Shingles, as its name suggests in its literal interpretation, is a blister in the shape of a belt. Shingles only appear on one side of the body, either on the right or left, starting from the body's central axis. Based on the prevalence rate, it is known to occur in about 1 in 3 people during their lifetime. For those who survive up to 85 years of age, it affects nearly 50% of the population, particularly more commonly among patients over 50.
In fact, according to the results of the annual report from Korea's leading portal site, Naver, in the past year, the most searched keyword on the online encyclopedia service, 'Knowledge Encyclopedia,' by users in their 50s was 'shingles.' Additionally, shingles ranked second in the most viewed headlines by all Naver users in 2022.
Shingle is a terrifying disease. Referring back to a personal experience with shingles from about ten years ago, I experienced excruciating pain. Two to three days before the onset of shingles, one experiences unbearable itching and flu-like symptoms that affect the whole body, making it impossible to sleep. Afterward, a red rash appears on one side of the body from the central axis. The rash bursts even with slight pressure, causing pain from that moment on. My pain was like "burning pain, a searing sensation." Fortunately, I took an antiviral medication within 72 hours, so there were no significant aftereffects. However, even now, when I feel very fatigued, the area where I had shingles is very itchy. However, my experience is nothing compared to the severity of some people's pain from shingles.
■Key is administering antiviral drugs within 72 hours
Shingles are caused by varicella-zoster virus (VZV) reactivation, which invades the body when the immune system is debilitated. Shingles typically occur on the skin of the chest and waist and can also manifest as eye shingles, which can impact the fifth cranial nerve and cause vision loss.
Shingles are mainly known for causing severe pain along with rash. The pain can be described as electric shock-like pain, needle-like or burning sensation, shock, etc.
Shingles can occur in people of all ages, but the incidence rate is exceptionally high among those over 50. According to the National Health Insurance Service, over 60% of shingles, patients in Korea in 2021 were over the age of 50.
The leading cause of shingles is the decline in immunity due to aging. A study conducted last year showed that COVID-19 infection in adults aged 50 and over could increase the risk of shingles. According to the study, adults aged 50 and over who had COVID-19 were found to have a 15% higher risk of shingles than those of the same age without COVID-19. Furthermore, the risk increased to 21% for those with a history of hospitalization due to COVID-19.
Shingles themselves cause severe pain, but the biggest problem is postherpetic neuralgia. Even after the rash disappears, it can decrease the quality of life due to various complications. The most common complication is postherpetic neuralgia, which occurs in 10-18% of patients, causing pain worse than childbirth, according to one study. Moreover, the pain can persist for several months to years, leading to chronic fatigue, sleep disorders, loss of appetite, depression, and in severe cases, can worsen to chronic pain syndrome.
Herpes zoster ophthalmicus (HZO), which occurs in 10-25% of shingles patients, is another common complication. Shingles-induced HZO can cause persistent pain, facial scars, and vision loss. In addition, various complications, such as skin lesions caused by secondary bacterial infections, paralysis, meningitis, pneumonia, and urinary disorders, can also ensue.
Therefore, antiviral drugs should be administered within 72 hours after the diagnosis of shingles. Starting the treatment after 72 hours may reduce the effectiveness of the treatment.
■Recombinant shingles vaccine with 97.2% prevention rate
Fortunately, shingle is a preventable disease. To prevent shingles, it is important to boost immunity through regular exercise, healthy habits, and avoiding extreme stress, fatigue, and chronic fatigue.
However, the most effective method is vaccination. Especially for adults over 50 or those with weakened immune systems, vaccination is critical since they have a higher risk of shingles recurrence compared to the general population. Even if a person has received the live vaccine or has had shingles in the past, vaccination with the shingles subunit vaccine is recommended.
The recently developed recombinant zoster vaccine (Shingrix) ascertained a prevention rate of approximately 97.2% when administered twice to adults over 50. This vaccine is also advised for immunocompromised individuals due to diseases or treatments, such as undergoing autohematopoietic cell transplantation, solid organ transplantation, or cancer treatment.
According to Dr. HyungGyu Oh, the CEO of Ohyool Clinic, "Adults over 50 and immunocompromised individuals have a higher risk of developing shingles, which can cause severe pain and complications. It is recommended to consult with medical professionals and get vaccinated with the shingles vaccine." He also explained that the recently developed shingles vaccine had been clinically proven to be highly effective and uncontroversial.
