It is known as 'shingles' to a disease of viral origin that affects both children and adults. The cause of shingles is the chickenpox virus, which is actually called the varicella-zoster virus, because the scientific name for shingles is herpes-zoster. And yes, the chickenpox virus belongs to the herpes virus family.
Of course, it is understandable that with such a tangle of names, in the end popular wisdom has been left alone with 'shingles'.
It is important that we know that we can never have shingles if we have not had chickenpox before. Once the disease is overcome, the virus remains latent in our body, specifically in the nerve ganglia of the spinal cord, and in situations of immunosuppression, when our defenses are weaker, it is reactivated and shingles appears. This can happen even in vaccinated people, although it is less frequent than after suffering from chickenpox. Why it is in some people and not in others remains a mystery, which is more related to the individual susceptibility of each host than to the virus itself. In most cases, the actual cause of varicella-zoster virus reactivation is unknown.
- Shingles usually affects only one side of the body. It appears as a linear belt of painful and itchy (itchy) vesicles corresponding to the affected nerve root (metamera).
- The most common locations are the back, sides and upper abdomen. It resembles the classic cold sore lesions, but more extensive and painful.
- Within a week the vesicles dry up and scabs appear which may take another week to disappear. Although rare, it can leave small dimpled scars.
- Sometimes, before the appearance of shingles, fever and nonspecific flu-like symptoms may occur.
- An added problem is post-herpetic neuralgia and it is that, once the skin lesions have disappeared, pain or tingling may persist in the affected area for months or even years.
- A serious situation is when it affects the eye, since can leave sequelae in the form of corneal scars and blindness.
However, and to reassure parents, in children, both the appearance of shingles and pain and complications are less frequent than in adults. More than 90% of the cases are described in people over 30 years of age. In addition, children do not usually require any type of treatment.
Given the peculiar location, the linear shape of shingles, and the history of having had chickenpox, the diagnosis is simple and does not require additional tests. However, if in doubt, they can be done.
As with most viruses, shingles has no cure. The main recommendations so that this 'skin snake' does not embitter the existence of our family are the following:
- Symptomatic treatment: that is, pain and fever with analgesics and antipyretics such as ibuprofen or paracetamol, and itching with antihistamines.
- Maintain good hygiene of injuries to avoid bacterial superinfections of the skin.
- Acetylsalicylic acid should not be given (Aspirin®) because there is a proven relationship between this drug, chickenpox and a very rare but very serious disease called Reye's Syndrome.
- It is also not recommended to administer corticosteroids, neither taken in pills nor on the skin, as they can also generate complications.
- Avoid contact with people who have not had chickenpox or have not been vaccinated. Especially avoid contact with children under 12-15 months (age at which the first dose of the vaccine is usually administered). Shingles spreads the virus to these people, who will get chickenpox (not shingles) if they come into contact with the fluid contained in the vesicles.
- There is an antiviral treatment It is indicated only in certain circumstances, mainly: under one year of age, some chronically ill, immunosuppressed children, ophthalmic involvement, prolonged fever or extensive skin involvement.
Finally, some parents may be wondering: why do we recommend vaccinating against chickenpox if the vaccine contains live attenuated viruses and also does not protect against shingles? Wouldn't it be better to hope that the chickenpox will not pass and that way you will never develop shingles? The question makes sense. The problem is that 95% of people are exposed to the chickenpox virus sometime in their life, making it almost impossible not to develop the disease. The vaccine prevents our children from getting the annoying chickenpox (or that this is much milder) and also, the risk of appearance of shingles in vaccinated children is much lower than after suffering chickenpox, so the benefits are obvious.
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