Shingles by Stan Wasbin, M.D.

What would life be without a little mystery?  I often ask this rhyming question in response to the endless unknowns that riddle the field of medicine.   Herpes zoster, also known as shingles, is reactivated chickenpox.  Why would a virus residing near the spinal cord — but quiescent for decades — suddenly re-emerge to cause a painful and sometimes dangerous eruption on the body’s surface?  While science often is able to answer questions concerning “Who?  Where?  How?  and What?,”  it seems ill-equipped to answer the question “Why?”

Yet the quest to understand nevertheless prompts us to wonder “Why?”  In the case of shingles, why is this condition growing more prevalent in our country — and, at a time when a vaccine is in use to prevent attacks?   And, why does a shingles attack leave its victim with an increased risk of stroke during the next six months?  According to The Journal of the American Medical Association (June 11, 2014, p. 2263), the risk is highest in the first month after a shingles episode, when the patient is 63% more likely to suffer a stroke.

While doctors often are unable to answer why questions, we still can offer useful advice when it comes to shingles:

• An antiviral drug (like Valtrex) can hasten the resolution of shingles, and the sooner it has begun, the stronger the effect.  Moreover, taking this drug for an acute attack of herpes zoster, confers some protection against the increased risk of stroke during the ensuing six months.
• A single shot of the shingles vaccine, which can be given as early as 50 years of age, offers some protection against the illness, and even better protection against one of the dreaded complication of shingles:  post-herpetic neuralgia, horrible pain that persists long after the shingles rash has disappeared.