Dormant virus makes its painful return

Remember when you had the chicken pox and your parents assured you once you had them you’d never get them again? Well, guess again. Herpes zoster, commonly known as shingles, is a painful mutation of the childhood ailment.

One of every three people will develop shingles in his or her lifetime and it generally affects men and women over age 50.

Like something out of “Night of the Living Dead,” the virus never actually goes away, lying dormant in the body for years. As a person’s immune system weakens with age, though, it becomes harder and harder to fight off the virus, which leads to the infection.

“Our bodies are able to suppress the infections, but usually not completely eradicate them,” Dr. Thomas Locke of the Clallam County Health Department explains. “Different herpes viruses lie dormant in the system, and as it turns out, the shingles virus lies dormant in nerve tissue. That’s what gives it its characteristic features.”

And because it affects the body’s nervous system, the characteristic features of shingles are pain, pain and more pain.

“People are absolutely miserable. It’s one of the worse, most painful things you can get. Even the strongest painkillers don’t do that good a job at controlling the pain well,” Locke said.

According to Locke, the first sign of shingles is pain, followed by a rash that is very much like a chicken pox rash: red blisters. Shingles derives its name from the pattern the rash takes. Like the shingles on a roof, the blisters form lines along the infected nerves. Locke, however, says that half the time the rash isn’t present, making shingles a complicated disease to diagnose.

“Sometimes the intense pain of shingles without a visible rash leads on a long diagnostic odyssey,” Locke said.

In the majority of cases, shingles subsides after only a few weeks, but 10 percent to 18 percent of the time the pain lasts for months, even years after the rash has disappeared.

“That’s an example of where your body’s immune system is able to react enough to take care of the skin rash, but the activity of the virus in the nerve continues,” Locke said, adding that if shingles infects facial nerves, it can lead to blindness or facial paralysis.

Until two years ago there was no way to prevent shingles, but today there is a vaccine. Available at area pharmacies, the vaccine is pricey, costing $165-$170 due to the fact that for the time being there is a limited number of available vaccines.

“One of our hopes in public health is that as it’s used more widely the cost will come down. When they develop a mass market, they can afford to sell it at a much lower rate,” Locke said.

The vaccine is only 50 percent effective, meaning that regardless of whether the vaccine is taken, there’s still a possibility that the dormant virus will come to life. The vaccine also has a 60-percent to 65-percent success rate of preventing repeat infections and post-shingles pain.

While Locke recommends that men and women over 60 be vaccinated, he says it’s not for everyone. The vaccine is actually a super dose of live virus meant to stimulate the immune system, so people with very weakened immune systems — such as cancer patients undergoing chemotherapy — might not be able to take the vaccine.

The vaccine’s cost is sometimes covered under Medicare Part D, depending on who your prescription provider is. Prescriptions, under Medicare, are contracted out to private insurance providers.

Locke believes that even if individuals have a strong and healthy immune system, they still should be vaccinated.

“The worse a disease is, the more benefit you get preventing it and that’s what the situation is here. Even though it doesn’t offer 100 percent immunity, it certainly reduces your risk,” Locke said.

With a chicken pox vaccine having been introduced in 1996, Locke says that the country will see a steady drop in the number of shingles cases from generation to generation until perhaps this dormant virus will finally be dead.

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