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June 2008 Mayo Clinic Women's HealthSource Highlights Shingles Vaccine for Pain Prevention, Tips to Avoid Antibiotic Resistant Infections, and Benefits of Broad Genetic Testing
Date:6/24/2008

ROCHESTER, Minn., June 24 /PRNewswire-USNewswire/ -- Here are highlights from the June issue of Mayo Clinic Women's HealthSource. You may cite this publication as often as you wish. Mayo Clinic Women's HealthSource attribution is required. Reprinting is allowed for a fee. Include the following subscription information as your editorial policies permit: Visit http://www.bookstore.mayoclinic.com or call toll-free for subscription information, 800-876-8633, extension 9PK1.

Pain Prevention for Older Adults -- the Shingles Vaccine

A vaccine to prevent shingles -- a painful and common skin rash -- has been available for more than two years, but few people reportedly are vaccinated.

The June issue of Mayo Clinic Women's HealthSource covers why this vaccine, Zostavax, is recommended for adults over age 60.

Nearly everyone in this age group has had chickenpox. And the virus that causes chickenpox, varicella-zoster virus, remains dormant in the body's nerves. In some people, the virus can reactivate and travel along nerve endings to the skin. An estimated 20 to 30 percent of adults over 60 develop shingles.

Shingles usually appears as a blistering rash along one side of the trunk, chest, back or face. The condition is particularly dangerous on the face because it can affect the eye and lead to temporary or permanent blindness. The most common complication of shingles is postherpetic neuralgia, a chronic pain that can be so severe people are willing to do just about anything to get rid of it.

The best medicine for shingles may be prevention. The Shingles Prevention Study, a large government-funded study, found that the vaccine prevented about 50 to 60 percent of shingles episodes in older adults. It also prevented about 70 percent of postherpetic neuralgia cases.

The vaccine, given in a single dose, is not appropriate for adults with weakened immune systems and those with allergies to gelatin, the antibiotic neomycin or any component of the shingles vaccine. The vaccine is an option for people who've had shingles and at least one year has passed since the last episode.

The vaccine costs can range from $150 to $300. Private insurance coverage varies. The vaccine is covered under the Medicare Part D drug benefit.

Nasty Superbugs

Tips to avoid antibiotic-resistant infections

Superbugs -- bacteria that are resistant to many commonly used antibiotics -- can seem scary. Antibiotic resistance means illnesses last longer, and the risk of complications and death increases.

Many factors have contributed to the emergence of superbugs, including overuse and misuse of antibiotics. One superbug, methicillin-resistant Staphylococcus aureus (MRSA), has been a problem in health care settings for years. In this environment, the bacteria is spread from one patient to another via the hands of care providers or by contaminated equipment.

Increasingly, MRSA is appearing outside of hospitals and is a growing threat. It can cause serious skin and soft tissue infections and a form of pneumonia. Clusters of MRSA skin infections have surfaced in certain groups of people, including athletes, children and members of the military. Risk factors in these groups include close contact, shared equipment that isn't cleaned, cuts on the skin, crowded living conditions, contaminated clothes or towels, and poor hygiene.

The June issue of Mayo Clinic Women's HealthSource offers tips to avoid superbugs:

Wash your hands: This simple procedure, done properly, remains the best defense. Carry alcohol-based hand sanitizers for times when hand washing isn't possible.

Keep personal items personal: Don't share towels, soap, sheets, razors, clothing or athletic equipment.

Sanitize linens: If you have a cut or abrasion, wash towels and sheets with hot water and added bleach. Wash gym and athletic clothes after each use.

Get infections tested: If an infection requires treatment, ask the care provider to take a culture to confirm what bacteria are present before you are given an antibiotic. If you test positive for a staphylococcus (staph) infection, ask that a culture be tested specifically for MRSA in case you need a special antibiotic.

Use antibiotics appropriately: When you take antibiotics, take all doses even when you start feeling better. Don't demand antibiotics for viral illnesses; antibiotics don't work with viruses. Taking too many antibiotics over time could become a detriment because the medication's effectiveness can be compromised by overuse.

Use antibacterial products sparingly: Antibacterial soaps and cleaning products probably don't prevent infections at home and may make these products less effective in hospitals.

Take precautions in the hospital: Ask all hospital staff and visitors to wash their hands or use an alcohol-based hand sanitizer before touching you. Ask care providers to wipe stethoscopes and other equipment with alcohol. Don't set food or utensils directly on tables or beds. Make sure that intravenous tubes and catheters are inserted under sterile conditions.

Benefits of Broad Genetic Testing Still Limited

Five years ago, scientists finished mapping the complete human genetic code, but genetic assessment of disease risk remains in its infancy, according to the June issue of Mayo Clinic Women's HealthSource.

Scientists know that people share essentially the same genetic makeup, differing only by one-tenth of 1 percent. By studying that small variation, they hope to explain why one person is healthy and another sick and which treatments are best suited for each individual.

Scientists have identified "simple" genetic disorders caused by mutation of a single gene, for example, sickle cell anemia. Much more research is necessary on common diseases such as cancer, heart disease and diabetes, which are likely caused by a combination of genetic changes along with environmental influences.

Already, some private companies are providing DNA analysis to the public to assess disease risk. A few also offer genetic counseling and disease prevention and screening advice.

Experts caution that current tests don't identify all genetic variants that combine to predict vulnerability or resistance to a disease. And even then, an accurate test might not provide useful information. For example, most women have an estimated 10 percent lifetime risk of breast cancer. Some medical providers question the practicality of informing a woman her personal risk may be slightly higher. In most cases, screening and prevention options aren't changed.

Though not as exciting as new technology, a careful analysis of the extended family medical history can provide a form of genetic risk assessment that is just as useful as newer tests.

Mayo Clinic Women's HealthSource is published monthly to help women enjoy healthier, more productive lives. Revenue from subscriptions is used to support medical research at Mayo Clinic. To subscribe, please call 800-876-8633, extension 9PK1, or visit http://www.bookstore.mayoclinic.com.


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