Anthony Ademiluyi
Experts have urged Nigerians to embrace getting vaccinated against shingles, noting that vaccination significantly decreased the incidence and burden of the disease.
They stressed that people with weak immune systems are often more at risk of the health condition, noting that this may be connected to why more cases of shingles are seen among the elderly.
Shingles also known as herpes zoster is a viral infection that occurs due to the reactivation of the varicella-zoster virus (the virus that causes chickenpox).
Speaking with our correspondent, the experts, Consultant Dermatologist, Federal Medical Centre, Ebute Metta, Lagos, Dr. Oluwatoyin Akinsiku, and the Chief Medical Director, Fesock Hospital, Lagos, Dr. Charles Ogueri explained that the disease often comes with pain, noting that it is usually characterised by painful rashes.
Shingles, they noted, can cause severe and long-lasting pain that could be very difficult to treat.
Speaking with Reportr Door HealthWise, Dr. Akinsiku said that shingles occur because of the failure of the immune system to contain latent varicella zoster infection, adding that presentation depends on the immune status.
Dr. Akinsiku explained that people who have had no prior exposure to the condition must have had chickenpox, adding that this is a common presentation in children.
She said: “The reactivation occurs years after primary infection in the setting of immunosuppresion such as diabetes, HIV, use of steroids or other drugs that suppress immunity, concurrent illness and sometimes due to old age.
“Shingles is usually painful and occurs along a dermatome( an area of skin supplied by nerves from the same spinal root). This pain is followed after some days(between 1-10 days) by eruption of vesicles along that same dermatome.
“The pain associated with shingles can sometimes be self-limiting lasting about two weeks but it can also be severe (this is the more common form) and persistent long after the rashes have cleared. It can be associated with headache, photophobia, myalgia and other symptoms depending on the part of the body affected.
The rash, she added, can take up to a month to heal completely, adding that the pain usually persists for more than a month after the rash has even cleared.
Dr. Akinsiku, however, noted that not everybody who has had chickenpox would eventually get shingles.
“It is important to state that not everybody who has had chickenpox will develop herpes zoster. Herpes zoster develops when the immune system is unable to contain the varicella-zoster virus due to immunosuppression from any cause ranging from stress to various illnesses.
Dr. Akinsiku also stressed that older people present more with herpes zoster because of advancing age and declining immunity, adding that the risk of having facial paralysis only occurs when the individual has herpes zoster affecting the facial nerve.
“Patients with facial nerve paralysis can have a hearing impairment, dizziness and altered taste along with paralysis of a side of the face,” she said.
Dr. Akinsiku also disclosed that shingle has no permanent cure, stressing, that hence the need to get vaccinated against it.
“There are vaccines available to prevent its occurrence when an individual has had a primary varicella infection. The vaccines are: Varivax for children and Shingrix for older adults
“This is because Herpes Zoster can occur as long as the risk factors are present and active. However, when it presents, it should be treated immediately to prevent complications.
“Herpes zoster is not hereditary although some studies have shown that there are racial differences in its occurrence,” Dr. Akinsiku said.
Also speaking with our correspondent, Dr. Ogueri noted that while shingles is the English name for the health condition, it’s actually called herpes zoster infection medically.
“So you can call it chicken pox, you can call it herpes zoster, you can call it shingles but they are outward diseases mostly called chicken pox. But the most important thing is that it is actually caused by a viral infection.
“There is no specific of where it occurs or the age group but the majority of the risk factor occurs when the immune system tends to be low. You can see it in people that are older, people that have some sort of health condition like cancer, or HIV, and those that are on steroids.
“A child that didn’t get vaccinated against chickenpox may have the infection. An adult that has some other viral infection can also be predisposed to having that. But many people that get shingles don’t actually fit into a category. It can affect the young, it can also affect the adult”.
Dr. Ogueri explained that there are antiviral drugs that can however help to heal shingles faster and cut the risk of complications, but stressed the need to get vaccinated to prevent it.
“Like I said, part of the treatment first of all is the young can be vaccinated against this virus. They have to get immunised, they have to be vaccinated so that they don’t come down with the infection.
“One of the ways of preventing shingles is to, first of all, get vaccinated. It is considered to be 90 per cent effective. It prevents shingles and its complications in adults of about 50 and older. Even those that are 60 years and older.
“Another way to prevent is to also boost the immune system, because that is one of the risk factors, especially when the immune system is actually low. It can predispose the patient to infections. So one has to actually prevent the immune system from being low and again because of the high contamination of these infections, one has to also be careful so as not to get in touch with someone that already has Shingles. If someone has it and he is aware and you go closer to the person, you can get it because it is highly contagious,” he said.
Dr. Ogueri, however, explained that shingles will come with pain so painkillers are often given to those with the condition.
“Sometimes it may come with fever and all that that you can use anti-inflammatory medications. But antiviral drugs that physicians can prescribe are one of the first-line treatments. It helps to ensure that healing is faster and also cut the risk of those complications,” he said.
According to a study published by the National Institute of Neurological Disorders & Stroke, Shingles infection cannot occur in persons not previously exposed to chickenpox.
Another study published by the Centre for Disease Control revealed that Postherpetic neuralgia is the most common complication of herpes zoster.
PHN is pain that persists in the area where the rash once was for more than 90 days after the rash onset. PHN can last for weeks or months, and occasionally, for years. the study says.
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