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.
Who Needs A Shingles Vaccine
Shingrix is recommended for adults aged 50 or older. You should still get the vaccine even if youve had shingles in the past, as it is possible to get it again.
You can also get Shingrix if you received Zostavax in the past. This is important because studies have shown that the efficacy of Zostavax over time.
How Are Hsv Infections Currently Treated And Prevented
People with HSV infections can take prescription antiviral medications like or to help resolve blisters when they appear. And some people will take these medications daily to prevent outbreaks, too. Over-the-counter options, such as the topical cream , are also available for cold sores.
One thing to know is that most people dont even know that they have an infection because they arent experiencing symptoms but its still possible to spread it to others if youre symptom-free. As a general rule, youll want to use condoms to help lower the chance of transmitting the virus during sex, especially if you know that youre carrying the virus.
But unfortunately, these strategies only work partially. People with HSV may find that available medications do not work well for them, and condoms may not cover all areas where blisters appear. This has prompted research into whether a vaccine for these viruses is possible.
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Current Hsv Vaccine Studies
In 2014, the World Health Organization released a report that listed 15 different vaccines that were being studied for HSV. Most of these were still in very early animal studies. One vaccine developed by GlaxoSmithKline, Herpevac, made it to the final clinical trial needed before seeking FDA approval. Unfortunately, Herpevac was not as effective as researchers had hoped.
However, in November 2020, scientists released results from an early animal study that are promising. Researchers are looking at a new type of HSV vaccine that hasnt been tested yet. This potential vaccine uses a different piece of genetic material from HSV to produce an immune response that past vaccine candidates have not. This newest attempt showed better protection against HSV in the animal study than previous vaccines have.
Currently, there are many studies of HSV vaccines underway. Some have been completed with mixed results, and others are still recruiting participants. Researchers hope future human clinical trials will have better results than past studies.
Just as with any vaccine, an HSV vaccine will need to go through three types of clinical trials phase 1, 2, and 3 trials before being approved by the FDA to make sure that its safe and effective in humans. This process typically takes several years, so it will likely be some time before we see an HSV vaccine come to market.
Shots May Help Prevent Genital Herpes Transmission
Three-shot regimen seems to control lesions as effectively as daily pills, but wider trials needed
Researchers tested the experimental vaccine in 310 people with herpes from 17 centers around the United States. The three shots, administered three weeks apart, appeared to reduce patients’ genital lesions and the process of “viral shedding” in which they can spread the disease through sexual contact.
Infectious disease experts hailed the vaccine as a promising development in the treatment of genital herpes. The incurable disease affects about one in every six people ages 14 to 49 in the United States, according to the U.S. Centers for Disease Control and Prevention.
“In general terms, people receiving have greater than 50 percent fewer days in which virus is present in their genital tracts, which in theory may reduce transmission,” said study author Jessica Baker Flechtner. She’s chief scientific officer at Genocea Biosciences, the Cambridge, Mass., manufacturer of the vaccine.
“However, this would need to be proven in a well-powered clinical trial,” she added. “Our trials have included both men and women, and to date, we have not seen a difference in the vaccine impact between genders.”
Patients were randomly split into seven dosing groups, including a placebo group.
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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
Why Is Creating An Hsv Vaccine So Difficult
Herpesviruses can live in your body undetected, meaning your immune system does not react to them right away. The longer the virus goes undetected, the more difficult it is to make an effective vaccine.
When scientists make vaccines, they target the part of your immune system that recognizes an invader like a virus or bacteria has entered your body. The vaccine then teaches your body how to kill the invader before it makes you sick. If the immune system does not react to HSV right away, a vaccine cannot teach your body how to protect you.
HSV vaccine studies in animals have had good results. But when these vaccines were studied in humans, they did not work as well. Thats when pharmaceutical companies have to restart their research attempts.
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Guidance On Reporting Adverse Events Following Immunization
Vaccine providers are asked to report AEFIs through local public health officials and to follow AEFI reporting requirements that are specific to their province or territory. In general, any serious or unexpected adverse event felt to be temporally related to vaccination should be reported.
For LZV the following AEFIs are also of particular interest and should be reported:
- Suspected transmission of vaccine-strain virus to a close household or occupational contact. This phenomenon has been documented following varicella vaccine but it is rare, and transmission has not been documented with LZV.
- Recurrent HZ following immunization of individuals with a history of HZ prior to immunization, noting the area of recurrence.
- Recurrent HZO following immunization of a person who has had a previous episode of HZO. If available, a vitreous fluid specimen should be sent to a laboratory with a request to determine whether the virus is the vaccine strain or wild type virus.
For definitions of serious and unexpected adverse events, refer to Adverse events following immunization in Part 2.
For more information refer to Reporting Adverse Events Following Immunization in Canada.
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Sanofi Pasteur Inc. is moving ahead with a vaccine called HSV529, Rinaldo said. “That’s based on an attenuated virus. They’ve taken out two proteins that are essential for the virus to replicate efficiently. The virus replicates poorly and apparently doesn’t cause lifelong infection.”
Other vaccine candidates are in the works, with at least one showing positive results in mouse models, Rinaldo said.
Linda Carroll is a regular health contributor to NBC News and Reuters Health. She is coauthor of “The Concussion Crisis: Anatomy of a Silent Epidemic” and “Out of the Clouds: The Unlikely Horseman and the Unwanted Colt Who Conquered the Sport of Kings.”
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Very Common And Common Adverse Events
Very common adverse events occur in 10% or more of vaccinees. Common adverse events occur in 1% to less than 10% of vaccinees.
Injection site reactions are very commonly reported for both LZV and RZV. For LZV recipients the frequency is slightly higher in adults aged < 60 years. For all ages, the majority of these events were rated mild or moderate in intensity and lasted less than 2 days.
Due to the adjuvant in RZV, which induces a high cellular immune response and helps address the natural age-related decline in immunity, RZV is more reactogenic than LZV.
Injection site AEs are very commonly reported by recipients of RZV. Approximately 80% report injection-site pain and approximately 30% report redness at the site of injection.
Systemic adverse events, primarily fatigue and myalgia are common in LZV recipients and very common in RZV recipients . For RZV, they include headache .
Local and systemic reactions that were severe enough to interfere with normal activities have been more frequently reported following the receipt of RZV than LZV. However, these reactions have been temporary . Patient education on the short-term reactogenicity of the RZV is recommended prior to vaccine administration to promote adherence to the second dose.
Is The Shingles Vaccine Worth It
Yes. Although many people are able to recover from shingles without any lasting problems, up to 30% of people go on to have postherpetic neuralgia. Approximately 18% of people have other long-term issues, including:
The vaccine is highly effective at preventing both shingles and its complications.
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Who Should Not Get Shingrix
You should not get Shingrix if you:
- have ever had a severe allergic reaction to any component of the vaccine or after a dose of Shingrix
- tested negative for immunity to varicella zoster virus. If you test negative, you should get chickenpox vaccine.
- currently have shingles
- currently are pregnant or breastfeeding. Women who are pregnant or breastfeeding should wait to get Shingrix.
If you have a minor acute illness, such as a cold, you may get Shingrix. But if you have a moderate or severe acute illness, you should usually wait until you recover before getting the vaccine. This includes anyone with a temperature of 101.3°F or higher.
The side effects of the Shingrix are temporary, and usually last 2 to 3 days. While you may experience pain for a few days after getting Shingrix, the pain will be less severe than having shingles and the complications from the disease.
Hsv Pathogenesis And Replication
Replication is a multi-step process. Post-infection, HSV glycoproteins interact with and attach to the cell. The viral envelope then fuses with the cell membrane, releasing its contents into the cell. DNA is uncoated and transported into the nucleus when nucleocapsid fuses with the viral envelope . Here, immediate-early genes are transcribed . Primary herpes infection involves replication within epithelial cells, with an incubation period of 46 days. Mature virions are then transported to the cell membrane, where they are released, causing cell lysis and local inflammation. Replication continues until host immune responses contain the initial infection .
Herpesvirus ascends peripheral sensory nerves to spread to the trigeminal ganglion, where latent infection develops. Latent virus can be induced to reactivate. Reactivation has been associated with various stimuli including stress, infections, and UV light exposure. However, from a molecular standpoint, reactivation is a phenomenon that continues to be studied and is not clearly understood. Clinical manifestations of reactivation vary widely in terms of presentation and severity .
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Coadministration With Influenza Vaccine
A total of 828 patients were included in the study, 413 in the co-administration group and 415 in the control group. Among coadministration patients, VRR was 95.8% , and anti-gE GMC ratio was 1.08 . Immunogenicity to the IIV4 vaccine was also noninferior between the groups. This study demonstrated that immune responses to both HZ/su and IIV4 were not affected by coadministration.
Is It Possible To Get Shingles Twice
Most people who get shingles only experience it one time in their lives. However, it is possible to get shingles more than once . This is known as recurrent shingles. Getting vaccinated can help minimize the chance that this will happen.
These are only a few of the many questions people may have about Shingrix. To learn more about the vaccine and shingles, individuals can consult a medical professional.
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Medicare Coverage For Shingles Vaccine
Shingrix is not the first shingles vaccine, but it is the only one currently on the market in the United States.Instead of using a live virus,the vaccine uses a protein from the virus to trigger an immune response. It is administered in two doses two to six months apart.
This shingles vaccine has been shown to decrease the risk for shingles by 97% for people between 50 and 69 years old and by 91% for people 70 and older. It reduces complications as well. The risk for post-herpetic neuralgia goes down by 91% and 89%, respectively, in those age groups.
Because the vaccine works well, it is important to know if and when Medicare covers it.
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 .
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This New Vaccine Has A Secret Benefit
For older adults, who are often the most vulnerable to severe and occasionally fatal infections, this kind of immune-boosting strategy will be a godsend.
Last Wednesday, elderly immune systems got a huge boost from an unlikely source. The Advisory Committee on Immunization Practices , which advises the Centers for Disease Control and Prevention , recommended moving forward with Shingrix, a shingles vaccine.
Whats remarkable about Shingrix is that it dramatically eases the pain and nervous system damage associated with shingles but seems to enhance the immune systems of the elderly.
Shingles occurs when chickenpox virus, which thrives silently in the nervous system after the initial infection, reawakens after hibernation and travels down a nerve root. The result is a rash that appears as a long, thin strip along the side of the body. Sometimes shingles causes a rash on the face when it involves the eye, shingles can cause blindness. Every year in the United States about 1 million people develop shingles. During their lifetimes, 1 of every 3 people will suffer this disease, most after they are 60 years old.
In 2006, the Food and Drug Administration licensed the first vaccine to prevent shingles. Called Zostavax, it contains a live, highly attenuated form of the chickenpox virus. At the time of licensure, Zostavax was recommended for all adults older than 60.
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How Long Does Chickenpox Immunity Last
The immunity produced by the chickenpox vaccine should last 10 to 20 years and possibly more. It has been a little more than 25 years since the vaccines introduction to the American public, so the lifetime protection of the vaccine is unknown.
So the answer to the question, can you get chickenpox after a vaccine? is that we dont fully know, but your odds are much lower if you get the vaccine.
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Persons With Chronic Diseases
Although definitive data are lacking, individuals with autoimmune disease not being treated with immunosuppressive drugs are not considered significantly immunocompromised. Individuals 50 years of age without contraindications should receive RZV.
Can A Vaccine Prevent Herpes Outbreaks Commentary
Researchers recently reported a successful test of a new vaccine for the herpes virus. Does this mean we will soon be able to use vaccines to eliminate herpes infections just like weve nearly eliminated some other virus infections ?
Not yet, unfortunately.
What is a herpes infection?
Infection with the herpes simplex virus causes recurring episodes of small, painful, fluid-filled blisters on the skin, mouth, lips , eyes, or genitals . Herpes simplex infection causes many problems across the globe. Experts estimate that over 400 million people worldwide are infected. In addition to the discomfort that genital herpes can cause, genital herpes can also cause life-threatening illness such as encephalitis and other serious infections in newborn babies if the virus is passed to a newborn during the birth process. And having herpes simplex virus infection can increase the risk of acquiring HIV infection.
Why do we need a herpes vaccine?
A big problem with the herpes virus is that once people have an infection, the virus stays with them for life. The virus stays dormant in the body and at various times reactivates and causes symptoms. Even when there are no visible blisters and no symptoms, the virus may be present on the genitals and can be spread to sex partners.
Is the new herpes vaccine the solution we want?
- How often they got outbreaks of herpes blisters
- How much herpes virus they were releasing based on test swabs taken from their genitals
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