Virus lying dormant in 90% of people can ‘reactivate’ and cause major brain, nerve and organ damage

Nine in 10 Americans carry a virus lying dormant that, if reactivated, may lead to lasting brain, nerve and organ damage, researchers have revealed.

Varicella zoster virus (VZV) is a type of herpes virus that causes chickenpox, shingles and other common infections.

Most people contract it during childhood, leading to chickenpox. Once patients recover, it lays dormant in the nerve cells, potentially reactivating later in life.

Researchers in Colorado are now warning that though the vast majority of people carry dormant VZV, the virus is still an underrecognized cause of serious neurological and systemic diseases. 

In a new scientific article, researchers explained that at least one in three people will experience VZV reactivation in their lifetime. When reactivation occurs, it can affect sensory nerves, blood vessels and multiple organs, creating a whole-body spectrum of disease.

Most commonly, reactivation manifests as shingles, a viral infection that causes an extremely painful, blistering rash on one side of the body. 

Shingles, which typically affects adults over 50, travels from the spinal cord down nerve paths throughout the body, causing debilitating nerve pain and damage.

Left untreated, the researchers warn the excruciating pain is a leading cause of suicide among older adults, and patients may suffer potentially permanent facial paralysis. 

In VZV reactivation, multi-organ damage can also occur to the heart, eyes, lungs and intestines due to nerve inflammation. Additionally, the authors note shingles may raise the risk of heart attacks, strokes, cognitive decline and dementia.

And while a blistering rash is a tell-tale sign of conditions such as shingles, the article, published in Nature Reviews Disease Primers, warns that VZV diseases may spread internally without a rash or other visible signs, making it even more difficult to detect. 

‘VZV is an extraordinarily stealthy virus because it can cause disease in places throughout the body without necessarily announcing its presence with a rash,’ Dr Maria Nagel, corresponding article author and professor of neurology and ophthalmology at the University of Colorado Anschutz School of Medicine, said. 

‘In my practice, one of the most under recognized manifestations of VZV disease without a rash is zoster sine herpete (“internal shingles”), in which the patient presents with severe, one-sided burning pain with normal imaging studies. 

‘Until the diagnosis of VZV infection is made, the underlying cause of the patient’s pain goes untreated.’

To prevent potentially irreversible complications, the researchers urge prompt detection and treatment, even dating all the way back to chickenpox in childhood.

Chickenpox, which affects about 150,000 US children every year, causes a fever, lack of appetite, headache and tiredness, along with the tell-tale raised red bumps and small fluid-filled blisters. 

Cases in the US have dramatically decreased over the past 30 years, with a 97 percent drop since routine chickenpox vaccination began in 1995. The CDC estimates about 90 percent of US children receive the two-dose vaccine each year, which is usually given once between ages 12 and 15 months and again between four and six years.

The shot is between 90 and 98 percent effective, the CDC estimates.  

Shingles most commonly causes a one-sided rash, along with sensitivity to touch, fluid-filled blisters, itching, fever, headache, sensitivity to light and fatigue. 

However, diagnosing other VZV-related conditions such as nerve and vascular damage, meningitis, brain swelling (encephalitis) and Ramsay Hunt syndrome, which causes possibly fatal facial paralysis, can be challenging.

‘Doctors need to recognize that VZV neurological and systemic disease can occur without a rash or months after a rash,’ Nagel said. 

‘When someone presents with a puzzling neurological or systemic condition that affects one side of the body, VZV should be considered as a potential cause, even when there is no obvious evidence of shingles.’

The chickenpox and shingles vaccines have been shown to reduce the risk of developing either disease. The shingles vaccine is given in two doses after age 50, or after age 19 for people with weakened immune systems, and it is 90 percent effective, according to the CDC. 

However, the researchers warn there is still little long-term research on other manifestations of VZV reactivation.

‘There is a critical shortage of clinicians and researchers who specialize in the neurological and systemic manifestations of VZV,’ Nagel said. 

‘Recognizing these infections requires an awareness that VZV can behave very differently from the classic picture of shingles.’