American Medical Association Family Medical Guide - American Medical Association [645]
Prevention
To help prevent tetanus, always clean small cuts with soap and water and apply an antiseptic to the wound. It is especially important to clean cuts that occur outdoors (where contamination with clostridium bacteria is more common) or puncture wounds (because they are hard to clean and provide an environment favorable to the growth of bacteria).
Infants are immunized against tetanus during their first year of life. Booster shots are recommended at 10-year intervals throughout life (see page 145). Make sure that each family member is immunized against tetanus and has a booster shot every 10 years; keep a record of the dates when family members received their shots. Because immunization against tetanus is routine, tetanus is rare in the United States, with fewer than 100 cases each year.
Shingles
Shingles is a condition caused by the reactivation of the varicella zoster virus (the virus that causes chickenpox; see page 439) and occurs mostly in older adults. During a chickenpox infection, the virus can invade the nerve cells in the brain stem or spinal cord and be inactive for years. If the virus is later reactivated, it can multiply, causing a rash of blisters and intense pain on the skin over the affected nerve. You cannot acquire shingles from contact with an infected person. However, if you have never had chickenpox, you can get chickenpox from a person who has shingles, because both conditions are caused by the same virus.
Shingles can affect almost any part of the body, but often affects one side of the trunk. The disorder can be serious if it affects the face or eyes, because it can cause temporary facial paralysis and impaired vision. It can also spread to the auditory nerves, resulting in hearing problems. In some cases, the pain from shingles persists after the blisters heal. This condition, called postherpetic neuralgia, can last weeks, months, or years.
A weakened immune system seems to play a part in reactivation of the virus. For this reason, people who have an impaired immune system, such as those who have an HIV infection or AIDS or who are being treated for cancer, are at increased risk of developing shingles. These people are also at increased risk of having recurring episodes of shingles.
Q & A
Shingles
Q. Can I get shingles from someone who has it?
A. You cannot get shingles from being around someone who has it. You can, however, get chickenpox, if you have never had it, from someone who has shingles because both are caused by the same virus.
Q. Both of my parents had shingles when they were in their 50s. Does this make me susceptible to getting shingles too?
A. No. Shingles does not have a genetic component. Anyone who has had chickenpox can develop shingles at any time, but the risk increases with age.
Q. Does stress cause shingles?
A. It’s possible. Any condition or illness that weakens the immune system, even temporarily, can increase a person’s risk of developing shingles. Stress can also weaken the immune system, making the dormant varicella zoster virus left in the body after a chickenpox infection more likely to be reactivated, causing shingles.
Symptoms
The symptoms of shingles include an itchy, tingling feeling or severe, burning pain in the affected area several days before a rash develops. A person may also have a headache, fever, or chills. The rash, which usually appears in a band or patch, can be itchy or painful and is contagious to people who have never had chickenpox. After a few days, the rash turns into small, fluid-filled blisters, which gradually become encrusted and less contagious. The blisters usually disappear after about 7 days and, in most cases, do not leave scars.
Diagnosis and Treatment
Your doctor can diagnose shingles from your symptoms. Laboratory tests can confirm the diagnosis.
To treat shingles and reduce your risk of developing postherpetic neuralgia, your doctor will prescribe an antiviral medication,