Summary And Quick Facts For Herpes And Shingles
- Herpes and shingles are both caused by members of the Herpesviridae family of viruses, which can establish latent infections that remain dormant before reactivating at a later time under certain conditions. Herpes simplex virus-1 and herpes simplex virus-2 cause oral and genital herpes, and varicella-zoster virus causes chickenpox in children and shingles later in life.
- In this protocol, you will learn about the viruses that cause herpes and shingles, and how these infections are conventionally treated. Several natural ingredients that may help ease the symptoms of herpes and shingles will also be discussed, and important lifestyle and dietary considerations that can help prevent outbreaks will be examined as well.
- Antiviral medication is the standard treatment for both shingles and herpes. Although there is no effective cure for herpes virus infections, several natural interventions may help reduce the frequency of outbreaks.
Herpes and shingles are both caused by members of the Herpesviridae family of viruses, which can establish latent infections that remain dormant and then reactivate under certain conditions. Herpes simplex virus-1 and herpes simplex virus-2 cause oral and genital herpes, and varicella-zoster virus causes chickenpox in children and shingles later in life.
Clinical Herpes Simplex Infection
Primary infection with herpes simplex involves grouped vesicles on an erythematous base. Mucocutaneus manifestations include eczema herpeticum, herpetic whitlow, herpes gladiatorum, folliculitis, or a severe/chronic mucocutaneous infection. Extracutaneous manifestations include ocular HSV keratoconjunctivitis. Herpes Encephalitis, Proctitis, and Neonatal HSV. These manifestations are often the ones with prominent morbidity and mortality .
Ocular HSV infection has complications that include corneal ulceration and scarring, globe rupture, and subsequent blindness. Epithelial keratitis has strong links to viral replication, while stromal keratitis is primarily immunopathologic and is promoted mainly by T cells . Consequently, HSV is one of the main causes of infectious blindness in developed countries .
Herpes encephalitis has > 70% mortality without treatment, with residual neurological defects in most surviving patients . Similarly, disseminated neonatal HSV has 50% mortality without treatment, 15% with treatment and with neurologic deficits in many recovering patients .
Long Term Side Effects
In rare cases, the live shingles vaccine, Zostavax, can cause a skin rash or shingles.
The rash that occurs with shingles can affect any area of the body, but it often appears as a line of blisters that wraps around the torso.
Within a few days the blisters cluster, and they continue to form for several more days. The blisters can take 2â3 weeks to heal, according to the American Academy of Dermatology.
Other common symptoms of shingles include:
two shingles vaccines for adults: the recombinant zoster vaccine and the zoster virus vaccine .
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How Cdc Monitors Vaccine Safety
CDC and FDA monitor the safety of vaccines after they are approved or authorized. If a problem is found with a vaccine, CDC and FDA will inform health officials, health care providers, and the public.
CDC uses 3 systems to monitor vaccine safety:
- The Vaccine Adverse Event Reporting System : an early warning system, co-managed by CDC and FDA, to monitor for potential vaccine safety problems. Anyone can report possible vaccine side effects to VAERS.
- The Vaccine Safety Datalink : a collaboration between CDC and 9 health care organizations that conducts vaccine safety monitoring and research.
- The Clinical Immunization Safety Assessment Project: a partnership between CDC and several medical research centers that provides expert consultation and conducts clinical research on vaccine-associated health risks.
Primary And Secondary Immune Responses To Hsv
Innate Immune Response
The innate immune system consists of a variety of components including neutrophils, natural killer cells, monocytes, dendritic cells, macrophages, and the complement cascade . It is the first line of defense against pathogens. A strong innate immune response to foreign antigens is essential to the development of the adaptive humoral and cellular responses of long-lasting immunity . Adjuvants are added to subunit vaccines to elicit an innate response for this purpose. Pattern recognition receptors on host cells allow for the detection and response to viral infections. On binding to pattern recognition receptors , signal transduction leads to the production of various proteins including interferons . Interferons are glycoprotein signaling molecules produced by infected cell lines. They act locally, priming viral defense mechanisms within local cells .
HSV-1 is known to have multiple ligands that bind TLRs, leading to activation of the NF-kB pathway . However, herpes simplex virus is also known to evade the innate immune responses, specifically TLR signaling and interferon production to further viral proliferation . Additionally, a critical aspect of the innate immune system that contributes to the adaptive response is antigen presentation. HSV infection can stimulate autophagy, leading to a more efficient presentation of antigens. However, HSV-1 ICP34.5 gene product antagonizes the response by binding Beclin 1 , essential to autophagy .
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Considerations For Patients Who Previously Received Zostavax
Studies have not examined the safety and immunogenicity of Shingrix administered less than 5 years following Zostavax vaccination. However, there are no data or theoretical concerns to indicate that Shingrix would be less safe or less effective when given at an interval shorter than 5 years following Zostavax. Since the risk of herpes zoster increases with age, providers should weigh a patients risk of herpes zoster with the age-specific protection expected from Zostavax to determine when to vaccinate with Shingrix.
Can My Grandfather With Shingles Give My Baby Daughter Chickenpox
Yes, although people with shingles cannot pass shingles to someone else, they can pass chickenpox virus to others through direct contact with the rash. If your baby has not yet had chickenpox or the chickenpox vaccine, she could become infected with the virus and develop chickenpox.
Unlike chickenpox that can be passed to others through coughs or sneezes, people with shingles can only pass the virus to others through direct contact with the rash. If the rash has yet to develop or has crusted, the patient cannot transmit the virus. Similarly, people who still have pain without the rash are no longer able to transmit the virus.
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Benefits Of Shingles Vaccination
Shingles vaccination significantly reduces your risk of developing shingles. Vaccination of older adults reduces the number of shingles cases in that population by about half, according to the National Institute of Neurological Disorders and Stroke.
Adults who get shingles despite vaccination typically get a much milder case than unvaccinated adults. Vaccination also greatly reduces an individuals risk of shingles complications, including post-herpetic neuralgia or vision loss.
Studies have found that the Shingrix vaccine is 97% effective in preventing shingles in adults ages 50 to 69 and 91% effective in adults ages 70 and older. The vaccine is 91% effective in preventing PHN in adults ages 50 to 69 and 89% effective in preventing this complication in adults ages 70 and older.
The Shingrix vaccine does not contain any live virus, so you cannot contract shingles from vaccination.
Disclaimer And Safety Information
This information is not intended to replace the attention or advice of a physician or other qualified health care professional. Anyone who wishes to embark on any dietary, drug, exercise, or other lifestyle change intended to prevent or treat a specific disease or condition should first consult with and seek clearance from a physician or other qualified health care professional. Pregnant women in particular should seek the advice of a physician before using any protocol listed on this website. The protocols described on this website are for adults only, unless otherwise specified. Product labels may contain important safety information and the most recent product information provided by the product manufacturers should be carefully reviewed prior to use to verify the dose, administration, and contraindications. National, state, and local laws may vary regarding the use and application of many of the therapies discussed. The reader assumes the risk of any injuries. The authors and publishers, their affiliates and assigns are not liable for any injury and/or damage to persons arising from this protocol and expressly disclaim responsibility for any adverse effects resulting from the use of the information contained herein.
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How Well Does Shingrix Work
Two doses of Shingrix provide strong protection against shingles and postherpetic neuralgia , the most common complication of shingles.
- In adults 50 to 69 years old with healthy immune systems, Shingrix was 97% effective in preventing shingles in adults 70 years and older, Shingrix was 91% effective.
- In adults 50 years and older, Shingrix was 91% effective in preventing PHN in adults 70 years and older, Shingrix was 89% effective.
- In adults with weakened immune systems, Shingrix was between 68% and 91% effective in preventing shingles, depending on their underlying immunocompromising condition.
In people 70 years and older who had healthy immune systems, Shingrix immunity remained high throughout 7 years following vaccination.
What Are The Side Effects Of The Shingles Vaccine
Just like with any other medication or vaccine, there is always a risk of potential side effects or allergic reactions. The shingles vaccine, however, is considered to be safe and poses a small risk of side effects.
- The Zostavax shingles vaccine may cause:
- Redness, soreness, swelling, or itching at the site of the injection, or
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When Should I See A Doctor Because Of The Side Effects I Experience From Shingrix
Shingrix causes a strong response in your immune system, so it may produce short-term side effects. These side effects can be uncomfortable, but they are expected and usually go away on their own in 2 or 3 days. You may choose to take over-the-counter pain medicine such as ibuprofen or acetaminophen. Contact your healthcare provider if the symptoms are not improving or if they are getting worse.
In clinical trials, Shingrix was not associated with serious adverse events. In fact, serious side effects from vaccines are extremely rare. For example, for every 1 million doses of a vaccine given, only one or two people might have a severe allergic reaction. Signs of an allergic reaction happen within minutes or hours after vaccination and include hives, swelling of the face and throat, difficulty breathing, a fast heartbeat, dizziness, or weakness. If you experience these or any other life-threatening symptoms, see a doctor right away.
Conventional Treatment And Prevention
Standard treatment for herpes virus infections is antiviral medication. The main antiviral medications used for both shingles and herpes are acyclovir, famciclovir , and valacyclovir .10,64,72 All three medications can be taken orally, reduce pain, and speed healing of the lesions however, famciclovir and valacyclovir areoften preferred because they require less frequent dosing than acyclovir.72
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Research To Find Better Treatments Vaccines And Cures For Herpes
Human herpesviruses are a family of pathogens that play an outsized role in inflicting pain and misery on people everywhere.Herpes simplex type 1 is responsible for oral herpes, or cold sores. Highly contagious, HSV-1 is estimated to have infected 3.7 billion people, about two-thirds of all people under the age of 50. It can also cause genital herpes through oral sex.Herpes simplex type 2 is the virus responsible for most genital herpes cases. HSV-2 causes recurrent outbreaks of small, painful blisters in a rash that may take 2-4 weeks or more to heal. It can be transmitted even when a person is asymptomatic. About 12 percent of the U.S. population aged 14-49 is infected, about 500 million throughout the world.Symptoms of genital herpes can be eased with antiviral drugs. But there are no vaccinations against herpes. There is no cure.
Problems of this scope demand attention from the worldâs top researchers. Thatâs why Fred Hutch scientists, with a wealth of expertise in virology, have made the study of human herpesviruses a priority.
Replication Defective Virus Vaccine
Dl5-29 is a strain of HSV-2 with mutations in essential viral genes UL5 and UL29 making it replication defective. It was tested as both a prophylactic and therapeutic vaccine. It was shown to be safe, producing neutralizing antibodies and CD4+ T-cell responses in seronegative subjects who were vaccinated . Recent studies have demonstrated the production of antibodies mediating NK cell activation. Additionally, HSV-2 gD antibodies were detected in cervicovaginal fluid at around one-third of the serum level .
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Can You Sleep With Someone With Herpes And Not Get It
Yes. Herpes can be passed on even if a partner has no sores or other signs and symptoms of an outbreak. And if a partner has a herpes outbreak, it’s even more likely to be spread. Even when a person doesn’t have visible sores, the only surefire way to protect against getting genital herpes is abstinence.
How Do I Get The Shingles Vaccination
Once you become eligible for the shingles vaccination, a GP or practice nurse will offer you the vaccine when you attend the surgery for general reasons.
You can have a shingles vaccine at the same time as most other vaccines. But try to leave 7 days between the shingles vaccine and a coronavirus vaccine, so that if you have any side effects you’ll know which vaccine they were from.
If you are worried that you may miss out on the shingles vaccination, contact your GP surgery to arrange an appointment to have the vaccine.
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For Patients Who Do Not Report A Prior Episode Of Varicella
When vaccinating immunocompetent adults aged 50 years and older, there is no need to screen for a history of varicella or to conduct laboratory testing for serologic evidence of prior varicella. More than 99% of adults aged 50 years and older worldwide have been exposed to varicella-zoster virus, and the Advisory Committee on Immunization Practices considers people born in the United States prior to 1980 immune to varicella. Therefore, even if a person does not recall having chickenpox, serologic testing for varicella immunity is not recommended. It is often a barrier to herpes zoster vaccination, and false negatives are common. However, if serologic evidence of varicella susceptibility becomes available to the healthcare provider, providers should follow ACIP guidelines for varicella vaccination. Shingrix has not been evaluated in persons who are seronegative to varicella, and it is not indicated for the prevention of varicella.
For adults 19 years of age and older who are or will be immunocompromised, see .
Contraindications And Precautions For Herpes Zoster Vaccination
Shingrix should not be administered to:
- A person with a history of severe allergic reaction, such as anaphylaxis, to any component of this vaccine.
- A person experiencing an acute episode of herpes zoster. Shingrix is not a treatment for herpes zoster or postherpetic neuralgia . The general guidance for any vaccine is to wait until the acute stage of the illness is over and symptoms abate.
There is currently no CDC recommendation for Shingrix use in pregnancy therefore, providers should consider delaying vaccination until after pregnancy. There is no recommendation for pregnancy testing before vaccination with Shingrix. Recombinant vaccines such as Shingrix pose no known risk to people who are breastfeeding or to their infants. Providers may consider vaccination without regard to breastfeeding status if Shingrix is otherwise indicated.
Adults with a minor acute illness, such as a cold, can receive Shingrix. Adults with a moderate or severe acute illness should usually wait until they recover before getting the vaccine.
To learn more, see Contraindications and Precautions, General Best Practice Guidelines for Immunization: Best Practices Guidance of the Advisory Committee on Immunization Practices .
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Fever And Feelings Of Malaise
Fever is one of the most common side effects of many vaccines, including Shingrix. This symptom often accompanies other feelings of malaise, such as muscle pains, chills, and headaches. A fever indicates that the bodys immune system is doing its job of responding to the vaccine.
Ibuprofen, acetaminophen, and other OTC fever reducers can help keep a fever and many accompanying symptoms at bay. However, if you develop a high-grade fever of 103°F or higher, reach out to your doctor immediately.
Vaccines To Help Prevent Pneumonia
Pneumococcal disease is a serious infection that spreads from person to person by air. It often causes pneumonia in the lungs and it can affect other parts of the body. Older adults are at higher risk than younger people of getting very sick or dying from pneumococcal disease.
The CDC recommends that all adults age 65 and older get pneumococcal vaccination. This vaccine will help protect you from getting a serious infection, including pneumonia. There are multiple forms of the pneumococcal vaccine: Talk to a health care provider to find out which is best for you. You can also visit the CDCs Pneumococcal Vaccination webpage to learn more about the types of vaccines that are available.
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New Approach Uses Mrna
Early efforts to produce a protein-based vaccine for herpes failed. But a new mRNA approach has outperformed the efficacy of the past vaccines in preclinical trials and is expected to be introduced in clinical trials in the second half of 2022, investigators say. This new approach for a prophylactic genital herpes vaccine showed great promise in early studies.1
Research into the mRNA herpes vaccine began long before the COVID-19 mRNA vaccines were developed, says Harvey M. Friedman, MD, professor of medicine/infectious diseases at the University of Pennsylvania Perelman School of Medicine.
Were pretty far along in the research, he says. We are using the mRNA technology in a vaccine effort for preventing genital herpes. Its not, at this point, intended for a treatment.
The vaccine, which was studied in mice and guinea pigs, showed exceptionally good prevention. Were hopeful it will make it into humans this year, Friedman says. Sometime in the summer of 2022 is our target.
This vaccine is good news for everyone at risk of STIs. More than one out of 10 Americans, age 49 years and younger, are infected with genital herpes, says Sita Awasthi, PhD, associate research professor in the infectious disease division at Perelman School of Medicine.
The vaccine also might help reduce HIV infection, since herpes greatly increases a persons risk of contracting HIV, Awasthi says.