Many older adults have asked me questions about shingles, a common viral illness, also known as herpes zoster or zoster. When I tell them that it is a form of herpes, they look at me the way I suppose I looked at a woman when she ordered sweetbreads when I waitress at a deli in Chicago. How could you eat cow brains to a college kid looks like how could I have herpes to a clean cut older adult.
The truth is that while people of any age can get a shingles infection once they have had a chicken pox infection; it is most common in people over the age of 60 (accounting for over ½ of all cases). It also strikes those who have altered immunity due to certain medications or treatments, such as chemotherapy, radiation therapy or steroid treatments or certain chronic conditions.
Shingles usually appears as a blistering rash along one side of the trunk, chest, back or face. There is a test for shingles in case you are not sure what to make of a new rash. It consists of a laboratory examination of cells taken from the skin.
There is also vaccine to prevent shingles, and it has been available for more than two years, but only a small percentage of my clients have reported being vaccinated. Many are distrustful of the vaccine and some think it is too expensive. Because the condition is particularly dangerous on the face (it can affect the eye and lead to temporary or permanent blindness), I urge everyone to get vaccinated.
There is also a risk of developing post herpetic neuralgia (pain, headaches, and nerve problems that occur as a complication of shingles). Post herpetic neuralgia lasts for at least 30 days and can continue for months to years. It most commonly occurs on the forehead or chest. The pain associated with post herpetic neuralgia may make it difficult to eat, sleep, and perform daily activities. It may also increase the risk for depression.
To address the first concern, I will cite to The Shingles Prevention Study, a large government-funded study, found that the vaccine prevented about 50 to 60 percent of shingles episodes in older adults. It also prevented about 70 percent of post herpetic neuralgia cases. Additionally, in the in the May 4, 2010 issue of Annals of Internal Medicine, scientists reported that the herpes zoster vaccine is safe and well-tolerated for most older adults. Finally, the vaccine has been recommended by CDC’s Advisory Committee on Immunization Practices, the American Academy of Family Physicians, the American College of Obstetricians and Gynecologists, and the American College of Physicians.
Please talk to your doctor about this because the vaccine is not appropriate for adults with weakened immune systems and those with allergies to gelatin, the antibiotic neomycin or any component of the shingles vaccine.
The vaccine costs can range from $150 to $300. Private insurance coverage varies. The vaccine is covered under the Medicare Part D drug benefit.
I never had the chicken pox and I never ate cow’s brains so where does that leave me? Can I catch shingles from an infected person? Or can you, my non vaccinated client pass it on to me? It appears only if I come in direct contact with the rash. The upshot? You can sneeze on me, cough on me but you cannot order or eat sweetbreads in front of me.
