The Herpes Zoster virus: Shingles
Blog vol 5.39. The Herpes Zoster virus: Shingles.
When we look back at the roaring ‘20s, that is the 2020s, one word that will come to mind will be the five letter word, “VIRUS”. Start your next Wordle with that one, but I get the credit if you get it in one try! We started with the Corona virus, COVID 19, have been watching for the next H5N1 bird flu virus, and continue our wrestling with the age old and ubiquitous Herpes Virus.
I will once again get on my soapbox about Herpes Zoster, or Herpes III, which causes Chicken Pox in children and can reoccur in adults as Shingles. We are all aware of mass immunization to prevent Chicken Pox, a good thing, because this can prevent us from having the Zoster Virus set up shop in our Dorsal Ganglions. Once this virus is in your system, when you least expect it, or want it, when your immune system is lagging, boom, full blown shingles. One side of your body can be tyrannized by lesions that show up on the skin and even the eye. If not treated the nerve damage can be extensive, deep, and chronic.
VERY IMPORTANT: If you have sores on one half of your body, get to your physician right away and start a dose of Valtrex (an antiviral) to get the viral load down. If the sores show up on your nose or around your eye, get to your eye doctor to reduce the effects of these lesions and to check for glaucoma. This is serious stuff, especially around the eye.
Unfortunately, I have a few patients that I follow for this condition that did not get immediate treatment and now have chronic pain and reduced vision as result. Some have had to have a corneal transplant; I actually saw a patient today who had a transplant for this reason.
The key to this virus is prevention. Prevention. Prevention. We use to have the Zostavax vaccine, a single shot that helped to prevent Zoster from reactivating. Introduced in 2006, it is a live attenuated vaccine, a weakened form of the virus, and it is injected subcutaneously. It was not effective over time and did not work as well with the elderly population. Now we have the Shingrix vaccine, which is a recombinant zoster vaccine and contains an inactivated form of the varicella-zoster virus. Shingrix is injected into the muscle and is administered in two doses over six months.
The good news is that Ontario government will pay for your shots if you are 65-70 and have not received the publicly funded Zostavax. More good news, actually very exciting and interesting, recent studies from Wales have found a positive link between getting the Shingrix vaccination and a reduction in cases of dementia (Read more here). The mechanism is yet to be found but strong causality is noted. (will be watching this)
Another good reason to get the shot.
Hopefully, we can eradicate this one like polio (for those who have never heard, a nasty virus that caused devastating damage to kids and came back to haunt many adults, FDR for one), as well as smallpox, …
Til next week,
the good doctor
