Stealthy Virus

The trouble began with what felt like a speck of grit in my left eye. I didn’t think anything was seriously wrong–until three days later when the eye puffed up and turned weepy and red. I called Glen Ellyn Clinic near my home in west suburban Chicago, and a couple of hours later I found myself seated in a darkened room across from ophthalmologist Mary Mehaffey.

Dr. Mehaffey seemed genuinely concerned, so I took a deep breath and decided to tell her everything. “You’re going to think I’m a hypochondriac,” I began. “But you know, around the same time this eye problem started, I also developed these bumps along the side of my face…” I brushed my hair aside so Dr. Mehaffey could see. She looked at the bumps and then at me. “It sure looks like shingles,” she said. I listed other odd things I’d noticed–the red line snaking down my forehead, the tingling sensation at the end of my nose. “It sure looks like shingles,” she repeated.

Shingles? I recalled that my father had been afflicted by this strange ailment, but I knew little about shingles until I did some digging. I learned that shingles could be thought of as the revenge of the chicken pox, or of varicella-zoster, the virus behind this childhood disease. A close cousin of herpes simplex, which causes cold sores, varicella-zoster can be beaten back by the immune system but never eradicated. Like a bandit pursued by a posse, it retreats to a safe haven–bundles of nerve cells in the spinal cord or cranium. There varicella-zoster lies dormant, usually for decades.

The name shingles derives from cingulum (Latin for belt or girdle) and refers to the fact that the accompanying blisters often cluster in a broad band, typically on just one side of the body. In my case, the skin lesions traced out the end branches of the fifth cranial, or trigeminal, nerve and affected only the left half of my face. In other cases, the lesions might appear on the chest, stomach or back.

Shingles (a.k.a. herpes zoster) is a common ailment. Over the course of a lifetime, 2 out of every 10 people who have had chicken pox will experience its misery. But while the disease can strike at any time, the risk increases sharply after age 50. Why? Probably because older people have fewer antibodies against varicella-zoster circulating in their bloodstream. Also at high risk are those whose immune systems are compromised, such as AIDS and transplant patients.

For the most part, the otherwise healthy completely recover from shingles, though when the eyes or ears are affected, permanent damage can occur. Other complications include excruciating pain that can linger for months, even years. “You were lucky,” said Dr. Philip Brunell, a shingles expert at the National Institutes of Health, when he heard that I had gone back to work within a week. “At your stage some people can’t bear to put on clothes.”

Current therapies–anti-inflammatories like prednisone and antivirals like acyclovir–are aimed at alleviating symptoms. But there may soon be a better option. A more potent version of the vaccine that’s used to inoculate children against chicken pox is being tested on older adults, and if it works as well as hoped, millions of aging baby boomers will be lining up for shots. As for me, I’ve crossed shingles off my worry list. Very likely the attack I endured has rendered me immune to another.

For more information on shingles, visit www.niaid.nih.gov You can e-mail Madeleine at JMadeleine@aol.com