Reawakening the beast

bear_head_vector_illustration_thumbTaking leaping strides back, he held tight to the rock in a firm grip.  He gazed left, then right, scanning the horizon for just the right moment.  The ongoing battle in front of him means he doesn’t have much time.  Just as he reacts to a bengal tiger pouncing to his right, he sees his opening and unleashes the bomb.  The tiger doesn’t stop and plows right into his midsection.  Others join the foray and soon there’s a pile, thousands of pounds on top of him, crushing.  He might have a broken rib and he definitely lost his breath for a moment.  As the pile lessens and he’s helped up by one of his own, he shakes away the ringing in his ears, and looks up to witness his success.


He bounds down the field to celebrate with his teammates, the aftereffects of the hit from the Bengals linebacker hardly a blip on the radar any more.  He’ll be fine, always is.

It’s a common feat in football.  It’s a tough, rough sport and the men who endure it successfully are placed on some of our culture’s highest pedestals–the likes of Peyton Manning and Tom Brady are invincible.  But alas, of course they’re not.

Terry Bradshaw may seem like an odd choice to promote awareness for a disease, but the reality is that athletes like Bradshaw got beat up and bruised on the field and got back up to throw another touchdown pass (Bradshaw has 212 regular season and another 30 in the playoffs). To win another game (107 regular season, 14 playoff). Another championship (4).  Yet he was felled by a virus that 5 year olds handle with ease.  Ironic now, isn’t it?

Shingles is the disease caused by the reawakening of the chickenpox virus (also known as varicella virus) and occurs in about 1 in 3 people who had chickenpox.

Once many years ago, Bradshaw like most of us, broke out in an itchy rash and spent a week home from school.  Some of us played with family or friends at so called “pox parties” to expose us all to the chickenpox virus.  Chickenpox is a relatively mild illness characterized by fever, malaise, and of course the vesicular rash, but can be more severe if acquired later in life.  So the best case scenario back then were these get-togethers with entire elementary school classes out with the pox at the same time.

I remember the itchy, fluid-filled vesicles on my body as if it were yesterday, perhaps many of you do as well.  My mom pleaded with me to stop scratching and to stop picking the pox that had crusted over, which would inevitably scar.  It was a short illness, but a prolonged battle to rid my body of all those little red pustules that I just would not leave alone.

The situation today is very different.  Kids get the chickenpox vaccine usually as part of their measles-mumps-rubella (MMR) shot, now known as MMRV (V for varicella).  There are no more chickenpox parties and pox scars are a thing of the past.

When my chickenpox was finally over, I was relieved.  What I didn’t realize at that time–I was just a first grader, you know–was that my body’s battle with the virus may not be over.  My body’s defenses, my immune system, had eliminated a large majority of those tiny viruses.  It had taken care of all the ones growing in the pus-filled poxes and those flowing through my blood, but unbeknownst to me, some viruses probably got into my nerve cells where they hide out to this day.

Declining immunity, which happens naturally as we age and can also be caused by certain drugs and diseases like HIV and cancer, is the number one risk factor for the reawakening of the chickenpox virus.  It’s like once the cops stop patrolling the neighborhood, the bad guys come back out again.

While the original pox weren’t painful, the reawakened virus grows and spreads in your nerve cells and causes extremely painful blistering skin eruptions, ie. Shingles.  The rash may take weeks to resolve and pain can continue for many months.  There’s no real cure, but antiviral treatment may speed recovery and acetaminophen or ibuprofen may help dull the pain.

Although not explicitly stated in these Merck ads, shingles can be prevented.  For anyone over the age of 60 who has had the chickenpox, the zoster vaccine (Zostavax) can significantly reduce the risk of shingles. Like a public service announcement to keep the cops in the neighborhood, the vaccine reminds your immune system that the chickenpox virus is still there waiting.

In the next 50 years, shingles may be a thing of the past.  Most kids born in the 2000s have gotten a chickenpox vaccine.  They never had chickenpox, so the virus is not hanging out in their nerve cells.  If the long-term protection of the chickenpox vaccine is good (which we don’t really know yet), there will be no virus to reawaken, no painful shingles to endure.  The neighborhood would have been free of bad guys all along and the police will be able to work to protect against some other foe in some other neighborhood in the body.

DynaMed Plus Herpes Zoster
DynaMed Plus Chickenpox
Vaccines 6th Ed. Plotkin SA, Orenstein WA, Offit PA. Elsevier Inc. 2013.

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