2023-06-23 09:02:42
The demand for prescription antiviral drugs against shingles has increased between January and May by 15% compared to the same period of the previous year. In March the figure increased to 22%. Experts closely follow the evolution of this condition.
These are data extracted from report “Varicella first, zoster later” from the Observatory of Trends of the pharmaceutical distributor Cofares on herpes zoster, which reveals the demand for antivirals to combat it.
Shingles, caused by the same virus as chickenpox, can cause burning, pain and in some more serious cases to cause a chronic ailment. It can be reactivated in adults.
In fact, more than 90% of adults have been infected with chickenpox and are therefore susceptible to developing shingles. The risk of suffering from it is around 30% throughout life and can reach up to 50% in the case of those over 85 years of age.
According to the Cofares report, herpes zoster appears in certain situations in which the immune system weakens as a result of age, suffering from certain diseases or receiving certain treatments.
Graphic from the Cofares report on reactivation risk factors
It is of special interest in the elderly, due to its higher incidence.
Increased vulnerability of the immune system
According to the document, experts closely follow the evolution of zoster. And they do so because the consequences derived from the pandemic and increased stress “could be triggering a greater vulnerability of our immune system, a favorable scenario for the reactivation of this virus.”
In this way, the registered demand from the community pharmacy for prescription antivirals to combat herpes zoster has grown between January and May by an annual rate of 15%.
A “growing and sustained” trend over time that has been “uniquely pronounced” in the month of March, with the highest figure since 2020: 22%.
“It should be noted that this period was characterized by health overload in Spain. In fact, in March numerous cases were reported from hospitals stressed by a strong rebound in patients coinciding with a wave of viruses and respiratory infections in the run-up to spring,” explains Cofares.
By communities, the greatest demand for prescription antivirals for herpes zoster has been registered in Aragon (26%), Catalonia (24%) and Asturias (22%). On the contrary, in the communities where its consumption has been lower are the Balearic Islands (3%), Extremadura (8%), followed by Castilla-La Mancha, Castilla y León, Navarra and Galicia (all of them with an increase of 11%). .
Epidemiological characteristics
The Cofares report emphasizes that the epidemiological characteristics of this disease vary little in the Western world, since the incidence is quite similar between countries and always increases with age.
It is more frequent in women, in people with chronic diseases and with reduced immunity (especially cellular), either due to the underlying diseases or due to the treatments used.
The average annual incidence of zoster in Spain is approximately 4.6 per 1000 people per year in the general population, a figure that increases in the case of people over 65 years of age.
Symptoms and phases
In most patients, the diagnosis is usually confirmed when the characteristic skin blisters appear, which are the most common clinical manifestation of this condition.
Clinical symptoms appear in three phases: pre-eruptive, acute and chronic eruptive.
Herpes phases report chart.
The pre-eruptive, explains the report, is characterized by burning, pain or itching in the affected area at least 2 days before the skin rash. There may be symptoms such as headaches, malaise, and fever.
In the acute eruptive, which can last from 2 to 4 weeks, multiple painful umbilicated vesicles develop. They often burst, ulcerate, and eventually dry up. It can become contagious, although it is rare. However, when they become scabs, the rash stops being so. The pain is usually intense.
Herpes zoster mainly affects the skin and the nervous system, however it can also impact other organs, and post-herpetic neuralgia is the most frequent trigger pathology.
Post-herpetic neuralgia is characterized by chronic, debilitating pain that lasts for more than 90 days. Patients experience dysesthesias, paresthesias, and sometimes sensations of shock. “The pain can become disabling and can last for several months.”
Chart of the report on the possible complications of shingles.
Treatment
Antivirals seek to reduce the extent of skin lesions, the intensity and duration of pain, among others.
In the event of an episode of herpes zoster, the indication is to receive antiviral treatment in the first 72 hours from the appearance of skin lesions, says Cofares.
vaccination
Vaccines against this herpes are indicated for the prevention of reactivation of the virus and the development of post-herpetic neuralgia.
There are effective and safe vaccines against this condition. In Spain there is only one marketed. It is for those over 50 years of age or people 18 years and older who are at risk of shingles.
For this reason, the report recognizes the importance of promoting vaccination against herpes zoster in the groups prioritized in the official recommendations from Public Health. “Specifically, through communication, recommendation and professional advice activities”‘.
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