According to latest data provided by the Bureau of Epidemiology, Ministry of Public Health, the incidence of shingles in Thailand has increased over the past 10 years. People over 65 years are most likely to contract shingles, but older patients can manage the risk of contracting this disease and can reduce its severity if it does occur.
Data from the Department of Preventative and Social Medicine at Siriraj Hospital rates shingles as one of the three most easily contracted infectious diseases, along with colds and pneumonia. These three ailments are the most frequent causes of death due to infection among people over 60 years old. People in this age group comprise 20 to 30 percent of Thailand’s overall population; the risk increases to 50 percent in those who are 85 years old and older.
It’s clear that this painful, tormenting disease is even more dangerous and prevalent than you might think.
Dr. Lily Chaisompong, who specializes in geriatric medicine, explains that the same virus that causes chickenpox also causes shingles. When a person recovers from chickenpox, the virus remains dormant in nerve ganglia tissue. When it detects weakness in the body’s immune system, the virus can reactivate and attack tissue.
“When a person’s immune system weakens – whether due to aging, immune-chronic diseases or diseases requiring immunosuppressive medication – the chance of getting shingles increases,” says Dr. Lily.
Shingles symptoms are different and potentially more disabling than those of chickenpox, which produces small red blisters all over the body. In shingles, similar red blisters appear, but only on the area of the skin which the nerve supplies. The disease begins with red spots, which develop into blisters that scab over. They often appear on the waist, back, and face. If it spreads to the eyes it can cause blindness.
Besides rashes and spots on the skin, shingles can cause severe neuropathic pain, characterized by burning sensations along the same area of the skin of the affected nerve. Some sufferers describe shooting, inflammatory pain like an electric shock.
“Some elderly feel severe pain at the red spots; others may feel pain even without any spots yet,” says Dr. Lily. “The more spots, the more painful it is; even the touch of soft, thin clothes is too much for some patients. Some elderly are unable to sleep because they find it impossible to find a comfortable position. This disease can be quite a torment.”
Some patients also suffer related complications, such as superimposed bacterial skin infection. Another debilitating symptom is nerve pain called “postherpetic neuralgia.” In this condition found in 70 to 80 percent of shingles patients over 50 years of age*, they experience pain even after the skin sores have healed. This pain may last for months or years through to the end of life.
“The nerve pain can happen to anybody, but it’s found mostly in the elderly because they’re the group with the highest rate of shingles,” says Dr. Lily. “This considerable pain severely degrades patients’ quality of life; they can never get comfortable. Some must take strong soporific painkillers that cause drowsiness. These drugs increase the risk for falls and the myriad health problems that ensue from those injuries.”
“When a person’s immune system weakens — whether due to aging, chronic diseases or diseases requiring immunosuppressive medication — the chance of getting shingles increases.” Dr. Lily Chaisompong
Treatment and Prevention
In patients with mild cases and no complications who receive adequate symptomatic treatment shingles may last only about a week. Regardless, don’t ignore shingles. Seek help from a doctor immediately because fast access to antiviral agents can reduce the outbreak’s severity.
“Many elderly patients do not know they have shingles, assuming instead that their symptoms are from allergies or insect bites,” Dr. Lily says. “If they put off seeing a doctor right away, symptoms can go to a severe stage. Family members and caretakers must be on the lookout for shingles symptoms like skin spots or rashes accompanied by pain.”
Because shingles treatment cannot prevent 100 percent of complications, doctors stress the importance of prevention by getting the shingles vaccine. Available in Thailand, it has reduced shingles incidence by up to 51.3 percent in patients between 60 and 70 years of age*.
Patients 60 years or older should get the vaccination, but those with chronic diseases or other conditions that weaken the immunity may get the vaccination sooner. One dose of vaccine provides protection from shingles for about 10 years from the day of vaccination. “Getting a shingles vaccination does not mean that you can completely avoid it, but it helps to reduce by over half the chance getting the disease as well as reducing its severity,” Dr. Lily says.
* Department of Preventive and Social Medicine, Faculty of Medicine, Siriraj Hospital, Mahidol University
Well Elderly Vaccine Program, a great option for Elder Health
Because prevention is better than cure, the New Life Healthy Aging Clinic at Bumrungrad International Hospital encourages our older patients to enroll in the Well Elderly Vaccine Program.
This comprehensive vaccine regimen designed for aged patients targets preventable infectious diseases. Vaccinations include:
- Shingles (Herpes Zoster) Vaccination
We recommended that persons 60 years and older receive the shingles vaccination.
It’s good to get a tetanus vaccination every 10 years.
- Influenza Vaccination (Flu Vaccination)
Get the yearly influenza vaccination during the rainy season through the winter.
We recommend two pneumococcal vaccinations, starting with the conjugate vaccine for 13 different serotypes, and the polysaccharide vaccine for another 23 serotypes.
We advise older patients to consult with our experienced medical team at New Life Healthy Aging Clinic to get information and appropriate recommendations for these vaccinations.
For more information, please contact +66 (0) 2667 2000.