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Herpes Zoster

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Infectious Disease in the Aging

Part of the book series: Infectious Disease ((ID))

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Abstract

Herpes zoster is characterized by unilateral, dermatomal pain and rash caused by the reactivation of varicella-zoster virus (VZV) from a latent infection of dorsal sensory or cranial nerve ganglia.

Aging and cellular immune suppression are the most potent risk factors for herpes zoster.

The main consideration in the differential diagnosis of herpes zoster is herpes simplex virus reactivation. Patients with recurrent or atypical zosteriform rashes should have definitive microbiological testing (immunofluorescent antibody, culture, or polymerase chain reaction).

In many older adults with herpes zoster, pain control is the most important objective of treatment; early antiviral therapy and scheduled analgesics help control acute pain.

The zoster vaccine reduces the incidence of herpes zoster by one-half and the incidence of postherpetic neuralgia by two-thirds.

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References

  1. Gnann, J.W. Jr., & Whitley, R.J. (2002). Herpes zoster. New England Journal of Medicine, 347, 340–346.

    Article  PubMed  Google Scholar 

  2. Hope-Simpson, R.E. (1965). The nature of herpes zoster: a long-term study and a new hypothesis. Proceedings of the Royal Society of Medicine, 58–59.

    Google Scholar 

  3. Schmader, K.E., Gnann, J.W. Jr., & Watson, C.P.N. (2008). The epidemiological, clinical and pathological rationale for the zoster vaccine. Journal of Infectious Diseases, 197, S207–S215.

    Article  PubMed  Google Scholar 

  4. Oxman, M.N., Levin, M.J., Johnson, G.R., et al (2005). A vaccine to prevent herpes zoster and postherpetic neuralgia in older adults. New England Journal of Medicine, 352, 2271–2284.

    Article  PubMed  CAS  Google Scholar 

  5. Thomas, S.L., & Hall, A.J. (2004). What does epidemiology tell us about risk factors for herpes zoster. Lancet Infectious Disease, 4, 26–33.

    Article  Google Scholar 

  6. Dworkin, R.H., & Schmader, K.E. (2001). Epidemiology and natural history of herpes zoster and postherpetic neuralgia (pp. 39–64). In C.P.N. Watson & A.A. Gershon (Eds.), Herpes Zoster and Postherpetic Neuralgia (2nd ed). New York: Elsevier.

    Google Scholar 

  7. Jung, B.F., Johnson, R.W., Griffin, D.R., & Dworkin, R.H. (2004). Risk factors for postherpetic neuralgia in patients with herpes zoster. Neurology, 62, 1545–1551.

    PubMed  Google Scholar 

  8. Schmader, K.E., Sloane, R., Pieper, C., et al (2007). The impact of acute herpes zoster pain and discomfort on functional status and quality of life in older adults. Clinical Journal of Pain, 23, 490–497.

    Article  PubMed  Google Scholar 

  9. Katz, J., Cooper, E.M., Walther, R.R., Sweeney, E.W., & Dworkin, R.H. (2004). Acute pain in herpes zoster and its impact on health-related quality of life. Clinical Infectious Diseases, 39, 342–348.

    Article  PubMed  Google Scholar 

  10. Straus, S., Schmader, K.E., & Oxman, M.N. (2007). Varicella and herpes zoster (pp. 1885–1899). In I. Freedberg, S. Katz & K. Wolff (Eds.), Fitzpatrick’s Dermatology in General Medicine (7th ed). New York: McGraw-Hill.

    Google Scholar 

  11. Forghani, B. (2000). Laboratory diagnosis of infection (pp. 351). In A.M. Arvin & A.A. Gershon (Eds.), Virology and Clinical Management New York: Cambridge University Press.

    Google Scholar 

  12. Dworkin, R.H., Johnson, R.W., Breuer, J., et al (2007). Recommendations for the management of herpes zoster. Clinical Infectious Diseases, 44, S1–S26.

    Article  PubMed  CAS  Google Scholar 

  13. Schmader, K.E. (2007). Herpes zoster and postherpetic neuralgia (vol. 23, pp. 615–632). In K. High (Ed.), Clinics in Geriatric Medicine. Infectious Disease, Copyright © 2007 W.B. Saunders Company.

    Google Scholar 

  14. Whitley, R.J., Weiss, H., Gnann, J.W., et al (1996). Acyclovir with and without prednisone for the treatment of herpes zoster: a randomized, placebo-controlled trial. Annals of Internal Medicine, 125, 376–383.

    PubMed  CAS  Google Scholar 

  15. Berry, J.D., & Petersen, K.L. (2005). A single dose of gabapentin reduces acute pain and allodynia in patients with herpes zoster. Neurology, 65, 444–447.

    Article  PubMed  CAS  Google Scholar 

  16. Bowsher, D. (1992). Acute herpes zoster and postherpetic neuralgia: effects of acyclovir and outcome of treatment with amitriptyline. The British Journal of General Practice, 42, 244–246.

    PubMed  CAS  Google Scholar 

  17. Van Wijck, A.J.M., Opstelten, W., Moons, K.G., et al (2006). The PINE study of epidural steroids and local anaesthetics to prevent postherpetic neuralgia: a randomised controlled trial. Lancet, 367, 219–224.

    Article  PubMed  CAS  Google Scholar 

  18. Seward, J.F., Watson, B.M., Peterson, C.L., et al (2002). Varicella disease after introduction of varicella vaccine in the United States, 1995–2000. Journal of the American Medical Association, 287, 606–611.

    Article  PubMed  Google Scholar 

  19. Garner, J.S. (1996). Guideline for isolation precautions in hospitals. The Hospital Infection Control Advisory Committee. Infectious Control and Hospital Epidemiology, 17, 53–80.

    Article  CAS  Google Scholar 

Suggested Reading

  • Dworkin, R.H., Johnson, R.W., Breuer, J., et al (2007). Recommendations for the management of herpes zoster. Clinical Infectious Diseases, 44, S1–S26.

    Article  PubMed  CAS  Google Scholar 

  • Gnann, J.W. Jr., & Whitley, R.J. (2002). Herpes zoster. New England Journal of Medicine, 347, 340–346.

    Article  PubMed  Google Scholar 

  • Oxman, M.N., Levin, M.J., Johnson, G.R., & the Shingles Prevention Study Group. (2005). A vaccine to prevent herpes zoster and postherpetic neuralgia in older adults. New England Journal of Medicine, 352, 2271–2284.

    Google Scholar 

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Acknowledgment

This work was supported by the Durham VA Medical Center Geriatric Research, Education, and Clinical Center (GRECC).

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  1. Geriatric Research, Education and Clinical Center (GRECC), Durham Veterans Affairs Medical Center, Durham, NC, 27705, USA

    Kenneth Schmader

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  1. Kenneth Schmader
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Correspondence to Kenneth Schmader .

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    © 2009 Humana Press, a part of Springer Science+Business Media, LLC

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    Schmader, K. (2009). Herpes Zoster. In: Norman, D., Yoshikawa, T. (eds) Infectious Disease in the Aging. Infectious Disease. Humana Press. https://doi.org/10.1007/978-1-60327-534-7_16

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    • DOI: https://doi.org/10.1007/978-1-60327-534-7_16

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    • Publisher Name: Humana Press

    • Print ISBN: 978-1-60327-533-0

    • Online ISBN: 978-1-60327-534-7

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