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Ongoing Study Provides Hope for Shingles Prevention

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WebMD Health News

Nov. 27, 1999 (Atlanta) -- A new study may make the debilitating nerve and skin infection called shingles go the way of smallpox. Anywhere from 200,000 to 1,000,000 people are diagnosed with the condition in the U.S. each year. Countless more may go undiagnosed. Though not necessarily life-threatening, the virus can destroy a person's quality of life for weeks, months, even longer. And to date, there is no cure.

However, a vaccine study being conducted by the Department of Veterans Affairs, in collaboration with the National Institute of Allergy and Infectious Diseases and the drug company Merck, is the best bet yet for shingles prevention.

The same virus that causes chickenpox, called varicella-zoster virus (VZV), brings on shingles. When a person gets over chickenpox, the virus doesn't leave the body, but instead hides out in nerve cells on either side of the spinal cord. For many people, that's the end of it. "Once you have the chickenpox, the shingles are in you. They live in the dorsal root ganglia, and you have it for life, and 80% of the time nothing will happen -- you'll die with the thing in you," Richard Perkin tells WebMD. Perkin is the chairman of the VZV Research Foundation, a nonprofit organization fostering research and education on the virus.

For the other 20%, though, the virus returns, at any time, with a renewed vengeance and a new name, herpes zoster, or shingles. No one knows exactly what brings it about, but lowered immunity, brought on either by advanced age, stress, or disease, plays a role. Michael Oxman, MD, the national chairman of the VA study, which is using a vaccine similar to the one used to fight chickenpox, tells WebMD that "sooner or later, [VZV] wakes from its sleep, causing a great deal of damage, killing nerve cells." The virus travels along the nerve, usually causing pain along the way and resulting in an excruciatingly painful rash that usually lasts three to five weeks.

There's still more, for the unlucky few. It's called post-herpetic neuralgia, and it's likely brought on by the damage shingles does to the nerves. For the person who has it, it can mean prolonged pain for at least a month after the initial attack, and perhaps lasting for years. Changes in temperature, the touch of clothing, even a breeze can be enough to trigger terrible pain.

"It's neuralgic pain," says Oxman, who is also professor of medicine and pathology at the University of California, San Diego. "So it's not like a broken leg or a burn, which you can relieve with painkillers. This is pain that's actually generated in the nervous system, and it doesn't respond very well to any methods of controlling pain. It's a major cause of suicide."'

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