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BAYWEST MEDICAL NEWS, Preventative Health

Shingles by Dr Jane Atkinson

 Lately quite a few patients have asked about the shingles vaccine- should they get it?  What does it cost? How long is the course?

You probably know someone who has suffered from shingles, more officially called varicella zoster, if you haven’t had it yourself. If you’ve ever seen it you know how unpleasant it can be.

Called Shingles from the Latin root cingulate meaning to encircle or girdle, that describes a common presentation of the disease.

If you have had chicken pox at any stage, you could develop shingles many years later. The infection is a reactivation of the chicken pox (varicella) virus which has been hiding in your body, just biding its time until you are run down, have some other severe illness, or undergo some trauma or stress. Sometimes we don’t discover the why- it’s just out of the blue.

Patients sometimes come in with a burningly sore or itchy area of skin, quite well defined, and it can be anywhere on the body. No rash at first, and this can lead to your doctor barking up the wrong tree- getting scans and blood tests, to no avail, until finally the rash itself erupts. It’s often an angry red crusting and weeping chain of lesions in the area that was previously sore. At last a firm diagnosis can be made, and if you get to the doctor within 3 days of the rash breaking out there is good medication to help.

Coping with the pain is a challenge because it is constant- nothing much eases it, although many medicines and ointments are tried. Treatment is tailored to you. Three weeks later you will be feeling better by and large, but some unlucky people have a persistent neuralgia, which will need longer term management.

The best option really is not to get it at all if you can help it and indeed that’s what the vaccines are about.

There are two vaccines- Zostavax and Shingrix. Both are expensive, more than $200 per dose, and neither is 100% effective. But vaccinated patients tend to have a shorter, milder illness, with fewer long-lasting symptoms.

If you are over 70, your Zostavax is fully funded by our health system, and only a single dose is needed.

The Shingrix has slightly improved effectiveness, and has the advantage that it can be given to immunocompromised people- those on anticancer drugs for example.

However the Shingrix is a two dose course, and it is not subsidised at any age as yet, and per dose is a comparable price to the Zostavax.

Ask about vaccination-  the proverbial ounce of prevention is better than a pound of cure.


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