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1,800 older residents sought for shingles prevention study (6-24-99)

About 1,800 South Texans age 60 or older are sought for a study on preventing shingles, a painful viral disorder that affects 15 percent of the U.S. population.

Interested individuals may call (210) 567-9258 at The University of Texas Health Science Center at San Antonio or toll free at 1-877-841-6251. The study is part of the U.S. Department of Veterans Affairs (VA) Cooperative Studies Program, which includes 15 sites. The university is one of the six National Institutes of Health (NIH)-affiliated sites nationwide to offer the trial.

Prospective enrollees must not have had shingles previously. A painful rash marks the condition, which is caused by the chicken pox virus, varicella zoster, one of the herpes viruses.

"We are testing a vaccine to try to prevent shingles," said Jean A. Smith, M.D., associate professor of medicine at the Health Science Center. "We are targeting people 60 and older because the incidence of shingles increases as people get older and the complications also increase. The most difficult complication is post-herpetic neuralgia—pain persisting after the rash."

Researchers will test the same vaccine given to children to prevent chicken pox, but in this case a stronger version of it. "To stimulate immunity to varicella zoster in adults, you need a jazzed up version of the children’s vaccine," Dr. Smith said.

The virus inflames nerves in affected areas, typically involves only one side of the body and most commonly strikes the chest or upper abdomen. The legs or face also may be affected.

Early treatment with an anti-viral drug decreases the extent of the rash and its severity. Rash and pain usually subside within four to six weeks.

"An older person faces a higher risk of pain persisting," Dr. Smith said. "For some people, even touching the bed covers causes a pain sensation. If the rash is on the face, even going out in the sun or wind is painful. It is an unusual discomfort and not easy to treat."

Scientists are searching for a drug to treat the symptoms. "So far, nothing works all that great," Dr. Smith said.

Patients will be enrolled through the Frederic C. Bartter General Clinical Research Center at the Audie Murphy Hospital Division, South Texas Veterans Health Care System. The trial is a randomized, vaccine-placebo study. "If the vaccine works, everyone will be offered the vaccine as soon as the study data are analyzed. This will be before the vaccine is commercially available," Dr. Smith said.

Participants will receive free treatment for shingles if they contract it during the study period. Patients will be tracked through four to five years of telephone follow-up, and will be asked to give blood samples if they develop shingles. "We will measure cell-mediated immunity to the virus and correlate to whether someone had the vaccine or not," Dr. Smith said.

"One reason people thought of using a vaccine is that when people have shingles, their immunity to varicella zoster virus is boosted," she said. "Someone who has had shingles usually has greater immunity against recurrence."

Patients will be enrolled in 1999 and 2000. Dr. Smith is the principal investigator for the San Antonio portion of the trial, which is a collaborative study among the VA, NIH and Merck Inc., maker of the varicella zoster vaccine.

Shingles incidence

  • If you live to be 85, you have a 50 percent chance of having shingles.

  • About 15 percent of all people will have shingles.

  • Risk of incidence increases gradually until age 60-65, then climbs.

    Source: Jean Smith, M.D.

Contact: Will Sansom