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WAVRE, Belgium—Most Filipinos would not be familiar with the viral infection shingles (herpes zoster or HZ) even if they may already be suffering from it. The infection’s scientific name strikes fear and carries a stigma because in the Philippines, you hear “herpes” and you think, sexually transmitted infection (STI)—the condition also known as genital herpes. You hear “shingles” and you probably would be more familiar with the term as a kind of roof tile. And while it is appropriately obscure, most have also never heard of its Tagalog name: kulebra.

But the first thing you need to know is what shingles is not: It is not an STI.

“Herpes simplex and herpes zoster belong to the same family, which is the herpes virus,” Yan Sergerie, PhD, vice president and Global Medical Portfolio lead of GlaxoSmithKline (GSK), told Inquirer Lifestyle.

In fact, shingles is actually caused by the same virus that causes chicken pox, the varizella-zoster virus (VZV). It has more to do with that illness that ruined a childhood summer than anything transmitted by sexual activity.

But shingles is “a painful, possibly debilitating disease that can have serious and long-lasting complications,” said Dr. Raunak Parikh, medical director for Global Medical Affairs for GSK.

What happens is that when you get chicken pox, say, as a child, you get those itchy rashes and fever, and are contagious. But then, after some time, the symptoms—especially the rashes—go away, but the virus actually stays dormant in your body in what is called the latency period.

Reactivation

Shingles is what happens when the virus is reactivated much later in life, kind of a resurrected chicken pox for adults—with some crucial differences.

No one really knows what causes the virus to reactive, though it has been linked to stress and having weakened immunity.

The first sign are the itchy rashes, often painful to the touch, that become clear blisters. Then the bad body pain; note that immunocompromised individuals will have worse symptoms, notes Dr. Parikh. Shingles itself often lasts anywhere from two to four weeks.

The pain is often extreme—what is called post-herpetic neuralgia (PHN)—enough to keep patients bedridden, and can require pain medication years after the bout of shingles.

Even worse are complications such as herpes zoster opthalmicus, a condition that affects 10–25 percent of patients that could lead to loss of vision, hearing loss, permanent scarring and discoloration; it could even lead to strokes.

Perhaps the strangest aspect of shingles is that while they will not give other people shingles, shingles patients can infect a person who has not yet had chicken pox.

Shingles is a very common disease as one out of three people in the United States will develop it, according to the Centers for Disease Control and Prevention. Furthermore, while you could get it anytime, there is a steep increase in cases after the age of 50. The older you are, the more likely you are to get it. And unfortunately, you can get shingles more than once.

Vaccines available

It’s also an old disease. “We were getting more and more familiar with it, but shingles has been around since the dawn of time,” says Sergerie. “But there were no appropriate preventive measures before. So, physicians were trying to treat it the best way they could, and there were some options, but not very effective ones.” It has traditionally been treated with analgesics and antivirals.

“Now that we have vaccines available,” he adds, “this is where you start to see more disease awareness campaigns, you're starting to see more indications coming from the physician to the patients, because they feel more confident in discussing this disease because now there are preventive options.”

It is certainly growing more important to make people aware of shingles, because they used to get treated for it only after they had already caught it, when they can now be vaccinated for it. They know what it is, and should not be embarrassed by it.

There is a particular need for this in the Philippines, because the Department of Health does not keep records of cases. In fact, the 2017 BMC Infectious Diseases medical journal article noted, “Epidemiology data from Indonesia, Malaysia, the Philippines, and Vietnam are needed to provide a more balanced picture.”

Filipino adults thus need to be aware of signs of kulebra and take preventive measures, especially among senior citizens. Talk to your doctor at the first sign of rashes.