickenpox. After a person recovers from chickenpox, the virus stays in the body. Usually the virus does not cause any problems; however, the virus can reappear years later, causing shingles. Herpes zoster is not caused by the same virus that causes genital herpes, a sexually transmitted disease.

What does shingles look like?

The rash starts as blisters that scab after three to five days. The rash usually clears within two to four weeks. Before the rash develops, there is often pain, itching or tingling in the area where the rash will develop. Other symptoms of shingles can include fever, headache, chills and upset stomach.

Are there any long-term effects from shingles?

Very rarely, shingles can lead to pneumonia, hearing problems, blindness, brain inflammation (encephalitis) or death. For about one person in five, severe pain can continue even after the rash clears up. This pain is called post-herpetic neuralgia. As people get older, they are more likely to develop post-herpetic neuralgia, and it is more likely to be severe.

How common is shingles?

In the United States, there are an estimated 1 million cases of shingles each year.

Who gets it?

Anyone who has recovered from chickenpox may develop shingles, including children. However, shingles most commonly occurs in people 50 years old and older.

Can shingles be spread to others?

Shingles cannot be passed from one person to another. However, the virus that causes shingles, VZV, can be spread from a person with active shingles to a person who has never had chickenpox through direct contact with the rash. The person exposed would develop chickenpox, not shingles. The virus is not spread through sneezing, coughing or casual contact.

Is there a treatment for shingles?

Several medicines, acyclovir (Zovirax), valacyclovir (Valtrex) and famciclovir (Famvir), are available to treat shingles. Call your doctor as soon as possible to discuss treatment options.

Source: Centers for Disease Control and Prevention

Reporter Janis D. Froelich can be reached at (813) 835-2104 or jfroelich@tampatrib.com.

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