Philip J. Goscienski, M.D.
Most of us over the age of 50 experienced measles, mumps and chickenpox by the time we made it through high school. Since the introduction of the measles vaccine in the early 1960s and the subsequent release of vaccines against mumps and chickenpox, today's newly trained pediatrician may spend years in practice without encountering a single patient with one of these diseases. Once we recovered from mumps or measles we never had to worry about them again. Not so with chickenpox.
Chickenpox is usually a benign childhood disease. By the time the classic tiny blisters have dried up and disappeared however, a few virus particles have taken up residence in certain nerve cells of the spinal cord where they slowly and silently maintain their numbers, awaiting the moment when their host's immune system is weakened. Unchecked, the virus travels down the long strands of nerve cells, most often on one side of the chest or abdomen. When it reaches the skin it produces a rash slightly reminiscent of the original chickenpox but in tight clusters and a stripe-like pattern. Even before the blisters develop the victim may feel a tingling or itchy sensation that soon becomes painful. The discomfort lasts for about 10 to 14 days but occasionally much longer, perhaps weeks or months, even years.
This late development is known as zoster or shingles. Both terms derive from the Greek and Latin words, respectively, for belt because of the pattern on the body.
When the rash occurs on the trunk it's uncomfortable but tolerable with over-the-counter pain relievers. It sometimes appears on the face in a pattern that involves the eye. Besides being especially painful it may be severe enough to permanently damage vision.
Shingles can occur in children but it usually attacks persons over the age of fifty. About 50 percent of adults will have an attack of shingles by age 85. Waning immunity, stress from other diseases such as cancer and certain prescription drugs break down the barrier to spread of the virus. If an antiviral drug can be given within the first 24 hours of the eruption, the illness is usually brief and mild.
The shingles vaccine is strongly recommended for persons over the age of 60. Although it completely prevents disease only about half the time it does make the rash milder and might prevent eye damage. Only one dose is required and side effects are rare.
Philip J. Goscienski, M.D. is the author of Health Secrets of the Stone Age, Better Life Publishers 2005. Contact him at firstname.lastname@example.org.