About one-third of Taiwanese are likely to develop shingles, also known as herpes zoster, in their lifetime, and about half of people aged 50 or older who contract the disease could develop post-herpetic neuralgia (PHN), a long-term nerve pain complication, the Taiwan Immunization Vision and Strategy (TIVS) said on Wednesday.
The group advises people to get a shingles vaccination.
Shingles is caused by the reactivation of the varicella-zoster virus — the same virus that causes chickenpox — and often occurs when the immune system becomes weakened.
Photo: Lee I-chia, Taipei Times
Studies show that 32.2 percent of Taiwanese are likely to develop shingles at some point, said TIVS honorary chairperson Lee Ping-ing (李秉穎), a pediatric and infectious diseases specialist.
Shingles can occur in people of all ages, with the risks increasing with age, he said.
After people contract chickenpox and recover from the illness, the virus remains in the body, but lies dormant — mainly in the dorsal root ganglion, or spinal nerve root, Lee said.
When the virus is reactivated, it travels along the nerves to the skin, causing itching, painful rashes and blisters, he said.
The symptoms can also include tingling, burning sensations or stabbing nerve pain, along with fatigue, he said.
People aged 50 or older, those who have had a stem cell or bone marrow transplant, cancer patients who are receiving chemotherapy, and people who are immunodeficient are at a greater risk of contracting shingles, he added.
Most people recover from shingles within a few weeks, with or without antiviral drug treatment, but for some people, especially those with weaker immune systems, the ailment can damage nerve fibers and lead to post-herpetic neuralgia after the rashes and blisters disappear, he said.
The severe nerve pain from post-herpetic neuralgia can significantly disturb sleep and quality of life, he added.
Chen Chih-jung (陳志榮), a professor and attending physician at Linkou Chang Gung Memorial Hospital’s pediatric infectious diseases division, said the symptoms of shingles usually appear on one side of the body, but can also spread to the face, affecting a person’s vision and hearing.
“More than 50 percent of patients with shingles who are aged 50 or older might suffer from PHN,” he said, adding that some patients describe its pain as similar to childbirth, but can continue for months or even years.
Antiviral drugs for treating shingles have a limited effect, and the ailment could lead to post-herpetic neuralgia, so getting vaccinated against shingles and PHN for people aged 50 or older is a better option, he said.
There are two types of zoster vaccines — a live attenuated vaccine and a non-live virus recombinant vaccine, he said.
The live attenuated vaccine is similar to the varicella vaccine for chickenpox, but at least 14 times its concentration, and it can reduce the chance of developing shingles by about 50 percent.
However, that vaccine is no longer available for use in the US.
The newer recombinant vaccine has proven more than 90 percent effective in preventing shingles, and about 80 percent effective against post-herpetic neuralgia, he said.
While shingles is rarely life-threatening, and the non-live virus recombinant vaccine is not yet covered by the National Health Insurance, people aged 50 or older or who have a higher risk of contracting the disease should consider vaccination to reduce the risk of lasting pain from post-herpetic neuralgia, he said.
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