Shingles shot good idea for adults 60 and older

Medical Matters

September 15, 2006|By Judy Foreman | Judy Foreman,Special to the Sun

I've heard there's a now vaccine against shingles. Should I get it?

If you are 60 or older, you should strongly consider getting the new vaccine, which was approved recently by the Food and Drug Administration.

"Shingles is an under-recognized, serious neurological disease that can lead to an extremely painful condition called post-herpetic neuralgia," said Dr. Anne Louise Oaklander, a shingles expert and associate professor of neurology at Harvard Medical School. The new vaccine, called Zostavax, appears to reduce the risk of shingles and the neuralgia and seems to be safe, said Oaklander, who has no financial ties to the manufacturer, Merck & Co.

Shingles, which affects an estimated 1 million people each year, is caused by reactivation of a herpes virus called varicella zoster, the same virus that causes chicken pox. Most American adults have been exposed to chicken pox - and therefore are at risk of shingles. After this infection, the virus hides in nerve cells, then can emerge years or decades later, typically showing up on only one side of the body along the tract of a nerve, often in a belt-like pattern around the torso or in a nerve near one eye.

The $150 vaccine is covered by some insurers and also by Medicare Part D, said Dr. Jeffrey Kelman, a chief medical officer for beneficiary choices at the Center for Medicare and Medicaid Services, the government agency that administers Medicare.

The FDA cautions that people who are allergic to neomycin or any component of the vaccine should not receive Zostavax, nor should people with weakened immune systems, because the vaccine is made from live virus. An immunization committee for the federal Centers for Disease Control and Prevention is expected to discuss guidelines for use of the vaccine next month.

Shingles can, and should, be treated - with anti-viral drugs such as acyclovir, valacyclovir or famcyclovir. But it's far better to prevent it in the first place, said Dr. Richard T. Johnson, a distinguished service professor of neurology at the Johns Hopkins School of Medicine. "People over 60 should definitely consider the vaccine because post-shingles pain increases with age."

Is it OK to feed kids the same healthy protein, vegetable and starch every night, or does variety matter?

Variety matters, and it's especially important to get variety in vegetables.

Kids can be balky eaters, but, ideally, they should learn to enjoy a wide range of foods in order to get all the nutrients they need, said Jeanne Cox, a pediatric nutritionist at Johns Hopkins Hospital.

Feeding kids green beans every night, for instance, means they are not getting other nutrients they need. "They need broccoli, carrots, the orange and yellow vegetables in addition to the dark green," Cox said.

The best approach, she said, is to offer small portions of a healthy protein, such as meat, fish, eggs or poultry along with a healthy starch such as whole grain rice or even potatoes or pasta, and a vegetable and a fruit.

At any given meal, the child may eat only vegetables or only starch or protein, "but in the long run, it evens out," she said. The key is to present a variety of foods and let kids pick from them.

"It takes an average of 15 tries per new food" to get a child to accept it, said Jan Hangen, a clinical nutrition specialist at Children's Hospital in Boston.

The reason kids should "eat the rainbow," she said, is that plants of different colors have different phytonutrients, the natural chemicals in food that are essential for health. "We know that people who eat a variety of colors tend to remain healthy," she said, even though scientists are still working to figure out exactly what each phytonutrient does.

Frozen veggies, by the way, are fine. "Unless you're buying food at a farm stand," said Hangen, "the frozen vegetables are best because they are fast frozen right from the field."

The "fresh" vegetables from supermarkets often "spend a lot of time on the truck, even though they look beautiful," she said.

Send your questions to foreman@baltsun.com.

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