Mayo Clinic article offers data about shingles virus

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Public release date: 12-Dec-2007

http://www.eurekalert.org/pub_releases/2007-12/mc-mca121207.php

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Mayo Clinic

Mayo Clinic article offers data about shingles virus

ROCHESTER, Minn. -- When a vaccine to prevent shingles was approved for

use in 2006, the Food and Drug Administration recommended the vaccine

for people age 60 and older who previously had chickenpox. But two

issues -- the vaccine’s cost and the perception that shingles primarily

affects adults with weakened immune systems -- have left some physicians

undecided about whether healthy adults need the vaccine. This

uncertainty prompted a group of researchers led by Barbara Yawn, M.D.,

of Olmsted Medical Center in Rochester, to gather new data about the

incidence and impact of shingles in unvaccinated patients.

Published in the November issue of Mayo Clinic Proceedings, Dr. Yawn’s

research findings suggest that shingles and the complications associated

with it may have a greater impact upon healthy adults than most

physicians previously assumed.

“The best way to make a decision about who we should vaccinate is by

gaining a better understanding about the true impact of this virus,”

notes Dr. Yawn. “Physicians have access to very few recent studies that

tell us how many people in the United States get shingles, what age

groups the virus affects most, and how many of these people go on to

develop related complications or other problems.”

Study rationale and findings

Shingles isn’t a life-threatening condition, but it can cause a painful

rash or band of blisters during an outbreak and other painful

complications that can persist for months or even years. The goal of

this study was to establish accurate, up-to-date data about the

incidence and impact of shingles in the United States before the vaccine

was introduced. Dr. Yawn and her team recorded the number of adult

residents of Olmsted County, Minn., who were diagnosed with shingles and

shingles-related complications from Jan. 1, 1996, to Dec. 31, 2001. Over

the course of the study, 1,669 patients were included.

Researchers calculated that shingles affects at least 1 in every 278

adults in the United States each year. Study data also showed that

shingles is even more common among people ages 50 to 59, affecting about

one in every 24 people each year.

“Overall, our data suggests that researchers and physicians also need to

consider preventing shingles in people ages 50 to 59,” says Dr. Yawn.

“Future research is needed to understand the risk of recurrence of

shingles to better advise people who previously had shingles about the

value of receiving the shingles vaccine.”

Dr. Yawn noted that study data also challenged the assumption that

shingles primarily affects adults with weakened immune systems.

“More than 92 percent of the study subjects with shingles did not have

any conditions like cancer or other serious illnesses that affected

their immune system,” says Dr. Yawn.

Post-herpetic neuralgia was the most common complication noted,

occurring in about 8 percent of all people and increasing with age. This

sometimes debilitating complication causes the skin to remain painful

and sensitive to touch for months or even years after the rash clears up.

“About 18 percent of people age 80 or older experience pain that lasts

more than 90 days beyond the shingles,” explains Dr. Yawn.

###

About shingles

Also known as herpes zoster, shingles is an infection caused by the

varicella-zoster virus, the same virus that causes chickenpox. Anyone

who has had chickenpox can develop shingles because some of the virus

lies inactive in the nerves and can reactivate as shingles. Shingles is

associated with a painful rash or band of blisters that affects a

limited area of the body, most commonly the trunk, wrapping from the

middle of the back and around one side of the chest to the breastbone.

Alternatively, the painful rash may affect the face, scalp or neck or

occasionally an arm or leg. Complications that affect about one in every

five people with shingles include infection of the eye and damage to the

nerve to the eye, which can result in decreased vision. In rare cases,

shingles can also cause temporary muscle weakness or paralysis on the

side of the face affected by the virus.

The shingles vaccine (Zostavax) can prevent shingles in about 61 percent

of those vaccinated. In vaccinated people who develop shingles, the

vaccine typically reduces the severity of the outbreak and the risk for

developing post-herpetic neuralgia.

A peer-review journal, Mayo Clinic Proceedings publishes original

articles, reviews and editorials dealing with clinical and laboratory

medicine, clinical research, basic science research and clinical

epidemiology. Mayo Clinic Proceedings is published monthly by Mayo

Foundation for Medical Education and Research as part of its commitment

to the medical education of physicians. The journal has been published

for more than 80 years and has a circulation of 130,000 nationally and

internationally. Articles are available online at

www.mayoclinicproceedings.com.

To obtain the latest news releases from Mayo Clinic, go to

www.mayoclinic.org/news. MayoClinic.com (www.mayoclinic.com) is

available as a resource for your health stories.

--

ne Holden, MS, RD < fivestar@... >

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