When Declan Costello (50) was diagnosed with shingles, he was relieved that the cause of his unbearable headaches and eye pain was not more serious. However, eight years on he is still on medication to treat the chronic pain he has been left with as a result of the disease.
The sudden attacks of pain caused by his shingles have left him on his knees screaming. He has panic attacks and has had to give up work.
Shingles, also known as herpes zoster, is a viral disease affecting nerves and surrounding skin. It is characterised by a painful rash, usually on one side of the body and most often on the trunk or torso, but it can also develop on the head and neck. Sometimes shingles can develop in the eye, causing severe pain and impacting vision. It can also lead to other complications such as scarring, skin infections or, rarely, hearing loss.
Shingles is a disease surrounded by myths, and new research shows that while all Irish adults aged 50 and over are aware of shingles, most have a limited knowledge of it.
The research, supported by Sanofi Pasteur MSD, Age Action, Chronic Pain Ireland and the Patients’ Association of Ireland, found that 81 per cent of those surveyed were unaware that you could not catch shingles from someone with chicken pox. Shingles is caused by the reactivation of the chicken pox virus within your body, so you cannot catch shingles from somebody with chicken pox.
The virus that causes chicken pox never leaves the body and can reoccur as shingles later in life.
Of those surveyed, only 8 per cent knew that you could not develop shingles unless you have previously had chicken pox. However, in rare cases you can catch (as opposed to develop) shingles from someone with shingles.
Two out of three cases of shingles occur in people aged over 50 and the disease tends to be more severe in older adults. Almost half of those surveyed aged 50 and over who developed shingles had experienced moderate to extreme pain as a result of their disease.
Of those who developed shingles, 41 per cent said the pain they experienced lasted a few days, and 42 per cent said the pain lasted a few weeks. Almost one in five sufferers (18 per cent) experienced pain that lasted more than a month.
Chicken pox
Limerick
GP
Johnny Loughnane
says the research shows a worryingly low level of awareness among those who are at risk.
“The majority of us had chicken pox when we were children, and if you had chicken pox as a child, you are at increased risk of developing shingles. We recommend starting a conversation about shingles with neighbours, friends and family to raise awareness.”
Studies show that 95 per cent of adults have had chicken pox and are, therefore, potentially at risk of developing shingles, and one out of four adults develops shingles in their lifetime. “The old wives’ tale says to run away from people with shingles because the chicken pox virus is in the blisters, but in fact children with chicken pox are far more contagious than an adult with shingles. I saw only one case where a wife got chicken pox from a husband who had shingles, it’s very rare.”
Most people do not have any long-term effects but, for some, shingles can cause complications. The long-term nerve pain that some people experience after the rash has healed is known as post-herpetic neuralgia (PHN).
This is the most frequent complication. It can be a severe, unpleasant, long-term nerve pain that is often described as burning, stabbing or throbbing and can last weeks, months or, for some people, even years. For some, even a slight breeze against the skin can be painful.
“The pain can start several days before the rash appears and it can be very severe, particularly in the elderly. The treatments are poor. The same antivirals have been around for the past 25 years and the most they do is shorten the illness by a small amount.
“Over-the-counter painkillers are ineffective – patients need specific pain medication that target neuropathic pain. This can help ease the pain, but some people have a very rough time with shingles,” Loughnane says.
A vaccine
However, he says there is a vaccine that can reduce a person’s risk of getting shingles or, if they do get the disease, can reduce their risk of post-herpetic pain.
“The vaccine is effective and it is available in Ireland, but it’s not covered by the GMS here unlike England where they have introduced a National Shingles Immunisation Programme, and it is expensive.
“It’s licensed here from 60 years on, but the best time to get it is between the ages of 50 and 60 to boost the immune system.”
For Costello, shingles is still impacting his life. He takes medication daily and is on morphine patches for back pain following a car accident. If he is even an hour late taking his medication, the shingles pain will start again in his eye and forehead.
A sudden change of temperature can trigger an attack, for example, walking into a warm room from the cold, or opening the oven door.
“I was very down for the first few months. I have got a lot better but it’s been a struggle. I have had 10 sessions with a primary care counsellor which was brilliant. It helped me not to feel so guilty and stop blaming myself if I couldn’t do things like housework on a particular day.”
For more information, see shingles.ie
