Duisburg/Oberhausen. Almost 1/3 of Germans have suffered from shingles at least once in their lifetime – and the trend is increasing. In people over the age of 85, 50 percent had herpes zoster. Despite an effective and well-tolerated vaccine, many people hesitate – the vaccination rate is only 7.7 percent*. Duisburg and Oberhausen dermatologist and head of the Helios expert group Prof. Dr. Alexander Kreuter reports.
About 300,000 to 400,000 people get sick every year – shingles is one of the most common diseases in Germany. The trend across Germany can be seen in the treatment statistics of the Helios clinics: from 2013 to 2019, the number of zoster cases requiring inpatient treatment increased by 25 percent. After a brief decline in treatment numbers due to the pandemic, the trend is now continuing and shingles diagnoses are on the rise again. A cause for concern for doctors. “Herpes zoster (herpes zoster) is caused by the herpes virus type 3, also known as the varicella zoster virus (VZV), Prof. Dr. Alexander Kreuter, head physician Helios Skin Clinics in Duisburg And Oberhausen. “VZV causes two diseases: the childhood disease chicken pox (varicella) is a primary infection and shingles is an endogenous VZV reactivation.”
The faster the treatment, the better the result
“Classic shingles can be recognized by the sudden appearance of blisters on a red surface accompanied by a dermatome – supplied by sensory nerves,” explains the head of the dermatology team at the Helios Group. “Shingles can be noticed by previous unpleasant sensations.” It also occurs in the forehead area. The former gave the disease its popular name – a disease in the belt region,” says Professor Grueter.
There are various oral antiviral treatments available to treat shingles. In addition, pain treatment and treatment of skin changes are necessary for a good therapeutic effect. The following applies: “The sooner shingles is treated, the better,” says Professor Grueter, who emphasizes early action and explains: “In people with facial disease and a weakened immune system, zoster should be treated intravenously. So usually in the hospital. If left untreated, shingles can have serious consequences.” The most common complication is post-herpetic neuropathy, which lasts for months, sometimes years. In addition, in some cases of zoster, the eye (zoster ophthalmicus), ear (zoster oticus), or brain (zoster encephalomyelitis) can develop. can also be affected, resulting in permanent nerve damage.
Effective shingles vaccine for risk groups
People over the age of 60 should pay particular attention to warning signs on their skin – because from the age of 60, the number of cases of shingles in the general population increases significantly. “This is due to a natural decline in specific T cells in the body that target VZV,” explains the dermatologist. “We see more young people with herpes zoster in our skin clinics in Duisburg and Oberhausen. The reason for this is still unclear – it may be related to “lifestyle factors” such as sun-exposed holiday trips.” People with acquired, congenital, or drug-induced immunosuppression have a significantly increased risk of shingles, as do patients. Certain underlying diseases (including chronic lung diseases, heart disease or cancer). The risk is particularly high after specialized cancer treatments such as stem cell transplants.
STIKO recommends a zoster vaccine (inactivated vaccine/Shingrix) for these immunocompromised individuals 18 years and older and for everyone 60 years and older. “Overall, the vaccine is well-tolerated and the immunogenicity of the vaccine is very high – meaning that the vaccine will be effective for many years,” explains Professor Kreuter. “Even if you already have shingles, getting vaccinated is worth it.” A multidisciplinary German expert group recommends vaccination with two doses of the vaccine 3 to 12 months later. It is important that the disease is completely cured at the time of vaccination.
