When I first started medical school, I accompanied my aunt on a trip to her physician. Her internist was a nice guy--a friend of my father's--who would try to teach me something about medicine every time I saw him. This specific time he pointed at the rash on the back of my aunt's neck and asked me what I thought it was. I didn't know. (No surprise there--most first-year medical students spend much of their time immersed in anatomy lab and don't start studying disease until second year.) My aunt's internist told me that the presentation was classic for shingles. It was the first time that I ever heard of the disease, but it certainly wasn't the last. For the next several months, my aunt complained of this "affliction" and its various iterations.

Herpes zoster (shingles) presents as a painful rash caused by the reactivation of the varicella (chickenpox) virus. Anybody who's had chickenpox harbors the virus. Shingles is remarkably painful, and although most people recover from the initial rash after a few weeks, they oftentimes suffer from various complications including postherpetic neuralgia--another painful condition. Approximately 1 million cases of herpes zoster occur each year, with the primary risk factor being advanced age (boomers are at particular risk). The good news about shingles is that, in many cases, it's preventable.

Recently, the FDA approved the herpes zoster vaccine for healthy patients ages 50- to 59-years-old. Furthermore, by late 2011, the Advisory Committee on Immunization Practices is expected to vote on recommending the vaccine for this same age group. Despite such strong support for the vaccine among medical pundits, fewer than 10 percent of eligible persons receive the vaccine!

The herpes zoster vaccine is particularly newsworthy and should be of great interest to boomers--a population at greatest risk. Unfortunately, this topic has received little media attention. Furthermore, many physicians fail to appreciate how effective the vaccine is.

If you haven't already received the shingles vaccine, you may want to ask your physician about it. Something to think about ...

Source: "Herpes Zoster and Postherpetic Neuralgia Prevention and Management," Fashner and Bell, American Family Physician, June 15, 2011

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