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Shingles is here: 1 in 3 adults will develop shingles in their lifetime

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25 February 2022

Most adults will remember childhood anecdotes of their encounter with chickenpox, retold at family gatherings or doctors’ visits. Many individuals move past the ill-fated playdate that caused the infection well into adulthood, never thinking twice of the pediatric issue: the very same virus that caused chickenpox can cause shingles later in life, which sometimes can lead to long-lasting complications.

One Virus, Two Diseases

Shingles is caused by the reactivation of the varicella zoster virus (VZV), the same virus that causes chickenpox. After one contracts chickenpox, the VZV virus lies dormant in the nervous system but may reactivate in adulthood, especially affecting older adults[1]. Although most common for people over 50, the virus can reactivate at any time. In addition to age, some other factors can increase the risk such as certain underlying conditions, or medications that weaken the immune system. Over 90% of adults above the age of 50 already carry the virus that causes shingles inside them[2], and 1 in 3 adults will develop shingles in their lifetime[3].

 

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The first signs of shingles can be a tingling or painful feeling in an area of skin, a headache, or feeling generally unwell. A few days later, a rash will appear. Usually a shingles rash starts on the chest or abdomen, but it can appear anywhere on the body, including the face. Shingles often presents as a blistering rash typically on one side of the body along the nerve where the virus was originally dormant. Besides the immediate pain and discomfort that usually accompanies a shingles rash, more serious conditions such as persistent pain (post-herpetic neuralgia) can last months or even years. Post-herpetic neuralgia is the most common complication of shingles.[4]

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Sabine Luik, Chief Medical Officer & SVP Global Medical Regulatory & Quality at GSK

“Shingles can occur at any time in adulthood, so it is important to understand the risk factors and how shingles can significantly impact the quality of someone’s life. The more people are aware of the links between chickenpox and shingles, the sooner people can take action and discuss their concerns with their healthcare provider."

The History and Science Behind Shingles

This mysterious reactivation was studied for the first time by a doctor in Cirencester, England more than half a century ago. By tracking 1,270 patients from 1947 to 1962, R. Edgar Hope-Simpson demonstrated that shingles was not a new infection from an unfamiliar pathogen but rather a reawakening of the VZV from within[5].

As people age, the cells in the immune system lose the ability to maintain a strong and effective response to VZV reactivation. Dr. Hope-Simpson noted this as well, noting that occurrences of shingles increased with age and in patients whose immune systems were suppressed due to conditions like leukemia or radiation therapy.

He hypothesized that during chickenpox, the virus travels from the surface of the infected skin along the length of nerves to hubs of nerve cell bodies outside of the central nervous system called ganglia. Inside a nerve ganglion, the virus becomes latent. It then remains in the body for life. If something triggers the virus to awaken and multiply, copies of the virus travel back along nerves to the skin, leading to the painful shingles rash[6].

The Genesis of Shingles Awareness Week

GSK is collaborating with the International Federation on Ageing (IFA), to raise awareness of shingles through the first-ever global Shingles Awareness Week (February 28 – March 6). The theme for this year is “Shingles Is Here,” to illustrate that if you are 50 or older, the virus that causes shingles is most likely already inside you[7]. The week will focus on increasing awareness around the risk of developing shingles for older adults, as well as understanding any possible consequences of the disease. Any concerns should be shared with a healthcare provider.

We aim to bring focus to all sides of the disease during Shingles Awareness Week so that adults can be well-informed about their own care.

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We are delighted to join efforts with the International Federation on Ageing on this new initiative. By kickstarting the first-ever Shingles Awareness Week, our joint aim is to provide evidence-based information to empower individuals to understand their risk and talk to their healthcare professional (HCP) if they have questions and concerns. We need to ensure we do our part to educate the global community on this preventable, painful condition.

Roger Connor, President of Vaccines and Global Health, GSK

References

[1] Bricout H, et al. Herpes zoster-associated mortality in Europe: a systematic review. BMC Public Health. 2015;15:466.

[2] Bricout H, et al. Herpes zoster-associated mortality in Europe: a systematic review. BMC Public Health. 2015;15:466.

[3] Harpaz. Prevention of herpes Zoster. June 2008. Available at: https://www.cdc.gov/mmwr/preview/mmwrhtml/rr5705a1.htm Last accessed: 20th December 2021 REF-2665.

[4] Dworkin RH, et al. Diagnosis and assessment of pain associated with herpes zoster and postherpetic neuralgia. J Pain 2008;9:S37–44.

[5] Hope-Simpson, R Edgar. “The Nature of Herpes Zoster: A Long-Term Study and a New Hypothesis.” Proceedings of the Royal Society of Medicine, vol. 58, no. 1, 1965, pp. 9–20., https://doi.org/10.1177/003591576505800106.

[6] Cunningham, Aimee. “With Its Burning Grip, Shingles Can Do Lasting Damage.” Science News, 29 Oct. 2019, https://www.sciencenews.org/article/shingles-virus-rash-chicken-pox-complications.

[7] Bricout, H l ne et al. “Herpes zoster-associated mortality in Europe: a systematic review.” BMC Public Health 15:466 (2015). Available at: https://doi.org/10.1186/s12889-015-1753-y Last Accessed: January 24th, 2022.

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