Serene Karplus, Nederland.  He thought it was a tiny bug bite the size of a pinhead – a funny sort of tingling burning itch.

Then a day or two later, about twelve inches further away, he discovered a small cluster of them. He resisted scratching them, but they grew larger on their own and the mild itch became little stabbing pains. Racing off to the doctor, he confirmed his suspicion; he had shingles.

Shingles is the common name for infection by the varicella zoster virus (also called herpes zoster, but not the same as genital herpes simplex). It can appear at any time in an adult who has had the chickenpox as a child. The virus resides in the spine forever and reactivates in the zoster form at a time of stress in adulthood, travelling along nerve paths to the skin. It appears typically as a rash of red bumps or fluid-filled blisters along one side of the body, often around the waist following the rib cage. It can also appear on the face near the eye up into the forehead or along the side of the face. These symptoms may be accompanied by fever, chills, headache, or an upset stomach.

While the bumps will crust over and heal within a week to ten days, the pain in the nerve takes longer to heal, for some it can take months or linger for years. The risks of post-herpetic neuralgia (ongoing pain), vision impairment or hearing and balance loss if the virus is located by the eyes or ears, are among the more compelling reasons to seek immediate medical attention if one suspects they have shingles. The pain alone can drive a person to the doctor quickly. It is important to start medication immediately, as the sooner one starts it, the more effective it can be at reducing the length of time and severity of the initial outbreak, as well as possibly reducing the risks of after-effects, which can include secondary bacterial infections, muscle weakness, immunosuppression, psychological stress, or more severe complications.

The medication prescribed is an anti-viral specific to the herpes or varicella zoster, with the generic names valaciclovir and famciclovir, considered slightly more effective than their predecessor, aciclovir. Topical creams of this are not much help, so oral pills are best. For those in pain, the doctor can prescribe high strength lidocaine or corticosteroid creams or one can try an over-the-counter topical pain and itch relieving gel or cream that contains numbing agents like lidocaine or calamine.

Home remedies include oatmeal baths and cool compresses. It is good to stay active and distract from the discomforts.

It is better to avoid shingles completely. While some research indicates that being around children with chicken pox can boost immunity, there is less likelihood that we can gain such exposure since the U.S. has tried to eradicate chickenpox with vaccines, so fewer children have it. The CDC recommends people ages 60 and older get the shingles vaccine Zostavax, unless they are in any of the few categories that contraindicate it. In a large trial, this vaccine cut the risk of developing shingles in half and reduced the risk of postherpetic neuralgia by 67%.

The vaccine will not treat a current outbreak of shingles, but it may prevent future attacks in those who have already had shingles. It seems to remain effective for about three years, so it may require a booster, but as a newer medicine, duration testing is not definitive. The FDA approved the vaccine for people as young as age 50, depending on a doctor's guidance, but some feel that it has not been tested enough for efficacy in this age range. It is still effective, but less so, after age 80. It costs over $200 and insurance companies tend to cover only after age 60.

All adults are welcome at all Mountain MidLife and Nederland Area Seniors events, attended mostly by folks over age 50. Everyone is invited to all meals at the Nederland Community Center. Please call two days ahead for lunch reservations (a week ahead for dinners and breakfasts if possible) to 303-258-0799. Missed the deadline? Call anyway. Costs listed show first the over-age-60 requested anonymous contribution, then the under-age-60. Please note that all over age 60 are welcome regardless of ability to contribute financially.

With one million new cases per year in the United States, some statistics indicate that about one third of all adults will develop shingles at some time, even if they are otherwise healthy. For those reaching age 85, the likelihood that they will have had at least one attack is 50%. It may be brought on by long-term stress or trauma, steroid medicines, some cancer medicines, or a weakened immune system from illnesses such as cancer or HIV – or even just the cellular changes of aging.

While statistics indicate that age is a factor and that people over 65 have a much higher likelihood of activating the virus, nearly half of cases are in people under age 50. For most people, it only activates once, but some may incur a flareup up a few times.

Let’s all take charge of our own health and initiate a conversation with our doctors about whether to obtain the vaccine for shingles immunity. Avoiding the risk of long-term effects that can occur after the shingles may be worth it.