Treating shingles (herpes zoster) in the older person

Shingles is a common problem and will affect a fifth of the population at some time in their lives (Opstelten, 2005). It may occur at any age but the incidence and severity of the condition increases with age (Johnson et al, 2008). It is therefore likely that community nurses, in their day-to-day work with older people, will encounter the problem. If they are able to recognize it and arrange treatment in the earlier stages of its development, they will be in the position of helping to speed the resolution of the rash and reduce the debilitating consequences that may follow, in particular in the form of post-herpetic pain, which may affect the patient for weeks, months or even years after the active stage is over, visual complications following ophthalmic herpes zoster or zoster encephalitis that may be fatal. Apart from pain and future of the patient, the condition may require the disruptive and expensive option of hospital admission. The possibility of the introduction of a new vaccine, that would reduce the incidence of shingles, will also be discussed.