SEVERAL years ago, the host of a popular late-night show in the US said he had shingles once and immediately, the female guest somewhat referred to shingles as a form of STD or sexually transmitted disease.
Of course, the host vehemently denied that shingles is an STD.
Shimmering facts about shingles
CONTRARY to the late-night show guest’s belief, shingles is definitely not a disease caused by unsafe copulation. Also known as “Herpes Zoster,” shingles is caused by the varicella-zoster virus, the same virus that can cause chickenpox. Health experts said that those who have had chickenpox before are those who may contract shingles since the virus lies dormant in the nerve tissue and may resurrect several years later. It is also a painful and debilitating viral infection that when overlooked, may result in serious complications, and may put to risk the health of many who suffer from it, if unattended properly.
Infectious disease specialist Dr. Rontgene Solante said that once the virus infects the body, it does not go away and will stay there and reactivate once the person reaches a particular age group or when the body’s immune system weakens. “You might ask where does the virus hide in the body. Well, it’s really an intelligent virus because it hides in the body’s central nervous system,” Dr. Solante commented in his presentation during the launch of the “Sabi Nila: The Truth About Shingles” nationwide awareness campaign organized by global biopharma company GSK and several health experts.
He cited global data which showed the incidence of zoster increases with age. Although those aged 30 or 40 years may be vulnerable to shingles, once one reaches the age of 50, the risk increases exponentially. “If you are aged 50, 60, or 70 and 80 years old, you are also prone to the complications of zoster, which is PHN or Postherpetic Neuralgia that can extend for a longer period of time.”
Dr. Solante said that before, they thought that age may be a triggering factor to reactivate zoster or shingles, but there are also other conditions, especially for those aged below 50 years old. These include chronic respiratory condition, or those with asthma, smokers, COPD or chronic obstructive pulmonary disease, diabetes, those infected by Covid-19 due to decreased immune response, HIV-AIDS, auto-immune disease like rheumatoid arthritis, steroids use, those with chronic renal disease.
“These are the underlying conditions where people don’t need to be 50 years old and above to have shingles,” Solante averred.
Manifestations, complications of shingles
THERE are several stages, Dr. Solante said, before the symptoms of shingles are felt. There is the “prodromal” stage, which is before the appearance of the shingles rash. This is where the patient suffers from headache, sluggishness, and to some, loss of appetite, and then an abnormal sensation on the site of the rash.
After that is the acute phase, which he said will last two to four weeks, and this is the time that patients will think it’s shingles because of the presence of a vesicular rash, which appears on only one side of the body. “It can’t appear on two sides of the body because it involves a specific area of the body’s nerve, and then associated with severe pain. Once the rash appears, the level of pain intensifies where patients will even find it difficult to dress up or do household chores,” Dr. Solante explained.
Then after one month, there comes subacute herpetic neuralgia (SHN), which comes with a tingling sensation at the rash area, which can be so disturbing that the patient cannot sleep or move with ease or can even lead to depression.
“The pain can really affect the normal living function of a patient, and the shingles complication can extend beyond three months or what we call PHN, featured with indescribable pain, with no treatment since the pain can be abated temporarily, which can last, for some, even for years,” Dr. Solante emphasized.
Patients are also advised to refrain from touching or worse, scratching the surface of the rash for it might cause some deformities or scar in the skin, and shingles is really beyond the appearance of rash. “When we have patients with shingles, we just don’t talk about the rash but also the complications, and some patients need to be hospitalized because of those complications.”
There is also the Herpes-Zoster Ophthalmicus which affects the nerve endings of the eyes, which may appear as lesions around the eye. But the danger there, Dr. Solante noted, is that it can also cause blindness in some patients and is quite difficult to treat. Other complications of zoster are inflammation of the brain or encephalitis, the Ramsay Hunt Syndrome or the paralysis of half of the face, which can cause distortion in hearing, and happens mostly on the elderly, Bell’s Palsy or weakness of one side of the face, or even cardiovascular/cerebrovascular events.
“There is now a direct correlation between shingles and stroke because the virus can also penetrate the blood vessel where it will transfuse the brain. One may not be hypertensive; it’s really about the virus causing the stroke that is common now in the above-50-year-old bracket,” Dr. Solante said.
Shingles have many other effects that may not be really visible to others like lack of sleep, no enjoyment of life because of limited mobility caused by pain, scars in the face that may cause embarrassment, performance of daily general activities, mood, working conditions, social relationship. “These are beyond the rash, beyond what we know about shingles. We need to know things that can help bring back life,” Solante averred.
Awareness, making informed decisions
THE many truths about shingles that the public does not know of is what made GSK mount the “Sabi Nila: The Truth About Shingles” nationwide awareness campaign, with the hope of educating the public about the risks, impact and prevention of shingles, which Solante earlier described as a debilitating viral infection.
The campaign also seeks to show how shingles impacts quality of life and the importance of consulting with a doctor, set right many common misconceptions about the disease and provide reliable information coming directly from healthcare professionals and even those who have, at one point in their lives, suffered from it, like Karen Davila, an award-winning broadcast journalist and shingles sufferer who was present during the launch. She shared her story to stress the importance of awareness about shingles. “I have had it twice. I felt depressed, scared, and honestly ashamed. I would not want anybody to experience that.”
Bottomline, the panelists in the launch emphasized the value of consulting with a doctor first about how to prevent shingles, and that the campaign will surely help provide the public with enough knowledge through educational materials from health experts that will dispel myths and provide accurate and reliable information about shingles so that every Filipino can make informed decisions about their health.