Response:

Shingles is an acute infection caused by the Varicella zoster virus, the same agent responsible for chickenpox. After a person recovers from chickenpox, the virus does not disappear completely but remains dormant in nerve ganglia. Normally, the immune system controls and keeps the virus inactive. However, when immune defenses weaken due to factors like advanced age, chronic illness, prolonged stress, or immunosuppressant medication, the virus reactivates, causing shingles.

While not directly causing the disease, alcohol subtly increases the risk of shingles outbreaks when the immune system is weak.

Alcohol does not directly "awaken" the Varicella zoster virus, but it impacts the immune system. Heavy and prolonged alcohol consumption impairs the activity of T-lymphocytes. These cells are crucial for controlling dormant viruses in the body. When T-lymphocyte numbers and quality decline, immune surveillance weakens, allowing the shingles virus to reactivate.

Additionally, alcohol can induce low-grade chronic inflammation, forcing the immune system to manage systemic inflammation and reducing its effectiveness in suppressing dormant viruses. Alcohol also diminishes the absorption and storage of essential micronutrients for immunity. Frequent alcohol consumption often leads to deficiencies in zinc and B vitamins, such as B6 and folate, due to reduced intestinal absorption. This hinders smooth immune function and weakens virus control.

Moreover, alcohol disrupts gut microbiota, diminishing the body's ability to combat infections and prolonging recovery. Consequently, individuals who drink heavily face an elevated risk of shingles, experiencing more severe and protracted illness.

Alcohol can promote virus reactivation, causing shingles. Illustration: *Vecteezy*.

Beyond painful skin lesions, shingles can lead to prolonged nerve pain, lasting months or even years after the rash heals. This persistent pain, often described as electric shocks or burning, severely impacts sleep, work capacity, and quality of life. In some instances, shingles causes dangerous complications, including ocular nerve inflammation, vision loss or blindness, and partial facial paralysis.

Therefore, individuals should limit alcohol consumption, avoiding heavy and prolonged drinking. Maintaining a healthy lifestyle, adequate sleep, stress management, balanced nutrition, and effective chronic disease management helps the body sustain control over dormant viruses. Additionally, shingles is preventable with the Shingrix (GSK) vaccine, which reduces the risk by up to 97% in people over 50 and lowers the incidence of nerve pain and other complications by more than 90%. People aged 50 and older receive two doses, two months apart; individuals aged 18 and older with underlying health conditions receive two doses, one month apart.

Master of Science, Doctor Ngo Thi Kim Phuong

(Medical Manager, VNVC Vaccination System)

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