Shingles, or Herpes Zoster, is a viral infection caused by the Varicella-Zoster Virus (VZV). This is the same pathogen that causes chickenpox. After recovery, VZV remains dormant within nerve cells for decades. Shingles occurs when the latent virus reactivates, often due to aging or a weakened immune system, causing a painful rash. In India, the clinical term is often replaced by various regional and colloquial names, which can sometimes lead to confusion about the condition.
Common Names for Shingles Across India
The medical name, Herpes Zoster, is recognized by healthcare professionals in India, but the general public uses descriptive, local terms. In Hindi and parts of North India, the condition is commonly called “Nagin” or “Sarpani,” both translating to “female snake.” This description comes from the rash’s characteristic appearance, which forms a painful, single stripe or belt of blisters wrapping around one side of the torso.
A common point of confusion is the term “Daad,” the Hindi word for ringworm, a fungal infection. Herpes Zoster is sometimes colloquially referred to as “Bhainsiya Daad” (buffalo ringworm) in some regions. It is important to understand that Shingles is a viral disease, not a fungal one like true Daad. This linguistic overlap necessitates accurate clinical diagnosis, as treating a viral infection with antifungal medication would be ineffective.
Recognizing the Symptoms of Herpes Zoster
The initial signs of a Shingles outbreak often begin with a tingling, burning, or deep pain in a specific area of the body. This pain can precede the rash by several days. This intense nerve pain is a hallmark of the condition because the virus travels along the nerve pathways to the skin’s surface.
The most recognizable symptom is the appearance of a painful, blistering rash. It manifests as a stripe or band on only one side of the body, corresponding to the affected nerve pathway. These fluid-filled blisters eventually crust over and typically heal within two to four weeks. Other accompanying symptoms can include a general feeling of being unwell, headache, and fever. A serious complication is Postherpetic Neuralgia (PHN), where severe nerve pain persists for months or even years after the rash has healed.
Current Treatment Availability and Access
The standard medical approach focuses on reducing the severity and duration of the outbreak and preventing complications like PHN. Antiviral medications, such as Acyclovir, Valacyclovir, and Famciclovir, are the primary treatment. They work by inhibiting the replication of the VZV. These antivirals are most effective when started within 72 hours of the rash’s appearance, making early diagnosis and access to a doctor paramount for a better outcome.
Pain management is another important aspect of treatment. This can range from over-the-counter analgesics to prescription nerve-pain medications like Gabapentin for severe discomfort. Access to these allopathic treatments is robust in urban centers and major hospitals, but can be more challenging in remote or rural areas. In these settings, people may first turn to traditional or local Ayurvedic remedies.
Preventive measures are also available, with highly effective Shingles vaccines like Shingrix approved for use in India. The vaccine is recommended for adults aged 50 and above to help prevent the disease and its complications. The vaccine is not part of the public health program and is predominantly accessed through the private healthcare sector. The cost can be significant, ranging approximately from ₹10,999 to ₹17,000 per dose, which often limits its uptake.