For some people, a childhood chicken pox infection can lead to a shingles infection later in life. The virus Herpes Zoster causes chicken pox, and lies dormant in a person's nerve roots after the body clears the initial infection. When the virus reactivates years or decades later in a single nerve root, the resulting infection is known as shingles.
"It's estimated that up to 25 percent of people age 60 and above will develop shingles in their lifetime. The major complication is pain, that can be very difficult to treat and to control," said Dr. Casmiar Nwaigwe, infectious disease specialist for Trinity Health in Minot.
"Complications can also occur depending on what part of the body the virus affects," he added. "Involvement in the eye can lead to impaired vision in that eye."
Katina Tengesdal/MDN - - Dr. Casmiar Nwaigwe, infectious disease specialist for Trinity Health, prepares a syringe with a shingles prevention vaccine.
The virus reactivates because a person's immune system has weakened. Shingles can cause severe infections in people with AIDS, weakened immune systems, or with forms of leukemia. It can also affect those who are taking transplant medications or other medications that weaken the immune system.
The virus reactivates in a single nerve root, and the initial symptoms a person experiences may include pain or tingling in that nerve root, followed by a rash. The rash may occur on any area of the body, causing vesicles, or blisters, that dry up after several days. The virus can cause pain, with chronic pain being more likely in an older person or a person with a suppressed immune system.
"As you get older, and the immune system is no longer as robust, and the virus can come back as shingles," Nwaigwe said. "The virus regrows from the nerve system. It starts with pain, then develops a rash with vesicles (blisters)."
"When you develop a rash and the vesicles rupture, you might also develop a secondary bacterial infection," he said. "Some people can develop post-herpetic neuralgia after the infection, a disabling pain that can last for months or years."
Those who have shingles can also transmit the virus to others.
Shingles treatment is mainly focused on lessening pain, though some people may need antiviral medications. Prevention is the best focus for avoiding shingles.
A shingles vaccination was licensed for use in 2004 for use in people 60 and over who have had chicken pox, and who have no contraindications to being vaccinated.
"The vaccine was licensed to decrease the incidence of shingles, but even with the vaccine, you can still develop it," Nwaigwe said. "The vaccine can decrease pain when you do develop shingles."
"Getting the vaccine re-challenges the immune system to make more antibodies against the virus," he added. "It's similar to the chicken pox vaccine, but that vaccine has less viral particles than the shingles vaccine."
Taking prevention steps against the initial virus infection, chicken pox, can prevent complications later in life.
"Since there is no cure (for the virus), prevention is the best medicine," Nwaigwe said. "Starting from childhood, get the chicken pox vaccine. If you can prevent chicken pox, you can prevent shingles later on."