Bolzano – In the past ten years there has been an increase in herpes zoster cases across Italy. This skin disease, also known as shingles, is a viral disease. Characteristic are small painful blisters on the skin surface. The risk groups include people who have already had chickenpox. South Tyrol’s Institute for General Medicine and Public Health provides information on the importance of herpes zoster vaccination.
“Every year around 150,000 people in Italy contract herpes zoster. Here in South Tyrol, every fourth person will sooner or later develop shingles,” warns Dr. Giuliano Piccoliori, Scientific Director of the Institute for General Medicine and Public Health in Bolzano.
“As a family doctor, I’ve recently noticed a greater severity of the physical effects of shingles. This is especially true for the most feared consequence – the so-called post-herpetic neuralgia. This is severe pain following the occurrence of shingles. They are similar to those caused by a burn, sometimes a sting. This has to do with the inflammation of the nerve: This is affected by the reactivation of the varicella virus,” explains Dr. Piccoliori. This type of pain occurs in almost a quarter of cases. They can last a few weeks or months, sometimes even years, if not a lifetime.
“Sleeping” chickenpox leads to shingles
First of all, it must be clarified that nobody can be infected directly with herpes zoster. “Shingles is caused by reactivation of the varicella virus (chickenpox). This virus ‘sleeps’, so to speak, for years – sometimes even for life – in the nerve nodes. Herpes zoster sufferers can only rarely transmit chickenpox to people who have never had varicella or who have not been vaccinated. About one in three carriers of the varicella virus will develop shingles at some point in their lives,” emphasizes Dr. Giuliano Piccoliori, general practitioner and Sprengel hygienist in Val Gardena.
symptoms
The origin of the word ‘herpes zoster’ already describes the main symptoms of this disease: herpes means ‘creeping damage’ in ancient Greek, while zoster means ‘belt’. The form of the rash is also the reason for the word ‘shingles’: The groups of nodules and blisters are arranged like a belt on the reddened skin (hence the term ‘rose’).
“The most obvious symptom of herpes zoster is the appearance of skin lesions in the form of blisters that cause itching. It is characteristic of the zoster rash that it affects only one side of the body. If the blisters – and at least the skin lesions – also affect the other half of the body, it is usually not herpes zoster. In the areas of the body affected by the rash, the pain is manifested by severe burning and itching. Sometimes there is also a fever,” explains Dr. Piccoliori. “Complications can occur, such as zoster oticus, which affects the ear and can lead to deafness, and zoster ophthalmicus, which affects the eye and can lead to blindness in the worst cases,” emphasizes Piccoliori. Both of these developments usually require immediate hospitalization and treatment. In addition, there is the dreaded post-herpetic neuralgia, the chronic and very painful inflammation of the affected nerve. It can be very debilitating and very difficult to treat.
The risk group
People who have a weakened immune system due to other illnesses and health problems (e.g. AIDS, leukaemia, transplants or dialysis) are primarily at risk. Diabetics and the elderly are at increased risk of contracting and developing severe forms of herpes zoster. This can be especially the case if they suffer from chronic heart or lung diseases. However, shingles is increasingly affecting younger people who have not been vaccinated once morest chickenpox. “Beyond that,” says Dr. Giuliano Piccoliori states, “there is already enough scientific evidence to confirm that zoster is more common in those who have recently been infected with COVID-19.”
prevention
In addition to the herpes zoster vaccination, the vaccination once morest varicella (chickenpox), which has been mandatory in Italy for a number of years, is the only possible form of prevention once morest herpes zoster – and that even at a young age. “Basically, it can be stated that any physical and mental stress can ‘wake up’ the varicella virus dormant in the nerve nodes and thereby trigger herpes zoster,” explains Dr. Piccoliori.
vaccination
“For a long time, the only vaccine available was Zostavac, i.e. a weakened live vaccine. The vaccine contains live microorganisms derived from viruses. But these viruses cannot cause the disease,” says Dr. Piccoliori. “The use of this type of vaccine is primarily appropriate for people over 64 years of age. It is also advisable for people over 50 who suffer from heart disease, chronic bronchitis and diabetes,” says Dr. Piccoliori. Six to twelve months must elapse following the zoster outbreak before Zostavac can be vaccinated. A so-called recombinant vaccine with effect enhancers has recently been on the market: Shingrix. This vaccine helps the immune system of people who are already immune to chickenpox to make antibodies once morest the virus. “Vaccination with Shingrix is advisable from the age of 18 for people with congenital or acquired immunosuppression, for dialysis patients, for people with severe forms of herpes zoster or in the case of renewed zoster,” informs Dr. Piccoliori. The vaccinations once morest shingles are carried out by the hygiene services of all South Tyrolean health districts. The Sprengel hygienists only administer the weakened live vaccine.
effectiveness of vaccination
Vaccination once morest shingles can reduce cases of post-herpetic neuralgia by regarding 65 percent and clinical cases of herpes zoster by 50 percent. Vaccinations will be offered free of charge to those at risk and to those over 64 years of age under the state immunization prevention plan 2017-2019.
From: Luke
