Caring for adults with shingles

My last piece was on how to take care of children afflicted with chickenpox. Today’s piece will be on shingles.

Although the same virus (varicella-zoster virus) causes shingles and chicken pox, they are not the same illness. Chickenpox is usually a milder illness that affects children. Shingles results from a re-activation of the virus long after the chickenpox illness has disappeared.

While it typically lasts about a month for most people, it can also cause severe and long-lasting pain that is very difficult to treat.

Shingles medically is called herpes zoster ,while chickenpox is called varicella-zoster.

Shingles usually affects older people, but it can also occur in healthy younger persons and in children. Those whose immune systems have been weakened by HIV infection, AIDS, cancer, or treatment with certain drugs are also at increased risk of getting shingles.

The torso (chest, trunk) is a common area, as is the face. The virus travels in specific nerves, so you will see shingles on a band on one side of the body. This band corresponds to the area where the nerve transmits signals.

Shingles infection is serious and so it does not require kid gloves treatment. The elders say that lightning never strikes the same place twice. But in the case of shingles infection, this saying is not true as one can be unlucky to have the illness more than once.

One cannot easily contract shingles from an infected person or one who has the disease. But if one has never had chickenpox before, one can be infected with the virus that causes shingles – and come down with chickenpox. The virus does not spread by sneezing, coughing, or causal contact. Rather, it spreads by direct contact with the fluid from blisters caused by the rash that characterises shingles.

Signs and symptoms

Shingles often starts with symptoms such as headache, nausea, fever or chills. Some patients then experience tingling, itching, burning or stabbing pain before the rash shows up. On a few occasions, some patients do not even get the typical shingles rash.

Within a few days or weeks, a rash will develop over the area of pain, which will turn into fluid-filled blisters. A few days after appearing, the blisters may dry out and scabs begin to form where the blisters have been. It usually takes two to four weeks for the rash to heal completely.

Many people recover but some may experience long-term nerve pain that can remain for many months, or even years.

The rash often takes two days to develop. As the virus becomes active in the nerves, there may be pain, tingling or burning in advance of the rash. People who have developed this on the chest have even mistaken this pain for a heart attack.

Prevention

If you have shingles, keep the rash covered and do not touch or scratch. Wash your hands often. Until the rash crusts over, avoid contact with pregnant women, who have never had chickenpox or got the varicella vaccine, people with impaired immunity and premature or low birth-weight infants.

The vaccine prevents shingles in 51 per cent of patients. The number is not great, but it means that half the people who may have had shingles will not suffer with the outbreak.

Someone with shingles cannot spread shingles, but he or she can spread chickenpox. The virus comes from the oozing lesions of the rash. If you have a rash with open sores, you should stay away from those who do not have chickenpox, or wait until the lesions scab clears.

Treatment

There are treatments available for shingles. The severity of shingles varies from person to person and some people will require immediate treatment to help ease its symptoms. A number of medications, injections, interventions and advanced treatments can help the painful condition that comes from shingles.

Compared with other painful conditions, it is a tough type of pain to treat. But, there are advances in the treatment guidelines for these types of pain almost every year and likely many therapies that were not available years ago.

Pain-relieving medications taken orally or applied topically are typically the first option. We then consider more invasive options such as injections in proximity to the area where the nerves exit the spine.

Complication

Most people do not have any long-term effects, but for some people shingles can cause complications.

The long-term nerve pain that some people experience after shingles is known as post-herpetic neuralgia.  This can be a severe, unpleasant and long-term nerve pain. This can last weeks, months or for a few people, even years.

For some people, even a slight breeze against the skin can cause painful. PHN can affect people’s quality of life. A majority of its sufferers say they have less enjoyment of life, as it disrupts their sleep, work and social life.

Sometimes shingles can develop in the eye and/or affect the skin of the eyelid. This can cause severe pain and lead to decreased vision or rarely, permanent blindness in the affected eye. Shingles can also result in other complications such as scarring, skin infections or, rarely, hearing loss.

In conclusion, if you think you have developed shingles, see a doctor as soon as possible. Early treatment may help reduce the severity of the symptoms and the risk of developing complications.

Caring for a child with chickenpox

Chickenpox, a viral illness characterised by a very itchy red rash, is one of the most common infectious diseases in children. It is usually mild but there is a risk of serious complication, such as bacterial pneumonia.

People who have had chickenpox almost always develop a lifetime immunity (meaning one is unlikely to get it again). However, the virus remains dormant in the body. Chickenpox is common among children, but when an adult is infected, it is generally severe and fatal.

Causes

Herpes varicella-zoster virus causes Chickenpox. It spreads by droplets from a sneeze or cough, or by contact with the clothing, bed linens or oozing blisters of an infected person. The onset of symptoms is 10 to 21 days after exposure. The disease is most contagious a day or two before the rash appears and until the rash is completely dry.

Symptoms

Chickenpox appears as a very itchy rash that spreads from the torso to the neck, face and limbs. It can last between seven and 10 days with the rash progressing from red bumps to fluid-filled blisters (vesicles).

Vesicles may also appear in the mouth, on the scalp, around the eyes or on the genitals and can be very painful. The disease is contagious until all the spots have dried up. The virus is also contagious for at least one day before the rash breaks out.

Get medical help immediately if:

• You think your child has chickenpox. A doctor can confirm the diagnosis.
• Chickenpox comes with severe skin pain, the rash produces a greenish discharge and the surrounding skin becomes red.
• It comes with a stiff neck and persistent sleepiness or lethargy. These are symptoms of a more serious illness such as meningitis or encephalitis.
• Your child is recovering from chickenpox and begins running a fever, vomiting, having convulsions or is drowsy.
• An adult family member gets chickenpox.
• You are pregnant and have never had chickenpox. This is so because the unborn child may be at risk.

Treatment for chickenpox

There is no cure for chickenpox, and the virus usually clears up by itself without any treatment. Its treatment focuses on the symptoms in order to prevent complications like pneumonias, shingles, among others. Chickenpox is extremely contagious. Keep your child at home until all the blisters have burst and crusted over.

In addition to over-the-counter painkillers, there is the need to administer an antihistamine on the patient in order to relieve pain, itching and swelling. The patient can use antibiotics if a secondary bacterial skin infection arises or if the person with chickenpox develops bacterial pneumonia.

Home remedies for chickenpox

• Trim the child’s fingernails or cover their hands with hand gloves to keep them from scratching. This can lead to infection.
• Apply cool, wet towels to the skin and allow them to dry.
• Dab calamine lotion on the lesions to relieve itching
• Leave your baby’s nappy off as much as possible to allow the vesicles to dry out and scab.
• Rinse mouth with 1/2 teaspoon of salt in a glass of warm water and use as a gargle to ease mouth sores. In older children, use lozenges or sprays containing a mild anaesthetic.
• Give paracetamol for fever and chickenpox symptoms. If you are pregnant and needs to take painkillers, then paracetamol is the first choice.
• Keep sores clean by washing daily. Apply lotion afterwards.
• It is important for children (and adults) with chickenpox to drink plenty of water to avoid dehydration.

Other treatments

Antiviral medicine: Aciclovir is an antiviral medicine that people with chickenpox sometimes take. Pregnant women if they visit the hospital within 24 hours of the rash appearing can still take Aciclovir. Newborn babies and people with a weakened immune system (the body’s defence system) can also use the drug. The drug is effective for shortening the duration of chickenpox symptoms

Though expensive, patients can receive immunoglobulin treatment in some situations.

In conclusion, as a protective measure, patients are usually required to stay at home to avoid spreading the disease to others. They can also receive treatment in an isolation ward..