Most adults over the age of 30 can remember the pain of contracting chicken pox. The isolation from friends, the hideous red spots and the relentless, maddening itch that had parents constantly yelling to “stop scratching!” were the stuff of nightmares. Finally, after the weeks of torment were over, we breathed a sigh of relief knowing we could finally rejoin our friends at school and never have to worry about getting chicken pox again. Right?
Unfortunately wrong. Around the age of 50, many of us start to hear about friends or acquaintances who are missing work and suffering at home with something called shingles (or in medical circles, herpes zoster). And voilà! The spectre of chicken pox once again rears its ugly (very red, uncomfortable and itchy) head.
“Shingles is a painful, blistering rash that develops as a result of the reactivation of the chicken pox virus,” explains Dr. Janet Nairn, a family physician in Guelph, ON. “More than 90 percent of Canadian adults had chicken pox when they were children. When we recover from the virus, it goes into hiding, living in some of the cells of the spinal cord. At any time later in life, it can re-emerge, work its way down a nerve and erupt onto the surface of the skin. The risk of this happening increases as we get older. About 30 percent of adults will develop shingles in their lifetime. The risk rises to 50 percent if we live to 85.”
To make matters worse, there’s really no way to tell whether or not you’re likely to contract the virus and – contrary to chicken pox – you can’t avoid getting shingles just by staying away from those who have it. “Unlike chicken pox, shingles isn’t easily spread from one person to another; you don’t get shingles because someone you know has shingles, you get it because you had chicken pox at some point in your life,” explains Dr. Nairn.
Shingles also occurs more often if the immune system is suppressed, as with diabetes, cancer, kidney disease or stress.
The severity of the outbreak increases with age, she notes. Shingles also occurs more often if the immune system is suppressed, as with diabetes, cancer, kidney disease or stress. It’s believed that the frequency of shingles will increase because we are no longer frequently exposed to chicken pox in the community because children are routinely vaccinated against it. Those kids won’t get chicken pox, and therefore won’t get shingles, but those of us older than 25 will likely get it at some point in our lives.
And it’s not just a painful rush that people with shingles must contend with. There may be other serious complications as well. “Shingles can cause damage to the cornea if the nerve root across the face or eyes is affected,” emphasizes Dr. Nairn. “The most common severe complication of shingles is post-herpetic neuralgia, which is pain in the affected nerve distribution that can persist for months or years after the rash has disappeared.”
While there is not yet a full-proof way to avoid getting shingles (aside from never having had chicken pox as a child), some vaccines have proven to be effective 90 percent of the time at avoiding the disease in clinical trials. While some provincial health plans, like OHIP, will cover the cost of the vaccines for adults between the ages of 65-70, it’s recommended that people as young as 50 get the vaccines.
“The vaccine works by reminding the immune system what the chicken pox virus ‘looks like,’ so the virus is kept contained rather than being allowed to migrate down the nerve root,” says Dr. Nairn.
Zostavax is the only single-shot shingles vaccine, while Shingrix requires two shots. The vaccines are formulated in such a way as to continue to provide immune protection in older seniors as well.
“If you’ve had shingles, however, you should wait a year after the disease subsides before having the vaccination,” says Dr. Nairn.
If you want to learn more about shingles and whether or not you’re a good candidate for the vaccine, speak to your family doctor or pharmacist about getting the vaccine. It may be your best chance of keeping chicken pox a distant, largely forgotten, memory.
