Shingles Appears to Be on the Rise in Canada. Here’s Why.
Shingles appears to be more rampant this year than previous years, and experts say the rise is related to the COVID-19 pandemic.
At the end of a busy and stressful spring, Christine Beard developed what she thought was a tension headache. Instead of subsiding after a visit to her chiropractor, the pain intensified in her right eyebrow, and spread to her forehead and scalp on that side of her face. Her family doctor told her to monitor the pain and come back if it got worse.
Not only did the pain increase, Beard developed a bump the size of a Cadbury mini egg on her eyebrow. She rushed to urgent care, but the doctor sent her home without answers. When the bump started to crack open and reveal an angry red rash, the 44-year-old finally received a diagnosis from a different urgent care physician: she had shingles. Beard was given antivirals to minimize the spread and told to self-isolate until the rash subsided.
The diagnosis doesn’t surprise Beard, a pastry chef instructor at the Southern Alberta Institute of Technology.
“Basically, shingles pops up when you’re stressed, and COVID changes in your lifestyle alone stresses you out,” says Beard. Prior to getting sick, she had weathered an entire year teaching under restrictive COVID conditions. She was also physically exhausted from trying to counter the stress with 100-km bike rides and 20-km hikes. “I was worn out.”
Shingles in Canada seems to be on the rise
Like sleepless nights and hair loss, getting shingles looks to be another knock-on effect of living under chronic stress during the pandemic.
I can relate—I developed shingles on my left inner thigh in September 2020, when I was 49, likely due to the nervous anticipation of sending my kids back to school (with the vaccine still months away from reality) after a summer of zero breaks from them. I was the third case of shingles the doctor at the walk-in clinic had seen that day.
“Shingles seems to be more rampant this year than previous years,” says Dr. Craig Jenne, an associate professor in the Department of Microbiology, Immunology and Infectious Diseases at the University of Calgary.
Data isn’t available on the percentage of increase in shingles cases in Canada over the course of the pandemic, but anecdotally, Jenne is hearing a lot more about it from colleagues commenting on the number of cases they’ve seen. And it makes sense given the nature of the virus that causes it.
Shingles typically presents as an itchy, tingly or painful skin rash with blisters on one side of the body, usually the trunk or face. It’s caused by a reactivation of the varicella zoster virus, the same virus that gives you chicken pox, so anyone who experienced that childhood illness is susceptible. Basically, after you recover from chicken pox the virus never entirely leaves your body—it goes dormant and lives in your nerves, kept in check by a healthy immune system. It’s like a ticking time bomb, waiting for the right combination of immune distress (or high stress!) to resurface as shingles.
“Shingles is very much a disease that activates or re-activates if the patient’s immune system begins to fade, and the principal cause of that in most people is things such as stress,” says Jenne. “So if you get stressed, we know that suppresses your immune system and that allows the shingles virus to reactivate.”
Decline in shingles vaccines
Adults over age 50 are more susceptible to developing shingles (our immune systems weaken naturally as we age), which is why a shingles vaccine is available to that group.
But fewer Canadians are getting routine vaccinations during the pandemic, which is another factor that could be playing into shingles’ prevalence—an estimated four million adults in Canada have missed or delayed shots during COVID, according to a poll conducted by the Neighbourhood Pharmacy Association of Canada. What’s more, internal market data shared by GlaxoSmithKline, the pharmaceutical company that manufactures the Shingrix vaccine for shingles, suggests a 22 percent decline in shingles vaccinations in Canada from Sept. 2019 to Sept. 2020, worsening to a 30 percent decline by Sept. 2021.
Though the majority of shingles cases appear in older Canadians, younger adults can get it, too, especially when shouldering the worries of the world—and juggling our work and personal life from home—like we’ve all been doing since March 2020.
It’s not run-of-the-mill stress that triggers it, either, Jenne clarifies. “We’re talking prolonged stress that’s amplified by things such as dysregulated sleep, perhaps diet changes,” he says. Not to mention the closed gyms and spas that have made it that much harder to de-stress these past 20 months.
(Related: COVID-19 Vaccines Are Vital—And So Are These)
How to protect against shingles
For Kelowna entrepreneur Jules Taschereau, the onset of both bouts of her ophthalmic shingles was undeniably stress-related. Taschereau, the proprietor of Limey, The British Shop, owns and runs three businesses and works 100-hour weeks. On top of that, Taschereau and her fiancé had to postpone their wedding five times during the pandemic due to gathering and event restrictions.
“It was brutal. It was stress beyond what you’d expect,” she says. “Living in a pandemic has pushed people over the edge.”
Taschereau’s second round of shingles this fall was so painful—even the weight of her hair hanging from her head hurt—that the 48-year-old does not want to get it a third time and plans to get vaccinated as soon as she turns 50.
For those under 50, the best advice for keeping shingles at bay is to keep stress levels down. Get enough sleep. Exercise. Eat a balanced diet.
“That’s the same advice we’re giving people to avoid colds and flus,” says Jenne. “If you’re stressed and overtired, all sorts of infections can take advantage of that.”
Beard has taken that advice to heart. Since recovering from shingles in the summer, she’s made a conscious effort to slow down.
“I’m not as busy as before and I’m saying no to a lot more things,” says Beard. “It’s really important to take care of yourself.”