Q: My 70-year-old mother is suffering from severe osteoporosis and has recently been diagnosed with herpes zoster. She has a lot of pain in the spinal cord, and sometimes the pain becomes unbearable. Our family physician prescribed her Cap Roles-D, Tab Virovir 500 mg, Nac 50 mg (all tablets for only seven days) and Ocuvir ointment for external use on blisters, which she is using twice daily. Now after three weeks, she still has severe pain. However, blisters have started disappearing. I have the following questions: 1) How did she get herpes zoster? 2) If her immune system is weak, then how can it be made strong? 3) How much time will she take to recover? 4) How can she get rid of the pain? 4) Does this raise her chances of getting other diseases like TB, viral fever, cold, etc.? 5) What precaution should she take so that she does not contract this disease again? 6) Is there any vaccine so that there is a faster recovery? Kindly advise.

A:Herpes zoster is caused by the same virus that causes chickenpox. Therefore, a person who has never been exposed to this virus can develop chickenpox when exposed to a patient who has blisters of herpes zoster. Once a patient recovers from chickenpox, the virus lies dormant in a small part of the spinal cord (the dorsal root ganglion). For some reason, when the body resistance goes down, this virus re-activates and presents itself in the form of herpes zoster. Normally, herpes zoster occurs only once in a lifetime, unless the person has severe immunodepression, for example, in AIDS. In elderly patients, one would like to exclude an underlying predisposing factor like malignancy. Pain is an important component of this disorder. Post herpetic neuralgia can be very severe. To minimise the frequency and the severity of this neuralgia, the specific antiviral medicine should be started within the first 48 hours, at the most within first 72 hours. Greater the age at which herpes zoster occurs, greater is the probability for severity and occurrence of neuralgia. Once it occurs, it will take its own time to go; this varies from person to person. Medicines are given to make the patient comfortable. In a rare case, one may have to block the nerve of the area.