"Na Ying cried" is trending! This disease is as painful as burning, and doctors remind...

On the evening of the 28th, during the "Singer 2024" competition, #那英泣了# became a hot search. During the competition, Na Ying covered half of her face with a veil. At that time, many netizens asked about her makeup. Later, they learned that Na Ying was actually singing while sick. The host He Jiong also explained: "Na Ying had shingles two days ago, around her eyes."

What is shingles? In fact, it has many nicknames, each more frightening than the last, such as "waist-wrapped fire dan", "waist-wrapped fire dragon", "waist-wrapped snake", "snake-wrapped sores", "snakes"... These names can at least make people feel cold, if not terrified.

There are generally several reasons why ordinary people know about the disease of shingles. One is because of the scary names mentioned above, and the other is that they know that shingles is very painful.

So, what is shingles really like? Is it dangerous? Is it contagious? How can it be prevented? This article will take you to a deeper level and explore important information such as its dangers, prevention measures, and how it spreads.

How serious are the dangers of shingles?

There are many skin diseases that cause people to worry, such as worrying that melanoma will be fatal, and worrying that shingles will be extremely painful. In fact, the harm of shingles can be great or small.

The reason for this is that the health effects of shingles vary greatly from person to person. Here are some of the milder effects:

Skin rashes and blisters usually heal on their own within 7 to 10 days.

· There is a certain degree of sensory abnormalities, such as itching, tingling, and burning sensations. These are manifestations of inflammation of the peripheral nerves, which is medically called "acute neuritis."

Figure 1. Typical herpes zoster (Source: https://thomsonspecialistskincentre.com/)

If you have a normal immune system and are young, then most of the time it is not a big problem. If you want to be serious, it can be very serious, for example:

Acute neuritis has severe symptoms, such as electric shock-like pain, which seriously affects normal life in the short term.

· The neuralgia lasts for a long time, more than 90 days, and becomes a sequelae, which greatly reduces the quality of life. Among them, 6% of people will have pain for more than 1 year!

Other complications occur, that is, not just the common rash and neuritis; complications can include herpes in the eyes, retinal necrosis, ear pain, bacterial infection, inflammation of the brain and meninges, etc.

Fortunately, the above serious situations are relatively rare, and most people don't need to worry too much. If your immune status is not good, such as if you have AIDS, malignant tumors, or have been taking immune-suppressing drugs for a long time, then your risk is higher than that of ordinary people.

Is shingles more dangerous as you get older?

1. The older you are, the more likely you are to get shingles

Indeed, the older you are, the more likely the virus lurking in your body will be activated and cause shingles. Specifically, there are several phenomena:

Phenomenon 1: The older you are, the higher your risk of contracting herpes zoster. Statistics show that the incidence of herpes zoster begins to increase significantly at around the age of 50, with 68% of herpes zoster cases occurring in people aged 50 and over. On the other hand, scholars estimate that about half of people who live to 85 have already had herpes zoster.

Phenomenon 2: The older you are, the more severe the symptoms of shingles tend to be. The average duration of pain is 34 days, and the total duration of pain increases dramatically with age.

· Phenomenon 3: The older you are, the longer it takes to recover from shingles. Many healthy young people can recover in 7 to 10 days, while some middle-aged and elderly people over 50 years old may take 2 to 4 weeks to recover.

Phenomenon 4: The older you are, the higher the probability of complications from herpes zoster. Studies show that 83% of postherpetic neuralgia occurs in people over the age of 50. In addition, 1 in 3 patients over the age of 79 will experience this painful sequelae.

All the above data show that herpes zoster is quite unfriendly to the middle-aged and elderly. Therefore, uncles and aunts should pay more attention to this disease.

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2. Young people, what should you pay attention to?

In addition, there must be many young people in front of the mobile phone screen. Will young people get shingles? What should they pay attention to in life?

First of all, let me reassure everyone that young people don’t need to worry too much because the probability of getting shingles is relatively small. Even if you get it, most of the time the discomfort will go away after a few days, and there is rarely any post-herpetic neuralgia.

To further reduce the risk of illness, there are a few things you can do on a daily basis:

Try not to be under stress or fatigue for a long time. When the immune system is not in good condition, the virus in the body is relatively easy to reactivate, which can cause shingles.

Do not abuse immune-suppressing drugs, such as blindly taking oral glucocorticoids such as prednisone. When the body's immune system is suppressed, viruses can easily take advantage of the opportunity to infect.

Maintaining good living habits, healthy diet and proper exercise can more or less reduce the risk of disease (not limited to shingles).

Is shingles contagious?

The contagiousness of shingles is something that is worth educating everyone about because it is very special.

1. Is shingles contagious?

Although herpes zoster is a disease caused by a viral infection, it is actually a secondary infection, or a secondary infection. Secondary infection means that this is not the first infection of the human body (primary infection). The manifestation of the first infection is not herpes zoster, but chickenpox. It may sound a bit confusing, so let's put it another way - the virus that causes chickenpox and herpes zoster is the same virus, it is called "varicella-zoster virus". A person basically gets chickenpox first, and after the chickenpox is healed, the virus will lurk in the body. When the time is right - such as old age and poor immune status, the virus will revive and cause a second infection, and the manifestation at this time is herpes zoster. Chickenpox only occurs once in a lifetime, while herpes zoster can occur many times in a lifetime. After understanding the basics, let's look at the contagiousness of herpes zoster. In general, herpes zoster itself is not contagious. However, the blisters of patients with shingles contain varicella-zoster virus, which can be transmitted to people who have never been infected with varicella virus through direct contact, causing them to be infected with chickenpox, rather than infecting others with shingles (key point: shingles is caused by the reactivation of the virus in each person's body). In addition to direct contact transmission, other routes of infection can be basically ignored (such as droplet transmission). Therefore, the overall infectiousness is relatively weak, far weaker than the infectiousness of chickenpox, and home isolation is not required.

2. What should I do if I get shingles?

During the active period of shingles, patients should pay attention to covering the rash area with clothing and try to avoid contact with people who have not had chickenpox and have not been vaccinated, especially children, pregnant women and immunosuppressed people. Seeing this, I believe everyone knows that shingles is a common viral disease that is relatively dangerous to the elderly and immunosuppressed people. By understanding the details of its hazards, transmission methods and prevention measures, we can better protect ourselves and others.

3. Get the shingles vaccine

It is particularly important to emphasize that vaccination is an effective means of preventing shingles. Although the cost may be high, considering the health benefits it brings, this investment is worth it. The good news is that there is a vaccine for shingles, and there is more than one. But the bad news is that vaccines are very expensive. Below are two vaccines that are available in China. You can see the comparison between them:

In general, according to relevant research results, the effectiveness of recombinant vaccines in reducing the incidence of herpes zoster and postherpetic neuralgia (basically over 90%) is higher than that of live attenuated vaccines. However, one advantage of the live attenuated vaccines approved in China is that people over 40 years old can be vaccinated. After the age of 50, you can get the recombinant vaccine again. Considering that the herpes zoster vaccine can significantly reduce the risk of disease (even if you get sick, the symptoms are much milder), from a doctor's point of view, although the cost of the vaccine is a bit high, in the long run, this can reduce unnecessary medical expenses and improve the quality of life. Therefore, getting vaccinated against herpes zoster is a health measure that is worth investing in. What do you think?

References

[1] UpToDate. Epidemiology, clinical manifestations, and diagnosis of herpes zoster. https://www.uptodate.com/contents/zh-Hans/epidemiology-clinical-manifestations-and-diagnosis-of-herpes-zoster

[2] Mayo Clinic. Shingles. https://www.mayoclinic.org/diseases-conditions/shingles/symptoms-causes/syc-20353054

[3] Yawn BP, Saddier P, Wollan PC, et al. A population-based study of the incidence and complication rates of herpes zoster before zoster vaccine introduction. Mayo Clin Proc. 2007; 82(11): 1341-1349.

[4] New shingles vaccine: Everything you need to know to protect yourself. https://www.samitivejhospitals.com/en/article/detail/zoster-vaccine

[5] Shinrix instructions. https://www.gsk-china.com/media/6581/shingrix%E8%AF%B4%E6%98%8E%E4%B9%A6.pdf

Author: Tang Jiaoqing, MD, attending physician of dermatology

Review | Feng Jun, deputy chief physician of the Dermatology Department of Sinopharm Tongmei General Hospital