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Editor's Message  |   March 2007
Fostering Successful Aging Through Therapeutic Advances in the Prevention and Management of Herpes Zoster
Author Notes
  • Address correspondence to Thomas A. Cavalieri, DO, FACOI, FACP, Interim Dean, Endowed Chair for Primary Care Research, Professor of Medicine and Director, New Jersey Institute for Successful Aging, University of Medicine and Dentistry of New Jersey–School of Osteopathic Medicine, One Medical Center Dr, Stratford, NJ 08084-1500. E-mail: cavalita@umdnj.edu 
Article Information
Geriatric Medicine / Preventive Medicine
Editor's Message   |   March 2007
Fostering Successful Aging Through Therapeutic Advances in the Prevention and Management of Herpes Zoster
The Journal of the American Osteopathic Association, March 2007, Vol. 107, S1-S2. doi:
The Journal of the American Osteopathic Association, March 2007, Vol. 107, S1-S2. doi:
The mean life span of Americans continues to increase. At 1900, the life expectancy in the United States was 48 years; by 2000, the life expectancy increased well into the late 70s; and by 2030, it is projected to be into the 80s.1 John F. Kennedy, years ago, said: “We have added years to life, but now we must add life to those years.” Evidence indicates that the frequency of disability in older adults has declined significantly during the past decades.2 United States Census data support the belief that the elderly are not only living longer lives, but they are living better lives. We must continue to find ways to enable the elderly to age successfully; that is, avoid or diminish the effects of diseases often associated with the aging process. 
The “state of the art” management and prevention of herpes zoster and postherpetic neuralgia (PHN) represent an advancement in healthcare that could enhance the quality of life of the elderly by preventing or reducing the severity of this age-related disorder. It is estimated that this painful disorder annually will affect more than 1 million people, mainly the elderly. In many, particularly those in the seventh or eighth decade of life, a chronic pain syndrome will develop as a result of the neuropathic effects of this disorder. Postherpetic neuralgia can reduce the quality of life of those afflicted with the condition by reducing their ability to continue their usual daily activities through PHN-associated chronic pain, insomnia, and depression.3,4 
Advances in medical management offer therapeutic interventions that reduce the course and complications of herpes zoster. A newly available vaccine, which has been endorsed by the Centers for Disease Control and Prevention's Advisory Committee on Immunization Practices, has been shown to significantly reduce the likelihood of acquiring herpes zoster or postherpetic neuralgia.3-5 This supplement to JAOA—The Journal of the American Osteopathic Association reviews evidence for the management and prevention of this potentially disabling disorder. 
In the first article, Bethany A. Weaver, DO, MPH, reviews the epidemiology, clinical manifestations, and risk factors of herpes zoster and postherpetic neuralgia. Next, Katherine E. Galluzzi, DO, summarizes evidence-based strategies for the management of both of these disorders. Finally, M. Susan Burke, MD, reviews the data from the Shingles Prevention Study,4 a randomized multicenter placebo-controlled trial aimed at evaluating the efficacy of the herpes zoster vaccine. 
Clearly, advances in the prevention and management of herpes zoster and postherpetic neuralgia have resulted in the reduction of the impact of these disorders on the well-being of the elderly. We must continue to identify additional interventions aimed at improving the quality of life of the elderly, enabling them to age successfully. 
 Dr Cavalieri discloses that he has no conflicts of interest related to the topic of this supplement.
 
Health, United States, 2006, with Chartbook on Trends in the Health of Americans. Hyattsville, Md: National Center for Health Statistics, Centers for Disease Control and Prevention, US Dept of Health and Human Services; November 2006. DHHS Publication No. 2006-1232. Available at: http://www.cdc.gov/nchs/data/hus/hus06.pdf. Accessed March 26, 2007.
Velkoff VA, He W, Sengupta M, Velkoff VA. 65+ in the United States: 2005. Washingaton, DC: National Institute of Aging, National Institutes of Health, US Dept of Health and Human Services; US Census Bureau P23-190 Current Population Reports: Special Studies;2005 .
Mitka M. FDA approves shingles vaccine: herpes zoster vaccine targets older adults. JAMA. 2006;296:157-158.
Oxman MN, Levin MJ, Johnson GR, Schmader KE, Straus SE, Gelb LD, et al; Shingles Prevention Study Group. A vaccine to prevent herpes zoster and postherpetic neuralgia in older adults. N Engl J Med. 2005;352:2271-2284. Available with registration at: http://content.nejm.org/cgi/content/full/352/22/2271. Accessed March 21, 2007.
Shingles (herpes zoster) vaccine. CDC Web site. National Immunization Program available at: http://www.cdc.gov/nip/vaccine/zoster/faqsvacc-zoster.htm. Accessed April 3, 2007.