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Sea Sick: Shingles most common in older adults, weak immune systems

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Sea Sick: by Keith Murray

Last month, a friend called to tell me he had shingles, and no, he was not talking about his roof. Most of us have heard about shingles but few truly understand what it is.

The first question most of us want to know is “Can I catch shingles from someone who has it?” The answer is yes and no.

Shingles is caused by the varicella-zoster virus, the same virus that causes chickenpox. People can catch shingles if they have not had chickenpox or if they have a compromised immune system. The virus is spread through contact with the open blisters of an infected person. Once the blisters scab over, they are no longer contagious.

Shingles occurs when the virus that causes chickenpox reactivates in the body. Most of us had chickenpox as a child and forgot about it. Well, it can come back as shingles. What happens is the chickenpox virus goes to sleep in the nerve roots. In some people, it stays dormant forever. In others, the virus “wakes up” when disease, stress or aging weakens the immune system.

Shingles is most common in older adults and people who have weak immune systems have a lot of stress, an injury or are taking certain medicines. The majority of the people who get shingles will make a full recovery and are unlikely to get shingles again.

According to the Centers for Disease Control in the United States, almost one in three people will develop shingles, also known as zoster or herpes zoster, in their lifetime. There are an estimated 1 million cases of shingles each year in this country.

Anyone who has recovered from chickenpox may develop shingles; even children can get shingles. However the risk of getting shingles increases as a person ages. About half of all cases occur in men and women 60 years old or older.

Early symptoms of shingles include headache, sensitivity to light, and flu-like symptoms without a fever. The patient often feels itching, tingling or pain where a band, strip or small area of rash may appear several days or weeks later. A rash can appear anywhere on the body but will be on only one side of the body, the left or right.

The rash will first form blisters, then scab over, and finally clear up over a few weeks. This band of pain and rash is the clearest sign of shingles. The rash caused by shingles is more painful than itchy.

The nerve roots that supply sensation to the skin run in pathways on each side of the body. When the virus becomes reactivated, it travels up the nerve roots to the area of skin supplied by those specific nerve roots. This is why the rash can wrap around either the left or right side of the body, usually from the middle of the back toward the chest. It can also appear on the face around one eye. It is possible to have more than one area of rash on the body.

Shingles develops in stages:

  1. Prodromal stage (before the rash appears)
  2. Pain, burning, tickling, tingling, and/or numbness occurs in the area around the affected nerves several days or weeks before a rash appears. The discomfort usually occurs on the chest or back, but it may occur on the belly, head, face, neck, or one arm or leg.
  3. Flu-like symptoms (usually without a fever) such as chills, stomachache, or diarrhea. This may occur immediately before or when the rash begins.
  4. Swelling and tenderness of the lymph nodes may occur.
  5. Active stage (rash and blisters appear). Pain, described as “piercing needles in the skin” may occur along with the skin rash.
  6. A band, strip, or small area of rash appears. It can appear anywhere on the body but will be on only one side, the left or right. Blisters will form. Fluid inside the blisters is clear at first but may become cloudy after three or four days. Not everyone will get a rash.
  7. The rash may occur on the forehead, cheek, nose, and around one eye. If the rash happens near the eye, this requires prompt medical attention as vision may be in danger.
  8. Blisters may break open, ooze, and scab over in about five days. The rash heals in two to four weeks, although some scars may remain.

There is a single injection vaccine for shingles. People over age 60 should talk with their doctor about this. The CDC recommends the shingles vaccine (Zostavax) for adults age 60 and older, whether they’ve already had shingles or not.

Trained as an emergency medical technician, Keith Murray now owns The CPR School, which provides onboard CPR, AED and first-aid training as well as AED sales and service (www.TheCPRSchool.com).

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