Shingles- Read this if you are above 50!!

1 in 3 persons above the age of 60 come down with shingles

So I have been doing a lot of things as regards my mother's health. I was able to see a consultant dermatologist and a neurologist. Then, an old friend came, complaining about his erection and numbness on his leg. I remembered him telling me about his blood sugar being on the high side and I told him to do a test to check how bad it is. After seeing the test, I told him to see an endocrinologist immediately.

I came to a conclusion that we all should take time to take care of our bodies while we are young or as soon as we can or else we will face the consequence later in life.

For today, I will be talking about a condition that almost made me cry because it happened to my mom. The condition is shingles.

By Fisle - Own work, CC BY-SA 3.0, wwikimedia

What is shingles?

Shingles is a condition caused by an infection with the varicella zoster virus. Varicella zoster is the virus that causes chicken pox and once a person has had chicken pox, the person can get shingles.

They appear as rash on the body with some vesicles. The problem with shingles is not the rash, it's the pain.

What causes shingles?

Like I earlier said, shingles is caused by the VZV virus. However, there are things that predispose one to this illness, and they include;

• a weakened immune system from any cause like HIV, cancer or diabetes
• Stress
• Increasing age with the highest risk in people over the age of 50
• Chemotherapy
• A serious physical trauma.
  -Long-term use of steroids: steroids are notorious for suppressing the immune system

How common is shingles?

According to CDC, a million cases occur annually. The incidence amongst people aged 60 and above is about 1 in 100 cases.
It is also important to note that 1 in 25 cases with Herpes zoster report complications with post herpetic neuralgia been the most common.

A study done in England showed that women came down with shingles more than men. People with digestive disorders have also been seen to be predisposed to shingles.

How do shingles occur?

First, there is an initial infection with varicella zoster virus. When this happens the person gets chicken pox. When the chicken pox heals, the virus doesn't leave the body and then it goes into the nerve and lies dormant in the spinal cord. When the body's immune system weakens, this virus comes alive and then affects a particular part of the body. Usually it affects just one nerve, which is why the pain is along the line of the rash.

By OpenStax Anatomy and Physiology - CNX, CC BY 4.0, Wikimedia
_{The dermatome is a part of the skin that is supplied by a nerve. The virus affects a dermatome and that is why the rash and the pain is along the dermatome of one side of the body.}

What are the Symptoms of shingles?

When my mother came down with shingles, she was complaining of a tingling and burning sensation on her back that extended to her chest. I didn't understand as her description was vague. Then few days later, she complained of a rash thereafter. I told her to send a picture and it appeared the rash was along a line on her body and did not cross the midline.

This is the typical way shingles may present.
The symptoms of shingles are;

• A rash that is vesicular and is along a line that doesn't cross the midline. The vesicles get burst and crust like chicken pox. The rash can appear on any part of the body, but it commonly affects the trunk. It can affect the eye and render someone blind. When it affects the eye it is called Herpes Zoster ophthalmicus. It can affect the ear and the tongue. When it appears on the tongue, eating becomes difficult.

By Burntfingers - Own work, CC BY-SA 4.0, wikimedia

• There is pain in the area where the rash appears and it is worthy to note that the pain comes first. The pain occurs in this area because the virus affects the nerve that provides sensation to that part of the body. The pain is described as burning or tingling.

The pain and the rash are the main symptoms of shingles. However, there are other symptoms people with shingles experience. They include

• Headaches- I remember my mother complaining of headache on one side of her head
• Fatigue
• Feelings of unwell
• Chills
• Fever-although this is very rare.

Stages of shingles

The national institute of aging deals with conditions that affect elderly people. According to the NIA, shingles have 4 stages
The first stage is the tingling stage, the next stage is the burning stage; then the numb stage; and finally the itching phase.

As a matter of fact, when I told my mum about these stages, she could relate to it.

How long does it take for shingles to heal.

On the average, it takes about 21 days to 35 days to heal.
As I said earlier, the pain starts first and approximately 5 days later the rash appears. The rash has vessicles, and when the vesicles bursts, it forms scabs and finally the scabs heal off. However, the rash might clear off and the pain can remain. When this happens, it is called post herpetic neuralgia. This is the most feared complication of Shingles.

How is shingles treated?

Treatment is mainly focused on clearing the rash, treating the pain by using pain relief and drugs that reduced the activity on the nerve. In addition to this, drugs that prevent the rash from being infected.

Since the causative agent is a virus, it should go on its own. Viruses do not die as a result of antiviral use. However, antivirals can help reduce the severity of the disease.
Vanciclovir and Acyclovir are commonly used in the treatment of this condition.
With Vanciclovir, you use it twice a day but with Acyclovir, it is used five times a day.

Pain relief is the mainstay of management as this is what bothers most patients. They really don't care about the rash. So NSAIDs, opioids will help in controlling the pain.

It is worthy to note that you can't use NSAIDs if you have been diagnosed with peptic ulcer disease. Codeine, Tylenol(paracetamol), and Panadol are safe pain killers.

Antibacterial ointment can be applied to the rash and the crust to prevent it from being infected by bacteria.

Drugs that inhibit the nerves and help reduce sensitivity are used to prevent the pain. Pregabalin and Carbamazepine are common drugs that are used. Although, people complain of light headedness.

It is also important to note that preventive causes of shingles should be treated. For example, a person with diabetes should work on his blood sugar or a person with HIV should be adherent to his medications.

What are the complications of shingles?

pexels

The commonest complication of shingle is post herpetic neuralgia- a condition in which the rash clears up but the pain remains.
Other complications include deafness, blindness, pneumonia nad some skin infections. On rare occasions, a person can come down with meningitis or encephalitis.

Is shingles contagious?

Yes it is. If he fluid from the fluid comes in contact with a person who has never had chicken pox before, the person will come down with chicken pox.

This is also why it is not advisable to nurse a person with shingles in the same place with a baby or a pregnant woman.

It is also important for people with shingles to avoid people who have a weak immune system, like older adults, people with HIV or people taking chemotherapy.

How is shingles prevented?

Prevention of any health related condition begins with health education. People above 50 years should be educated on how to identify the early signs of this disease.

By Whispyhistory - Own work, CC BY-SA 4.0, wikimedia
The CDC recommends that every adult above the age of 50 should take the shingrix vaccine or those above 18 years who are going to be immunodeficient due to disease conditions.

The vaccine is said to be 90% effective and even if you took a varicella zoster vaccine before 2020, you still need to take it.

Complications can be prevented by prompt treatment as soon as you recognize the symptoms.

Conclusion

Shingles is a disease caused by the same virus that causes chicken pox. It happens when an individual is immunosuppressed by conditions like old age, chemotherapy, diabetes and HIV. The earliest sign is a tingling burning sensation around a particular part of the body that doesnt affect the other part of the body. After this a rash appears that doesn't cross the midline. The treatment is mainly the use of antivirals and painkillers. Finally, shingles can be prevented by use of vaccines.

_{stages of my mother's shingles.}