If you are at least old enough to remember Captain Kangaroo or Mister Rogers, then you probably remember when chicken pox was a right of passage for young children.
When I was sick and covered with this unpleasantly itchy rash, I remember spending nearly a week lying on the couch watching TV. I’m told that parents used to intentionally expose their children to the illness when there was an infected child in the neighborhood, to “get it over with.” I don’t think my parents did that to me. I just got it in the usual way. Pretty much every kid did.
You don’t hear much about chicken pox anymore. The reason is that a safe and effective vaccine, implemented in the United States in the mid-1990s, has significantly reduced the frequency of this disease.
However, we are still dealing with the consequences of chicken pox virus, known as varicella zoster. As a member of the herpes virus family, the varicella zoster virus tends to stick around in our bodies, residing in our nerves, even after the original chicken pox infection has been controlled by our immune system. A healthy immune system is actually quite effective at holding the virus at bay for decades, and rarely do we experience problems from the virus again.
Unfortunately, varicella zoster virus doesn’t just cause chicken pox. It is also the responsible agent for a painful condition known as shingles.
Shingles, also known as zoster, typically affects people with a compromised immune system, either because of disease or advanced age. When the immune system is weaker, it can let down it’s guard, which gives the virus an opportunity to become active.
Shingles is usually diagnosed as a painful rash consisting of groups of small blisters on a base of red skin. These may be isolated or may extend in a band that represents the distribution of a single peripheral nerve. It’s not uncommon for this to occur on the chest or upper abdomen, although other sites may be affected. Involvement of the eye is considered an emergency and requires immediate medical attention.
Sometimes, the rash of shingles is preceded by abnormal sensation in the areas where the rash later occurs. This may include itching, tingling, pins and needles sensation, or a burning type pain.
Ask anyone who has had shingles, and they will generally tell you that the pain was the worst part of it. While this usually resolves with the rash in a week or so, some sufferers experience pain long after the rash has resolved. This is a condition known as post-herpetic neuralgia, and it is the most significant consequence of shingles.
Fortunately for older adults who are at higher risk for shingles, there is a vaccine available to boost the immune system and attempt to prevent it. The Centers for Disease Control and Prevention recommends vaccination in all adults age 60 years and older. In this age group, studies have shown the vaccine to be effective at preventing shingles in more than half of recipients. The vaccine also has been shown to reduce the rate of prolonged nerve pain from shingles by two-thirds.
Dr. Matthew A. Clark is a board-certified physician in internal medicine and pediatrics practicing at the Ute Mountain Ute Health Center in Towaoc.
