1 R Special Advertising Section | Sunday, March 26, 2023 11 When Lisa Drover of Edmonds was 53, she awakened one morning to a vague tingling sensation on her left side and abdomen. By the next day, the sensation had turned into a mild stinging, which became increasingly difficult to ignore. “It felt like a sunburn, but on the inside instead of the outside of my skin,” said Drover, now 59. By the time she was able to see her family doctor, faint pink spots had begun to form in the stinging area. After a brief internet search, the diagnosis confirmed what Drover suspected: She had a herpes zoster outbreak, also known as shingles. Drover had a painful skin rash caused by the varicella zoster virus, the same virus that causes chickenpox. After a person recovers from chickenpox, the virus can remain dormant in the body for many years, until it reactivates and becomes shingles. “Of course I had heard of shingles, but nobody I knew had ever had it, so I thought it was quite rare somehow,” Drover said. “For whatever reason, getting the shingles vaccine was never high on my list of things to do.” “The only way to prevent shingles is the vaccine,” said Dr. Anthony Barnett, who practiced medicine for 10 years at the Swedish Issaquah Campus before joining the concierge practice Seattle Premier Health. A shingles rash usually produces painful blisters that typically develop on one side of the face or body and last between 2-4 weeks. “The worst part about it was that the rash seemed to get worse and worse, and it just went on and on, week after week,” Drover said. “Just getting dressed was painful. Or moving side to side. Or bathing.” In very rare cases, the shingles virus can lead to pneumonia, hearing problems, blindness, swelling of the brain or death. According to Barnett, there’s a limit to what medicine can do to treat shingles, besides prescribing antiviral drugs and letting the virus run its course. “We do want to start treating people as soon as symptoms occur, but we typically would use antivirals, which can probably slow down and sort of abort the outbreak, but more importantly can reduce the risk of a complication called postherpetic neuralgia,” he said. Postherpetic neuralgia, the most common complication of shingles, is long-term nerve pain, sometimes debilitating, that can last for months or years after the rash goes away, according to the Centers for Disease Control and Prevention. About 98% of adults have had chickenpox and are at risk for shingles, according to Washington Department of Health data, and at least 1 million people contract the virus each year in the U.S. About half of shingles cases occur in people older than 60, especially in people who have a weakened immune system, according to the DOH. But shingles doesn’t just affect the aging population. Research has shown that children can catch it, too. In some cases, the shingles virus can produce mild symptoms such as malaise or a general feeling of ! " # $ " # " ! " % $ & ' % # " " " " " " $ " " " " " " " " $ The CDC reports the following effectiveness with the Shingrix vaccine unwellness even before the rash appears, Barnett said. “People can have a prodrome [set of preliminary symptoms] where they can have pain and itching in the area where the rash is going to appear,” he said, an experience consistent with Drover’s symptoms. “On top of the numbness on my side, I felt run down and tired for a couple of days before,” she said. Barnett said the shingles rash typically appears on just one half of a person’s body — abdomen and face are common sites — before eventually blistering and healing over a period of several weeks. For topical relief, the American Dermatological Association recommends calamine lotion, which has cooling properties. Shingles is not particularly virulent, and is very seldom spread by airborne transmission, Barnett said. “Contagion can occur when there is physical contact with the sores, but it’s generally only contagious to people that are naive to the virus — to people who never had chickenpox in the first place,” he added. If a virus-naive person is infected by someone’s rash, that person will develop chickenpox first, and possibly shingles later. The CDC recommends vaccination against shingles for adults 50 and older, as well as those 19 and older whose immune systems are weakened. The shots are given in the upper arm, in two doses separated by 2-6 months. Today’s FDA-approved vaccine is a recombinant vaccine called Shingrix that contains no active virus. However, a live vaccine called Zostavax was in use for years until being discontinued in November 2020 in favor of the new product. Even though Drover is not a likely candidate for reinfection with varicella zoster, she plans to receive the vaccine every five years for protection against postherpetic neuralgia. “It was bad enough the first time,” she said. “There won’t be a second if I can help it.” What to do if you contract shingles To allow your rash to heal quickly, avoid wearing tight clothes, eating unhealthy foods or scratching the rash. Try to stay at home until the rash scabs over. Otherwise, you may pass the virus to another person. Speak to your doctor as soon as you experience the first shingles symptoms. !" # $ " GETTY IMAGES
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