SHINGLES is a painful and debilitating condition which mainly effects older people, yet many Australians seniors are missing out on the chance of free vaccination, according to an article in the latest edition of Australian Prescriber.
Shingles is the common name for herpes zoster and it is caused by a reactivation of the chickenpox virus varicella zoster which most older Australians will have had as children.
The virus can lie dormant for decades in nerve cells near the spine until it is triggered, usually as a result of a decline in immunity due to age or immunity-suppressing medical treatment. You can only get shingles if you have previously had chickenpox but many older people may not remember their childhood illnesses.
Shingles causes a painful, often itchy blistering rash usually on one side of the body, either on the face, chest, back, abdomen or pelvis. The rash can take several weeks to settle. It can also cause postherpetic neuralgia which can cause severe pain or burning sensations on the skin. In one in 10 people, the pain and tingling of shingles can last for months or even years.
The virus can also affects an ophthalmic nerve (herpes zoster ophthalmicus) causing pain, redness and swelling in and around the eye, as well as temporary or permanent loss of vision.
Shingles can also affect the mouth and in some cases the internal organs.
About one in three people will develop the illness at some stage during their lifetime and in Australia around 120,000 new cases of herpes zoster occur each year accounting for approximately one in 1000 of all GP visits.
According to the Health Direct website shingles often occurs with no known trigger. It is more likely to occur if you:
- are 60 years of age or older
- are experiencing physical and emotional stress
- have HIV and AIDS
- have had an organ transplant
- have recently had a bone-marrow transplant
- have a condition which requires treatment that impacts the immune system, such as chemotherapy for cancer
Professor Kristine Macartney, Director of the National Centre for Immunisation Research and Surveillance says people aged 85 and above have a 50% chance of developing shingles.
"Someone with shingles experiences a rash, often with pain which can develop into long-lasting, difficult to treat nerve pain," she said.
"The vaccine reduces the risk of this long-term pain."
The vaccine Zostavax is free for people aged 70 with a five year catch-up program for people aged 71 - 79 years until October 31, 2021. It reduces the risk of shingles by over 50% and makes any cases that do occur less severe.
Only about a third of 70-year-olds in Australia have had the free vaccination.
Zostavax is registered for use from 50 years of age and is recommended in the Australian Immunisation Handbook for all immunocompetent adults aged 60 years and older.
Routine administration from 50-59 years is not recommended because of the relatively low disease incidence and because waning vaccine immunity in the 5-10 years after vaccination would result in insufficient protection when reaching an older age.
Someone with shingles experiences a rash, often with pain which can develop into long-lasting, difficult to treat nerve pain. The vaccine reduces the risk of this long-term pain.
The vaccine has a good safety record in Australia, but it should not be used by people with a lowered immune system.
A new non-live shingles vaccine, not part of the free National Immunisation Program, may potentially be used for people with a lowered immune system. This vaccine is, however, currently unavailable in Australia due to a limited global supply.
If you think you may have shingles, it's important to see your doctor as soon as possible as antiviral medicine given in the first three days from the start of the rash appearing will reduce the severity of the attack and the risk of post-herpetic neuralgia.
To find out more about the shingles vaccination talk to your GP.
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