Shingles (Herpes Zoster) (cont.)

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What can be done for recurrent shingles?

Though most people will experience only one episode of shingles during their lifetime, recurrence can occur in certain individuals. In order to help prevent recurrent episodes of shingles, individuals with no contraindications can receive the zoster vaccine (Zostavax), which has been shown to be effective in decreasing recurrent episodes of shingles. Otherwise, people who do experience a recurrent case of shingles should see their doctor as soon as the rash appears in order to promptly receive antiviral medication.

What is the prognosis of shingles?

Generally speaking, shingles typically resolves within two to four weeks in most individuals. The prognosis is excellent for younger and healthy individuals who develop shingles, with very few experiencing any complications. However, in older individuals and in those with compromised immune systems, the prognosis is more guarded, as complications and more severe outbreaks of shingles occur more commonly in these groups.

Approximately 1%-4% of people who develop shingles require hospitalization for complications, and about 30% of those hospitalized have impaired immune systems. In the U.S., it is estimated there are approximately 96 deaths per year directly related to the varicella zoster virus, the vast majority of which occur in the elderly and in those who are immunocompromised.

Is it possible to prevent shingles with a vaccine?

In 2006, the United States Food and Drug Administration (FDA) approved a shingles vaccine (Zostavax). Currently, the FDA has approved its use for individuals age 50 years and older, and the Centers for Disease Control and Prevention (CDC) has recommended its use for individuals age 60 years and older. It is a live attenuated vaccine that boosts the immune system and only needs to be administered one time. Ongoing studies are underway to determine how long the vaccine confers protection. It has been shown to significantly reduce the risk of developing shingles by about 60%, as well as reducing the incidence of postherpetic neuralgia by approximately 66%.

The shingles vaccine is not recommended for individuals who are pregnant or for those with weakened immune systems from disease or immunosuppressive medications, as it is a live vaccine. It is also not recommended for cases of active shingles or for those who have already developed postherpetic neuralgia. However, even if you have had shingles in the past, the vaccine can still be administered to help prevent future recurrent shingles.

The vaccination can be administered at a pharmacy or at your doctor's office. If you are vaccinated with the shingles vaccine, it is safe to be around children, pregnant women, and immunocompromised individuals, as there are no documented cases of people getting chickenpox from a recently vaccinated person.

REFERENCES:

United States. Centers for Disease Control and Prevention. "Shingles (Herpes Zoster)." <http://www.cdc.gov/shingles/>. May 18, 2012.

United States. NIHSeniorHealth. "Shingles." <http://nihseniorhealth.gov/shingles/aboutshingles/01.html>.


Medically Reviewed by a Doctor on 11/18/2013

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