Shingles + diving liveaboard trip

[DandyDon]

I don't know how common Chicken Pox or the vaccine for it is where you're traveling, but those are not common everywhere. As cozy as things are on a liveaboard, I wonder how much you'd be exposing others to the illness?

What if you have increased problems? Not much can be done on the boat, and I don't know that'd be much better ashore? As much as I'd want to follow thru with the trip plan, I think it'd be wiser to get needed doctor's orders not to go, collect on trip insurance, and replan.

Thanks, good advice. Funny, never think of sea water as being 'contaminated' it always seems to have a healing effect to me! Will consult doctor in any case...

It's healthy shin that usually protects you from all the nasty things living in the water, but yours isn't. Have you seen the numerous stories like this one? The Science Behind The Rise In Deadly Flesh-Eating Bacteria In America?s Waterways | ThinkProgress

Likelihood of recurrence is quite low, and at the time of the outbreak or shortly thereafter is probably not the best time for shingles vaccination. The immune system is already reacting to the virus, and all a vaccination does is stimulate the immune system to react against a virus (or other pathogen).

Is that a fact you can backup? You may be a physician, but I am not aware?

 

[Ricky B]

Is that a fact you can backup? You may be a physician, but I am not aware?

No, I am not a physician, and yes, I can back it up. I'll let a physician back it up, however, so it's a shorter discussion.

 

[DandyDon]

No, I am not a physician, and yes, I can back it up. I'll let a physician back it up, however, so it's a shorter discussion.

My son-in-law had a bad round of it, and Facebook friends told him to get vaccinated. I don't guess a doctor would give such orders if what you say is true, and I assume he got the diagnosis from one. Getting him to a doctor is challenging, as it is with me. He seems over it tho, and it'd be nice to think it will not reoccur.

 

[TSandM]

The one study I could find looking at shingles recurrence rates came up with about a 6.2%, higher in those who had longer duration of pain with their initial episode. Recurrences were also, for whatever reason, more common in women.

I would not typically administer a vaccine against an infection while the patient had active disease from that organism. It seems counterintuitive. I don't know that there are any data at all on the comparative efficacy of the zoster vaccine when administered during or remote to an episode of shingles.

 

[uncfnp]

An individual over 60 may still benefit from a shingles vaccine even after they have had shingles. While there is no specific wait time before the individual can get the vaccine, the rash should be resolved. I know many of the family MD's/NP's in this area still recommend the vaccine post shingles.

However, the vaccine does not treat an active infection.

 

[Ricky B]

From the Harvard Health Blog in 2011 (emphasis added by me):

Zostavax may very well protect against shingles recurrence, but that’s an assumption at this point. No studies have been done that show that to be the case. When I asked Merck officials about this, I was told in an email that no such study is planned.

Shingles can strike twice. Will the shingles vaccine help? - Harvard Health Blog - Harvard Health Publications

From WebMD:

Hirsch is an infectious disease specialist at the North Shore University Hospital in Manhasset, N.Y. "This study provides new information about the nature of shingles," he says. "I am not going to give the shingles vaccine to individuals who had a recent history of shingles."

Risk of Shingles Recurrence Is Low

None of this is to say that one should not be vaccinated. The CDC says:

Anyone 60 years of age or older should get the shingles vaccine, regardless of whether they recall having had chickenpox or not.

From what I've read, there's a very low risk of any side effects.

 

[uncfnp]

From that same CDC page, few paragraphs down...

Even if you have had shingles, you can still receive the shingles vaccine to help prevent future occurrences of the disease. There is no specific time that you must wait after having shingles before receiving the shingles vaccine. The decision on when to get vaccinated should be made with your health care provider. Generally, a person should make sure that the shingles rash has disappeared before getting vaccinated.

As with any other healthcare decision, it's best made between the patient and his healthcare provider.

I admit I do not do primary care so not up to date regarding the latest research. Just going on the local PCP's and CDC recommendations. A number of years ago when the vaccine was relatively new, I was surprised that a post shingles vaccine was an option. I do understand why it might be beneficial to anyone that is a significant number of years post outbreak, especially if younger than 50 and now over sixty. Personally, I had it in my 20's and plan to get the vaccine when I reach 60 unless there is compelling evidence to the contrary.

 

[gert7to3]

I developed shingles at the age of 58, on a limited area of my left ribcage. So don't think 60 is a magic number. I was lucky to recognize it and obtain treatment.

So far as getting shingles on your face, that is a very critical issue. Leaving on a dive trip compounds the issue. Not only is there the risk of secondary infection from organisms in a new environment, there is the possibility of it hitting your eye, lips or facial nerves. Never mind that the OP might have his/her mask pressing across the infected area. I have a friend who developed shingles during a dive festival. I made the diagnosis and literally dropped everything to get her into medical care. It was around one of her eyes, the absolute worst place for such a hit. She was in and out of hospital for 6 months and was still severely impacted more than a year after the initial diagnosis. Bad enough that you go through chicken pox as a child. Totally blows that it can come back and cripple you as an adult.

As the shingles blossomed, my thinking was that I had gotten poison ivy. But it was in an odd place, accompanied by deep aching pain and did not respond to topical treatments. That's when I realized this was different and I sought medical care. Keep this in mind if you develop an odd case of poison ivy.

On the theory that my immune system now knows about shingles, I haven't gotten the vaccine, yet. I probably will get it in my late sixties.

 

[DandyDon]

Sounds like it can get serious...

I haven't gotten the vaccine, yet. I probably will get it in my late sixties.

Why are you waiting...??

 

[gert7to3]

DandyDon,

Since I already had a bout of shingles, six years ago, my immune system is mostly ready if it tries to occur again. One of the other posters said recurrence is on the order of 6.4%.

I get flu shots and I am considering the pneumonia shot. Want to check the risk factors on pneumonia to see if I am at higher risk for some reason.