h2g2 The Hitchhiker's Guide to the Galaxy: Earth Edition

Entry: Chickenpox and Shingles - A2866430
Author: radioactiveBIGAL1 - on a different planet - U723247

I was stimulated to write an article on 'shingles' after my wife caught it this week. Then I became engaged in conversation with a Researcher whose child had chickenpox. As both are caused by the same virus, decided to write about both at once. Hope people find it interesting!

Good, informative and easy to understand I learnt a lot from this. But one thing I couldn't get my head around was two statements that appear in the same paragraph and seemingly contradict each other.

The lifetime risk for shingles in those who have had chickenpox in childhood is 10%,

The risk of any individual of developing shingles in his or her lifetime is 20%

Is it 10% or 20% or am I missing something?


SK

Yes, I agree; they do seem to contradict each other. Yet, If I recall, I obtained both figures from the same reputable source. I'll check.

I've checked my sourcwes on that. The stattttements came from 2 separate sources, both reputable (official),. I've read elsewhere that the chances of anyone getting shingles in their lifetime is 1 in 5 (i.e. 20%) so I think I'll delete the phrase about the 10%.

for notiocing that.

BIGAL

be back later

Looks good to me it's well written interesting and informative!

My only cristism is I'm afraid nit picking, could you put a and tag around all the blocks of text that are paragraphs, just to save the sub ed some work .

I thought I had paragraphed this properly?
At present 'testuser page' won't let me in to check; it says "this entry has been deleted".

BIGAL

I've managed that now.
BIGAL

Just a couple of comments.

"and the child is probably not infectious for longer than a week after the rash appears"

As a parent we are told that the child is infectious until new spots stop appearing - which can continue for a while - and have all crusted over.

I missed that! Yes a child stops being infectious when the last set of spots crush over..

One observation: acyclovir is very effective against shingles, reducing weeks of pain to one or two days of mild discomfort. However, it often doesn't get prescribed because it costs about £20/tablet, and health authorities don't seem to understand that this is in fact a much cheaper option than allowing someone to suffer weeks of pain and lose working time.

I caught chickenpox at the tender age of 25. I have never felt so ill in my life. This is why now, when the doctor said to me: 'these migraine tables are *very* expensive, costing £4 each' I shouted back at him 'have you ever *had* a bloody migraine? No, I thought not!' Eejits, the bloody lot of 'em.

*checks latest BNF*

Acyclovir has changed name to aciclovir and has gone off patent, and it's not that expensive, a course for shingles would be £31.75 that's about the same price as a month of tablets for hypertension and it's only a one off treatment.

Zorvirax, the branded verison of aciclovir is £75.11 for a course to treat shingles.

Every patient I've seen who's got shingles has had it prescribed. Maybe it was more expensive in the past when only Zovirax available.

It looks like it has become cheaper after it became generic. Still, it used to cause about £18/tablet years ago, I swear.

Yeah that makes sense the cost of Zovirax will have come down to make it competative with generic acyclovir.

Just returned from a week's vacation, so I'll check through some of these replies later. However, I know that cost of drugs can prohibit them from being prescribed. I have a friend whose wife has Alzheimers Disease. Apparently, galantamine (derived from snowdrops) is effective but is inordinately expensive so the local health authority won't fund it. This may be another e.g. of 'postcode lottery' because, if my memory serves me correctly, otheer HA's do prescribe it.

I've modified the section which covers the infectious period of CP.
BIGAL

Very clear & comprehensive.

Brings back vividly when my family suffered! First the 2 year old (mildly - we watched the spots appearing on his face over breakfast!) then almost simultaneously the 6 year old (after a couple of days he said he felt like he was going to explode, he was so itchy) & my then 38 year old husband (laid out for a fortnight, with pustules all over, including the soles of his feet).

Treatment for my husband included Piriton (recommended by the GP, probably for its sedative qualities) & oodles of calamine. Even baby lotion seemed soothing & harmless.

My son had chicken-pox at the start of July and his 3 year old sister started spotting whilst on holiday - both had no serious re-action.

I remember my Grandmother having shingles, and the old story coming out about how if the ring around her middle joined up she would die. She said it was the most painful thing she'd ever known.

For a time Acyclovir was only prescribed if the shingles was on the face, due to the threat of blindness, this because of the cost.

Nice readable entry.

Thorough, informative and well written

Spotted a few typos, though.
Opening para - H in Herpesviridae not italicised.
On your chart - 'Cytomegalic Inclusion Disease either doesn't need opening quotemark, or needs closing quotemark.

In Chicken Pox
Clinical features - "i.e an eruption of vesicles" > I must confess I've never known what i.e. stands for, but either it needs a period after the 'e', or maybe it would be better to say: "The visible symptom of chickenpox is an eruption of vesicles (a rash) which is centripetal,"
Neurological Complications - developes > develops
Causes Virus to Reactivate - 'run down > end quote or no quotes.

In Shingles
Opening para needs full stop at the end.
Clinical features - shingles one one side > shingles on one side

My only other question has to do with the belief that you can only get chicken pox once. This was a very popular belief when I was a child, I wonder if it is a widespread belief and, if it is, if it would be a good idea to affirm or dispel that belief here. Knowing (now, since reading your entry ) that the virus stays dormant in your system after the disease has passed it seems possible that it could reoccur as chicken pox again just as easily as it could reoccur as shingles. Is this true?

Hi Miloso,

I've corrected the typos. for that. Also, to cover your last point (excellent point - again) I've also included a new sub-heading entitled 'Can I catch chickenpox twice'

The reason that you can catch shingles and not chickenpox must be due to the fact that CP is caufght primarily through the respiratory route, and the immune system can come into play.

Shingles is a re-activation of the virus that is 'hiding' from the immune system in nerve tissue.