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Shingles awareness can prevent long-term pain


The painful, burning twinge and irritated skin that can be early warning signs of shingles are often overlooked or misdiagnosed at the time when antiviral medications can be effective in shortening the outbreak.

Karen Roos, M.D., the John and Nancy Nelson Professor of Neurology at the Indiana University School of Medicine, said she sees about 10 new cases of shingles each month. One person in 100 over the age of 60 typically will develop shingles.

Although a vaccine is available to prevent shingles, Roos said the shingles vaccine is too new to have a proven safety record. She believes there are other effective ways to monitor people at risk for a shingles outbreak.

The herpes zoster virus that causes shingles also causes chickenpox, a disease more common in children. The virus lies dormant in the nervous system and can reactivate as shingles when a person's immune system becomes impaired by age, illness, stress, disease or other factors.

Although shingles can be extremely uncomfortable during the outbreak, long-term neurological pain can persist and be debilitating for months.

"People who are at risk should have their virus antibody levels checked with a simple blood test regularly to see if an antiviral drug should be prescribed to prevent the onset of shingles," said Roos. "People need to be aware of the symptoms, which can include pain or tingling in the back, usually to the right or the left of the midline, and reddened skin in the same area. If caught in time and antiviral medications are prescribed, the shingles outbreak can be disrupted."

Shingles appear on the skin as fluid-filled blisters or a red rash. The most common location for an outbreak is a band, called a dermatome, that follows the nerves that wrap from one side of the spine to the abdomen. The outbreak also can follow nerves that run down the arm or the blisters can appear on the forehead and get into the eye which can cause blindness.

Roos said the chickenpox vaccine decreased the incidence of chickenpox in children, but time has proven individuals need to be immunized more than once to be protected against the disease. Chickenpox is unpleasant for children, but when adults get the disease, it can be much more serious and can cause encephalitis, brain damage and infertility, she explained.

"The message to the public should be that the discomfort and disability caused by shingles can be avoided if people are more aware of the warning symptoms of shingles and if physicians monitor at-risk patients' viral levels and overall immune status," she said.