The pain is excruciating and can last for months. Shingles can be so bad, some would say that it gives truth to the cliché, “You wouldn’t wish it on your worst enemy.”
Now, older adults might be able to avoid shingles altogether - or at least greatly reduce the pain if they do suffer an outbreak. In May, the Food and Drug Administration approved the first shingles vaccine for people 60 and older.
Ongoing research shows that the vaccine, called Zostavax, cuts the risk of a shingles outbreak in half. In those patients who still had an outbreak, the vaccine significantly reduced the pain.
Shingles, medically known as herpes zoster, is actually a reactivation of the chickenpox virus. What causes that reactivation is still unknown, but the risk of a shingles outbreak does increase with age.
“You cannot get shingles without having had chicken pox,” explains Steven Gordon, M.D., Cleveland Clinic Chair of Infectious Disease. “After you’ve been infected with chicken pox, it remains dormant in what we call the dorsal root ganglia, or spinal nerve. If it becomes activated, it comes out as shingles.”
Thirty percent of us will experience a shingles outbreak at some point in our life. Shingles usually appears as a belt-like rash on just one side of the body. In fact, “zoster” means “belt” in Greek. As the rash fades, a patient often is left with debilitating pain, called “postherpetic neuralgia,” caused by irritation of the nerve roots in the spinal cord. It is present in about 20 percent of shingles cases in the elderly -- defined as anyone over 60 -- and can last beyond 90 days.
In the past, physicians have treated the pain with everything from analgesics, such as aspirin and ibuprofen, to complete nerve blocks. Zostavax is a significant step forward in preventing or, in the event of an outbreak, reducing the pain. Side effects of the vaccine are limited to irritation at the injection site.
Zostavax is approved for people 60 and older who have not had shingles before. Since more than one outbreak of shingles in a lifetime is rare, Dr. Gordon says it would not be appropriate to give the vaccine to anyone who has already had shingles. The vaccine -- which is made from a live form of the herpes zoster virus -- also should not be given to anyone with a compromised immune system, such as from a transplant, chemotherapy or HIV infection.
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This information is provided by the Cleveland Clinic and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition. This document was last reviewed on: 12/1/2006
