Monday, October 15, 2018

Shingrix Shingles Vaccine - What You Should Know

Most of you have heard of shingles.  It is a painful, blistery rash caused by a virus.  Did you know that shingles is caused by the same virus that causes chicken pox?  When you have chicken pox, although the infection seems to go away completely, the virus actually stays in your nerve cells, alive but in an inactive state.  Many years later, this exact same virus can become reactivated, probably due to lowered immunity.  This reactivated virus travels down the nerve fibers to cause the shingles rash.
  
The most common serious complication of shingles is called post-herpetic neuralgia (PHN).  This causes severe pain in the area in which the shingles rash was present, lasting long after the rash is gone, sometimes even lasting years.

There has been a vaccine available for shingles since 2006, called Zostavax.  Unfortunately, Zostavax only reduced the risk of shingles by 51%, and was only recommended routinely for patients 60 or over.

There is now a new shingles vaccine, called Shingrix.  This vaccine is more than 90% effective at preventing shingles, and can also be given at an earlier age.  Shingrix is given in 2 doses, separated by 2 to 6 months.  Because it is so much more effective, Shingrix is now the preferred vaccine for prevention of shingles.  Here's what you need to know about this vaccine.

Who should get the Shingrix vaccine?
All healthy adults 50 years and older.  You're never too old to get Shingrix.                 
You should get the Shingrix vaccine even if you...   
  • Have already had shingles in the past, because it does help prevent future shingles outbreaks.
  • Have received Zostavax vaccine in the past, as long as you wait 8 weeks in between.
  • Don't remember having chicken pox, because studies show that 99% of Americans over 40 years old have had chicken pox, even if they don't remember having it!
  • In adults 50 to 69 years old who got two doses, Shingrix was 97% effective in preventing shingles, and 91% effective in preventing post-herpetic neuralgia. 
  • In adults 70 years and older who got two doses, Shingrix was 91% effective in preventing shingles, and 89% effective in preventing PHN.
Why is the Shingrix vaccine important?
  • Your risk for shingles and the painful complication of post-herpetic neuralgia, increases as you get older, so it is important to have strong protection against shingles in your older years.
What are the possible side effects of the Shingrix vaccine?
  • Most people will have some soreness in the arm where the vaccine was given, for 2-3 days.
  • Some people will have mild redness or swelling where they got the shot, for 2-3 days.
  • Fewer people have fatigue, headache, muscle pain, nausea, or low grade fever, for 2-3 days.
If you want to learn more, you can go to https://www.cdc.gov/vaccines/vpd/shingles/public/shingrix/

If you have any questions about Shingrix Shingles Vaccine, please log into your account and send us your question. We are here to help.

Dr. Anita Bennett MD - Health Tip Content Editor

Friday, October 5, 2018

Shingles

I'm sure that most of you have heard of shingles, but you may not actually know that much about it.  Shingles is a rash which is a concentrated area of blisters that typically scab over in 7 to 10 days.  The rash then slowly clears up completely over the next 2-3 weeks.  This rash is typically quite painful, although the severity of the pain can vary from one person to another.

What causes Shingles?
Shingles is caused by the varicella-zoster virus, which is the exact same virus that causes chicken pox.  After you recover from having chicken pox, the virus enters your nerves, where it can lie dormant for years and years.  Later on in life, the virus can be reactivated to cause shingles.

Reactivation of the virus can happen for many reasons, usually related to low immunity.  Once the virus is reactivated, it travels down the nerve and causes a rash on the skin wherever that nerve comes to the skin surface.   It is usually only reactivated in one nerve at a time. This is why the rash usually develops on one side of the body, often on the face or torso, in a horizontal line that is fairly small in area.

Is Shingles contagious?
Since the shingles rash contains live varicella-zoster virus in the blisters, a person with shingles can actually transmit this virus to anyone who is not immune to chicken pox.  Once exposed, this person would get chicken pox, not shingles.  Shingles is contagious until all blisters have scabbed over.  Chicken pox can be dangerous for some people, so people with shingles should be careful not to expose others.

Who is at risk for Shingles?
  • Anyone older than 50, with the risk increasing the older you get.
     
  • Anyone with a disease that weakens the immune system.
      
  • Anyone taking medications which suppress the immune system.  This includes cancer treatments, medications to prevent transplant rejection, steroids, and many of the newer medications to treat autoimmune diseases.
What are the possible complications of Shingles?
  • Post herpetic neuralgia is the most common complication of shingles.  This causes pain, sometimes severe, that can last from weeks up to years, after the shingles rash improves.
     
  • Vision loss can happen if the shingles rash affects the eye.
     
  • Skin infections are not uncommon if the shingles blisters are not treated properly.
     
  • Neurologic problems such as inflammation in the brain, facial paralysis, or balance or hearing problems can happen, depending on which nerve is actually affected.
Can you prevent Shingles?
There is a very good vaccine to prevent shingles.  Next week I will tell you all about it!

If you have any questions about Shingles, please log into your account and send us your question. We are here to help.

Dr. Anita Bennett MD - Health Tip Content Editor

Monday, October 1, 2018

Lead Poisoning

There has been significant press coverage recently regarding lead poisoning.  I thought this might be an interesting topic for our Health Tip this week.

What is lead poisoning?

Lead poisoning is the result of lead build up in the body.  Once lead is taken into the body, it distributes throughout the body.  It can damage the nervous system, kidney function, immune system, reproductive systems, and the heart and blood vessels.  Lead is stored in your bones, and can be released along with calcium during pregnancy, leading to exposure of the unborn fetus to lead.
Lead PoisoningInfants and young children are especially sensitive to lead, even at very low levels, which can cause severe and long lasting effects on both physical and mental development.  It can contribute to serious behavioral problems, learning deficits, lowered IQ, slowed growth, hearing problems, anemia, and even death.

How do people get exposed to lead?
  • Lead-based paint - Any house that was built prior to 1978 is very likely to contain some lead-based paint. 
  • Water - Public water supplies are sometimes contaminated.  Lead is also the most prevalent toxicant in U.S. school drinking water.  Lead release from plumbing is the main source of lead in water at schools.
  • Air - This decreased after lead was removed from gas, but there are still sources that contaminate air.
Who is at risk for lead poisoning?
  • Age less than 6 years.
  • Anyone living in an older home, and/or remodeling an older home.
  • Having a hobby like making stained glass or refinishing old furniture.
  • Living in developing countries where the rules are much less strict about exposure to lead. 
What can you do to protect your family from lead poisoning?
  • If your home was built before 1978, check regularly for peeling paint, and fix problems promptly.  Try not to sand the paint, as this can generate dust which contains lead and can get everywhere.  If you are remodeling an older home, wear a mask and keep children well away from any area being renovated.
  • If you have older plumbing containing lead pipes or fittings, you can find effective and affordable water filters which are specifically designed to remove lead.  Make sure the particular filter you purchase is designed to remove lead (pitcher filters usually are not).  Use filtered water for drinking and cooking.
  • Eat a healthy diet.  A diet with enough calcium, vitamin C, and iron can help lower lead absorption.
  • Talk with your doctor about when lead testing might be recommended for your child.
  • Find out if the water at your child's school has been tested for lead.  If not, consider sending a water bottle with your filtered water to school with them.
You can find more information at https://www.cdc.gov/nceh/lead/publications/books/plpyc/contents.htm.
If you have any questions about lead poisoning, please log into your account and send us your question. We are here to help.

Dr. Anita Bennett MD - Health Tip Content Editor