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Shingles can be deadlier-and more painful-than you think.

Byline: Anne A. Jambora

Surviving chicken pox at a young age will not exempt you from developing shingles later on. If anything, the varicella zoster virus (VZV) that triggered chicken pox-the same virus that causes shingles-is now lying dormant at the root of your nerves, and could make you susceptible to shingles.

Also known as zoster or herpes zoster, shingles is a skin rash so painful that some women, in a 1999 survey in the United States, swore it was more excruciating than labor pains.

A person who has had chicken pox could find the virus reactivated in his/her senior years. The reason is still unclear, since there are cases in which the virus never reawakens at all.

The pain associated with shingles has been described as sharp, shooting and throbbing, often with discomfort subsiding as the rash heals. The nerve pain can be serious and severe and can last for several months or even years, disrupting daily activities and leading to emotional distress, said Dr. Lillian Villafuerte, MD, chair of the Dermatology Section of the Department of Medicine at The Medical City and a faculty member of Ateneo School of Medicine and Public Health.

The rash can last up to 30 days. It begins as a cluster of red spots that, in time, turns into blisters, causing discomfort and pain. Ninety-six percent of shingles patients complain of intense pain.

The VZV often reactivates after age 50, when the immune system begins to weaken. A person with diseases that compromise the immune system, such as diabetes, cancer or human immunodeficiency virus, also becomes more susceptible to the VZV. In the United States, one out of three people develops shingles at some point in their lives, with many occurring in men and women after age 60.

Zeroing in

But unlike chicken pox, where blisters occur all over the body, shingles zeroes in on one spot or one side of the body. The word shingles comes from the Latin word cingulum, meaning belt. It usually breaks out on the torso, and wraps around the waist like a belt.

The physical symptoms look similar to that of chicken pox- raised blisters that burst and ooze fluid before crusting over the open wound.

Blisters scab in about seven to 10 days, and eventually clear within two to four weeks. After this, scarring and other pigmentation changes may occur, said Dr. Rontgene M. Solante, MD, past president of the Philippine Society for Microbiology and Infectious Diseases.

The rash stage is generally the most painful part of the experience.

But before all that happens, patients first experience one or more of the following symptoms: itching, pain or tingling in the area where the rash will develop. Other symptoms include upset stomach, headache, fever and chills.

Dr. Villafuerte said shingles can also have life-threatening complications, like postherpetic neuralgia and bacterial infections, or ophthalmic zoster that can lead to blindness.

But it cannot be passed on from one person to another, and is therefore less contagious than chicken pox. For example, you can't get shingles if someone who has it accidentally sneezes on you. Those who've had chicken pox already have the virus, which may not necessarily be reactivated when one is exposed to another person with shingles.

But the VZV, when the blisters are fresh and oozing, can spread to people who've never had chicken pox or those with compromised immune systems. Those exposed to the VZV who have never had chicken pox will develop chicken pox, not shingles.

One example of this is journalist Barbara Walters, who was hospitalized in 2013 with chicken pox. She was then 83 and has never had chicken pox. When she was exposed to someone with shingles, she contracted chicken pox.

Shingles can be prevented with a vaccine, Dr. Solante said. The vaccine has undergone stringent efficacy and safety trials. They can either prevent the shingles from occurring at all, or make them less painful when they do occur.

Consult with your doctor about what vaccines you must have, based on your health and medical condition.
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Publication:Philippines Daily Inquirer (Makati City, Philippines)
Date:Apr 26, 2016
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