[HEALTH IN NEWS] INCHEON, South Korea — Shingles, a painful condition caused by the reactivation of the varicella-zoster virus (VZV), affects approximately 10.4 out of every 1,000 people annually in South Korea, according to data from the country’s Health Insurance Review and Assessment Service. The disease is notably more prevalent among women, with 12.6 cases per 1,000 compared to 8.3 per 1,000 for men, making women about 1.5 times more likely to develop it. With a lifetime prevalence rate of around 30%, roughly one in three South Koreans may experience shingles at some point in their lives.

Shingles, triggered by the reactivation of a virus due to weakened immunity, damages nerves, causing severe pain and complications, making early treatment within 72 hours and vaccination critical. (Photo=ClipArtKorea)
Shingles, triggered by the reactivation of a virus due to weakened immunity, damages nerves, causing severe pain and complications, making early treatment within 72 hours and vaccination critical. (Photo=ClipArtKorea)
Dr. Jeongho Lee, a pain medicine specialist at Incheon Hi Hospital, emphasizes the critical link between shingles and weakened immunity. “Shingles is closely tied to immune suppression,” Dr. Lee said in an interview. “After causing chickenpox in childhood, the virus lies dormant in nerve ganglia. Factors like stress, chronic illness, or immunosuppressive medications can trigger its reactivation, leading to painful rashes and blisters.”

Shingles manifests as a distinctive band-like rash that wraps around one side of the torso or face, accompanied by intense nerve pain. The term “shingles” (from the Latin *cingulum*, meaning belt) derives from this characteristic pattern. The virus spreads along affected nerve pathways, causing skin lesions.

In 70% to 80% of cases, patients experience prodromal symptoms before the rash appears, including stabbing or burning pain, itching, or flu-like symptoms such as muscle aches. These early signs can mimic a cold, complicating diagnosis. Within days, redness, papules, and blisters emerge, progressing to pustules and crusting over within two to three weeks.

While shingles is not highly contagious, the virus in blister fluid can transmit chickenpox to individuals without prior exposure, particularly through mucosal contact. Dr. Lee advises avoiding contact with infants, pregnant women, and immunocompromised individuals until the blisters scab over, as airborne transmission via coughing or sneezing does not occur.
Timely treatment is critical. Antiviral medications administered within 72 hours of blister onset can reduce nerve damage and improve outcomes. Delayed treatment may lead to nerve degeneration, resulting in chronic pain known as postherpetic neuralgia (PHN). PHN, defined as pain persisting beyond three months after the rash, can become intractable if it lasts over six months.

PHN is particularly prevalent among older adults. Studies indicate that half of patients over 70 experience lingering pain a year after onset. Severe acute pain or lesions on the head or face heighten the risk of complications. Treatment for PHN focuses on pain relief through medications and conservative measures like nerve blocks.

Vaccination offers a powerful preventive tool. Older live vaccines had a modest 60% efficacy rate, but newer recombinant vaccines with adjuvants boast an average efficacy of 95%. Widely adopted in countries like the United States, these vaccines are recommended in South Korea by the Korean Society of Infectious Diseases for adults over 50 and immunocompromised individuals over 18.

Photo=Dr. Eungdon Kim, Professor of Pain Medicine at Daejeon St. Mary's Hospital, The Catholic University of Korea
Photo=Dr. Eungdon Kim, Professor of Pain Medicine at Daejeon St. Mary's Hospital, The Catholic University of Korea
Dr. Lee underscores the importance of proactive measures. “Early and aggressive treatment is paramount,” he said. “For older adults or those with compromised immunity, vaccination should be considered even in the absence of symptoms. Seeking immediate medical attention at the first sign of trouble is key to minimizing complications.”

저작권자 © Hinews 무단전재 및 재배포 금지
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