Shingles Strikes When Immunity is Weak
Learn About Medicine with Chula Pharmacists: Shingles Strikes When Immunity is Weak
Recently, a friend of mine went to a private hospital for a flu shot. While there, he noticed an advertisement for the shingles vaccine, which recommended the shot for individuals aged 50 and above. Curious, he asked me whether he should get vaccinated, what the chances were of contracting shingles, and whether the disease could be fatal. He had heard a common belief that if shingles encircled the body, it could be deadly. Since this is a concern for many, I thought it would be useful to address the topic in this column.
What is Shingles?
Shingles, also known as Herpes Zoster, is caused by the Varicella-Zoster Virus (VZV)—the same virus responsible for chickenpox. After a person recovers from chickenpox, the virus remains dormant in nerve cells and can reactivate later in life when the immune system weakens, leading to shingles.
Over the past decade, shingles cases have been rising in Thailand, particularly among those aged 65 and older. Globally, the incidence rate is 3-5 cases per 1,000 people per year, increasing to 7-12 cases per 1,000 people per year in individuals over 50. Women have a slightly higher risk than men.
Risk Factors for Shingles
Several factors increase the likelihood of developing shingles:
Age – Risk rises significantly after age 50 and is highest in those 80 and older.
Weakened Immune System – Individuals with HIV, cancer (undergoing chemotherapy), organ transplants, autoimmune diseases, or those taking immunosuppressive medications are at higher risk.
Stress & Trauma – Physical or emotional stress can trigger the virus’s reactivation.
Symptoms and Complications
Shingles usually begins with a burning or itching sensation in the affected area. This is followed by a red rash with blisters that appear along a nerve pathway.
Common complications include:
Secondary bacterial infections
Post-herpetic neuralgia (PHN) – Nerve pain that can last for months or even years, especially in older individuals.
Treatment
Shingles is treated with antiviral medications, which are most effective if taken within 72 hours of the rash appearing. The treatment typically lasts 7 days, but may extend to 10 days in immunocompromised patients. The type and dosage of medication depend on the severity of symptoms and kidney function, so it’s essential to consult a doctor or pharmacist before taking any medication.
Additional symptom management includes:
Cold compresses to reduce itching
Pain relief medications such as paracetamol, NSAIDs, or nerve pain relievers
Stronger pain medications for severe cases, as prescribed by a doctor
Maintaining a strong immune system through a healthy diet, adequate rest, hydration, and stress management can also help prevent or lessen the severity of shingles.
Preventing the Spread
Since the virus can spread through direct contact with blister fluid, individuals who have never had chickenpox or the chickenpox vaccine—especially pregnant women, newborns, and immunocompromised individuals—are at risk of contracting chickenpox. To prevent transmission:
Keep shingles blisters covered with a non-stick dressing
Wash hands thoroughly after touching the affected area
Shingles Vaccine
A shingles vaccine is available and is one of the best preventive measures. Recommended vaccines include:
Zoster vaccine, advised for:
Adults 50 and older
Immunocompromised individuals 18 and older
This vaccine is over 90% effective in preventing shingles and post-herpetic neuralgia. It requires two doses, given 2-6 months apart.
One downside is its high cost, but for those who can afford it, the vaccine reduces both the likelihood of getting shingles and the risk of long-term nerve pain, which can sometimes be more painful and expensive to treat than the vaccine itself.
Would you consider getting vaccinated against shingles? Stay informed and take steps to protect your health.
Assoc. Prof. Dr. Nattada Areepiam and Assoc. Prof. Dr. Bodin Tiwasuwan
Faculty of Pharmacy Chulalongkorn University
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