What is the history of Shingles in America and other countries?

Herpes zoster (shingles) and herpes simplex were named by Hippocrates, who initially described the ulcerative skin rashes. Herpes zoster, however, differed from herpes simplex, as it was noted to present as a line of painful blisters along the nerves, on one side of the body. Celsus (25 BC – c. 50 AD) was the first to use the term Zoster, from the Latin and Greek word for belt. The word Shingles came from the medieval Latin word “cingulus” which means “girdle”, and referred to the lesions typically found around the waist.¹

Chickenpox and shingles were investigated independently for many years. Richard Bright hypothesized that shingles originated in the nervous system in 1831. In 1863, Von Barensprung suggested that shingles was found in the sensory ganglia, as lesions appeared to correspond with spinal nerves. By the 20^th century, Campbell and Head had determined that the features of shingles consisted of inflammation and necrosis of the ganglion cells in the posterior ganglion root. It was still not yet known what caused shingles.²

In 1892, Von Bókay initially suggested a relationship between chickenpox and shingles after noting the presence of both illnesses in the same household at the same time. He also reported that the skin lesions appeared to be similar in nature. In 1923, de Lange reported the presence of antibodies to chickenpox in all patients who developed shingles.³

Additional studies were conducted on human subjects. These experiments reported that persons injected with the vesicular fluid from shingles lesions developed a rash identical to what was seen in persons with chickenpox. The invention of the electron microscope allowed scientists to further examine fluid from shingles and chickenpox and found them both to be indistinguishable at an ultrastructural level.⁴

In 1965, Hope-Simpson hypothesized that shingles was due to the reactivation of a latent virus and that exposure to the virus would prevent this from occurring. He also postulated that reactivation occurred when antibody levels fell below what was necessary to stop this from happening.⁵ It is now believed that a decline in cell-mediated immune response also plays a role in the development of shingles.⁶ 

Is there an association between chickenpox vaccine and an increase in shingles?

In 2005, Gary Goldman, PhD, was among the first researchers to publish an analysis of the mass use of chickenpox vaccine by children in the U.S. since 1995. His conclusion was that, by limiting the circulation of wild type Varicella Zoster virus in the population through mass vaccination, there is limited asymptomatic boosting of natural chickenpox immunity among adults, who had recovered from chickenpox as children. This would, in turn, cause an epidemic of shingles.⁷

In 2008 the Health Protection Agency (HPA), an independent organization formed by the government of the United Kingdom in 2003, published new modeling that confirmed that mass use of chickenpox vaccine would lead to an increase in shingles despite the shingles vaccine.⁸

The HPA estimated that, while mass vaccination would reduce the incidence of chickenpox in children, there was an over 20 percent projected increase in the incidence of shingles in adults. The HPA confirmed that this projected increase in shingles is because adults are no longer coming in contact with natural chickenpox cases due to vaccine acquired immunity among children. In addition, studies from countries that routinely vaccinate children against chickenpox, such as the U.S., demonstrate that there is an increase in shingles in unvaccinated persons, who have not had chickenpox or the chickenpox vaccine.⁹

A study in 2002 confirmed that adults exposed to natural chickenpox disease were protected from developing shingles and that there is concern that mass vaccination against chickenpox will cause future epidemics of shingles among more than 50 percent of Americans aged 10 to 44 years.¹⁰

There are also reports that young children and teenagers who have gotten chickenpox vaccine are also experiencing shingles.¹¹

Shingles in the United States

The CDC estimates that one million Americans develop shingles each year and the incidence of the illness is about four cases per 1,000 U.S. population yearly. In adults 60 and older, the rate is estimated at one case per 100 U.S. population. The CDC also estimates that 96 shingles-related deaths occur yearly.¹²

IMPORTANT NOTE: NVIC encourages you to become fully informed about Shingles and the Shingles vaccine by reading all sections in the Table of Contents , which contain many links and resources such as the manufacturer product information inserts, and to speak with one or more trusted health care professionals before making a vaccination decision for yourself or your child. This information is for educational purposes only and is not intended as medical advice.

 

---

References: