Shingles in Lung Disease Patients: The Impact of Asthma and COPD

Lung diseases like asthma and COPD (chronic obstructive pulmonary disease) are obstructive pulmonary diseases that have impacted millions of individuals worldwide.¹

They also have been associated with an increased risk of developing shingles, also known as herpes zoster.^2,3

This blog will help you understand the relation between lung disease and shingles.

What type of lung diseases are Asthma and COPD?

Asthma and chronic obstructive pulmonary disease (COPD) are both types of lung diseases that cause restricted airflow and breathing difficulties.^4,5

Asthma

It is a common obstructive airway disease having symptoms including cough, difficulty in breathing, and wheezing.⁴

Chronic Obstructive Pulmonary Disease (COPD)

On the other hand, COPD encompasses several lung conditions, such as emphysema and chronic bronchitis, leading to airflow blockage and causing symptoms like cough, phlegm production, and fatigue.⁵

These diseases can coexist in patients, leading to a condition known as asthma-COPD overlap syndrome (ACOS), characterized by characteristics of both asthma and COPD.^6,7

How Asthma and COPD Increases Your Risk for Shingles?

Asthma⁸ and chronic obstructive pulmonary disease (COPD)³ have been associated with an increased risk of developing herpes zoster (HZ), commonly known as shingles.

Research has shown that individuals with asthma and COPD are at a higher risk of HZ. A meta-analysis reported a 24% increased risk of HZ in individuals with asthma and a 41% increased risk in those with COPD, as compared to healthy people.²

This increased risk is attributed to the impaired cell-mediated immunity often observed in individuals with chronic respiratory diseases like asthma and COPD.^2,9

What is Shingles (Herpes Zoster)?

Shingles, also referred to as herpes zoster, is an infection characterized by a painful skin rash accompanied by blisters. The causative agent of shingles is the varicella-zoster virus, which is the same virus responsible for causing chickenpox. Following a previous episode of chickenpox, the virus remains latent within the body and has the potential to reactivate later in life, resulting in the development of shingles. ¹⁰

A compromised immune system raises the susceptibility to shingles, rendering it more prevalent among older adults, and the likelihood of encountering the condition rises with advancing age.¹¹

In an investigation concerning the prevalence of antibodies against the varicella-zoster virus in Indian subjects, it was discovered that over 90% of individuals above the age of 50 carried the virus in their system, rendering them susceptible to shingles.^12,13

Shingles Symptoms

Before the outbreak of the rash, people might feel discomfort, itchiness, or a tingling sensation in the impacted area, typically happening a few days earlier. Some people might also get a fever before the rash. ¹⁴

Common symptoms:

^{• The rash often causes discomfort and itchiness. It consists of blisters that typically form scabs within 7 to 10 days and fully clear up in 2 to 4 weeks.14
• This rash typically appears as a single band on either the left or right side of the body.10
• The shingles rash may develop on one side of the face, which may impact the eye and lead to vision loss.15}

Other symptoms may include:

• Headache
• Chills
• Upset stomach

Shingles Prevention

Vaccination can help prevent shingles.16 It is advised for adults 50 years or older and having compromised immune systems due to conditions such as COPD & asthma.17,18

Disclaimer: A public awareness initiative by GlaxoSmithKline Pharmaceuticals Limited, Dr. Annie Besant Road, Worli, Mumbai 400 030, India. Information appearing in this material is for general awareness only. Nothing contained in this material constitutes medical advice. Please consult your doctor for medical advice or any question or concern you may have regarding your condition. Please consult your doctor for the complete list of vaccine-preventable diseases and the complete vaccination schedule for each disease.All scientific information is validated, for details write to us on askus@gsk.com.

CL Code: NP-IN-HZU-WCNT-230017 DoP Sep 2023

References:

1. Cukic, V., Lovre, V., Dragisic, D., & Ustamujic, A. Asthma and chronic obstructive pulmonary disease (copd)-Differences and similarities. Materia Socio-Medica. 2012; 24(2):100-105.
2. Safonova, E., Yawn, B.P., Welte, T. et al. Risk factors for herpes zoster: should people with asthma or COPD be vaccinated? Respir Res. 2023; 24, 35.
3. Yang, Y.-W., Chen, Y.-H., Wang, K.-H, et al. Risk of herpes zoster among patients with chronic obstructive pulmonary disease: a population-based study. Journal de l’Association Medicale Canadienne [Canadian Medical Association Journal], 183(5), E275–E280.
4. World Health Organization. Asthma [Internet]. WHO. World Health Organization; 2023. [Accessed 2023 Sep 9] Available at: https://www.who.int/news-room/fact-sheets/detail/asthma
5. What is COPD. [Accessed 2023 Sep 9] Available at: https://www.cdc.gov/copd/index.html
6. Dodd, K. E., Wood, J., & Mazurek, J. M. Mortality among persons with both asthma and chronic obstructive pulmonary disease aged ≥25 years, by industry and occupation. Weekly I. 2020;69(22):670-679.
7. Freiler, L. C. J. (2015). The asthma-COPD overlap syndrome. [Accessed 2023 Sep 9] Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6375482/
8. Kwon HJ, Bang DW, Kim EN, et al. Asthma as a risk factor for zoster in adults: A population-based case-control study. J Allergy Clin Immunol. 2016 May;137(5):1406-12
9. Zhu, Xueyi & Cui, Jie & Yi, La, et al. The Role of T Cells and Macrophages in Asthma Pathogenesis: A New Perspective on Mutual Crosstalk. Mediators of Inflammation. 2020.7835284.
10. CDC clinical overview of Herpes zoster (Shingles). [Accessed 2023 Sep 9] Available at: https://www.cdc.gov/shingles/hcp/clinical-overview.html#:~:text=Herpes%20zoster%2C%20also%20known%20as,in%20the%20dorsal%20root%20ganglia.
11. CDC 5 things you should know about Shingles. [Accessed 2023 Sep 9] Available at: https://www.cdc.gov/shingles/5-things-you-should-know.html#:~:text=Because%20our%20immune%20system%20naturally,t%20remember%20having%20the%20disease.
12. Lokeshwar, M. R., Agrawal, A., Subbarao, S. D, et al. Age related seroprevalence of antibodies to varicella in India. Indian Pediatrics, 37(7).
13. GSK launches Shingrix in India- A vaccine for the prevention of shingles in adults aged 50 years and above. (2023, April 24). Gsk.com. [Accessed 2023 Sep 9] Available at: https://india-pharma.gsk.com/en-in/media/press-releases/gsk-launches-shingrix-in-india-a-vaccine-for-the-prevention-of-shingles-in-adults-aged-50-years-and-above/
14. Signs and Symptoms of Shingles (Herpes Zoster) | CDC [Internet]. www.cdc.gov. 2023 [Accessed 2023 Sep 9]. Available at: https://www.cdc.gov/shingles/about/symptoms.html#:~:text=Most%20common%20symptoms
15. Sampathkumar, P., Drage, L. A., & Martin, D. P. Herpes zoster (shingles) and postherpetic neuralgia. Mayo Clinic Proceedings, 84(3), 274. [Accessed 2023 Sep 9] Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2664599/
16. Prevention and Treatment (Herpes Zoster) | CDC [Internet]. www.cdc.gov. 2023 [cited 2023 Sep 9]. [Accessed 2023 Sep 9] Available at: https://cdc.gov/shingles/about/treatment.html
17. CDC. (2023, May 25). Shingles vaccination. Centers for Disease Control and Prevention. [Accessed 2023 Sep 9] Available at: https://www.cdc.gov/vaccines/vpd/shingles/public/shingrix/index.html
18. Adult immunization schedule – healthcare providers. (2023, August 31). Cdc.gov. [Accessed 2023 Sep 9] Available at: https://www.cdc.gov/vaccines/schedules/hcp/imz/adult.html