What Is Shingles? What Are Its Symptoms? A New Vaccine Now Makes Prevention Possible

What Is Shingles?

Shingles, medically called herpes zoster, also commonly known as night burn or belt disease , is a viral infection causing a painful rash. Shingles is caused by Varicella zoster virus (VZV) ; this virus also causes chickenpox. In people who have previously had chickenpox, the virus remains dormant in the body and may reactivate years later, causing shingles.

Shingles generally appears as a one-sided blistering rash affecting a particular area of the body. Usually appearing in a belt-like pattern on the right or left side of the trunk, the rash can also occur on the back, chest, face or neck. Shingles rashes can cause severe skin pain, burning, tingling and itching.

What Causes Shingles?

Shingles, like chickenpox , is caused by Varicella zoster virus (VZV) . Almost anyone who has previously had chickenpox can develop shingles, although not everyone does. After chickenpox resolves, the virus can settle in the nervous system and remain dormant for years. A weakened immune system, stress, illnesses or certain medications can trigger the virus to reactivate and cause shingles.

Risk factors for shingles:

• People over 50
• A weakened immune system (conditions such as cancer, HIV/AIDS and organ transplantation)
• Intense stress and fatigue
• Medicines that suppress the immune system (corticosteroids, chemotherapy drugs)
• Chronic diseases (such as diabetes and heart disease)

How Is Shingles Transmitted?

Shingles itself is not directly contagious, but during the active rash phase, direct contact with fluid leaking from blisters can transmit chickenpox to people who have not previously had it. Shingles is not transmitted through breathing. People in contact with shingles patients, particularly children and immunocompromised individuals, should therefore be careful.

What Are the Symptoms of Shingles?

Symptoms of shingles include:

• Severe pain (usually beginning before the rash appears)
• Burning, tingling or numbness
• Red skin rash and blisters
• Itching and skin sensitivity
• Headache, fever and fatigue
• Swollen lymph nodes

Who Is at Risk of Shingles?

• People over 50
• People with weakened immune systems (cancer patients, people with HIV/AIDS, organ transplant recipients)
• People with stressful lifestyles
• People taking immunosuppressive medicines (such as corticosteroids and chemotherapy)

Ways to Prevent Shingles

• Getting the shingles vaccine (particularly recommended for people over 50)
• Keeping the immune system strong
• Avoiding stress
• Eating regularly and healthily

What Are the Complications of Shingles?

• Postherpetic neuralgia (persistent nerve pain after shingles)
• Eye involvement (ocular shingles) and vision loss
• Nerve damage
• Bacterial infections

Shingles can cause serious complications if it is not diagnosed and treated early. The disease may be more severe, particularly in people with weakened immune systems. It is therefore important to consult a healthcare professional without delay when shingles symptoms are noticed.

Shingles Treatment

Treatment for shingles can shorten the duration of the disease and reduce its severity when it is diagnosed early and treatment is applied correctly. Treatment generally uses antiviral drugs . These medicines ease the disease's effects by stopping viral replication.

Methods Used to Treat Shingles:

• Antiviral drugs: (acyclovir, valacyclovir or famciclovir), when used early, relieve shingles symptoms and help prevent complications.
• Pain relievers: Prescription or nonprescription pain relievers may be used to relieve severe pain.
• Antihistamines: May be used to relieve itching.
• Steroids: May be used under medical supervision to reduce severe inflammation.
• Topical creams: Creams applied to the rash may reduce skin irritation.

The Importance of Starting Treatment Early:

• Using antiviral medicines within the first 72 hours after rash onset has a positive effect on the course of the disease.
• Early treatment reduces the risk of complications such as postherpetic neuralgia.

The Shingles Vaccine Makes Prevention Possible

In 2015, NEJM published a study that informed the entire medical and scientific community about a preventive shingles vaccine. This vaccine was found to be %97 effective in preventing shingles.

Study Type: Randomized, placebo-controlled phase 3 clinical trial

Number of Participants: 15.411 (7698 vaccine group, 7713 placebo group)

Participant Age Group: Aged 50 and older (stratified as 50-59, 60-69, 70+)

Follow-up Duration: Average 3.2 years

Primary Objective: Assessing the vaccine's effectiveness in reducing shingles risk

Results:

• Shingles was identified in 6 people in the vaccine group, compared with 210 in the placebo group.
• Shingles incidence: 0.3/1000 person-years in the vaccine group, 9.1/1000 person-years in the placebo group
• Overall vaccine efficacy: %97.2 (95% CI: 93.7 - 99.0)
• Vaccine efficacy in each age group: between %96.6 - %97.9
• The vaccine has a higher risk of causing mild side effects at the injection site and throughout the body

Conclusion: The study shows a significant reduction in shingles risk in adults aged 50 and older. Vaccine efficacy is similarly high in the group aged 70 and older compared with other groups.

Additional Information About Shingles

• Shingles is contagious. It can be transmitted through contact with fluid leaking from blisters in the rash.
• Shingles usually resolves within 2-4 weeks.
• In rare cases, complications such as nerve pain after shingles (postherpetic neuralgia) may occur.
• Shingles can be prevented with vaccination.