Some 95% of U.S. adults had chickenpox when they were children. Chickenpox, scientifically called varicella, is usually an annoying but not dangerous illness in children.

            What makes the illness treacherous is that the causative varicella-zoster virus can go into a dormant phase, hiding out mostly in nerve roots near the spinal cord. When our immune system is weakened by stress, illness, medications or simply aging, the virus can spread out from the nerve root along the nerve.

            This recurrence of virus along the course of a nerve is shingles.

            The clinical course of shingles is usually very stereotyped. With a patient who is a good observer, I can usually diagnose it over the phone.

            Stage one is an itching or burning pain localized to a band around one area of the body with nothing visible. To many, it feels as if they burned themselves when they did not.

            The next phase sees them break out with blisters in the same area. It can be on any part of the body, head to toe, but is virtually always only on one side, right or left.

            The blisters scab over and eventually dry up, but this may take weeks. Particularly in older people, the pain may linger for months or years after the rash has gone. This is called post-herpetic neuralgia and is very distressing.

            If the involved nerve is one of the nerves of the face, the eye may be affected, and this can be a sight-threatening issue.

            To fight back, we have treatment and prevention.

            Two anti-viral drugs, acyclovir and famciclovir, are useful in shortening the course of the illness and in preventing post-herpetic neuralgia. To be effective, they should be given early, ideally within a day of the rash appearing. If you break out with what may be shingles on Friday, do not wait until Monday to seek help.

            Vaccines are available that reduce the likelihood of getting shingles. The older one, Zostavax, is about 65% effective, and the newer one, Shingrix, is over 90% effective. While Zostavax is easy to get: one shot, minimal side-effects, the more effective Shingrix requires two shots and is more likely to give you a day or two of flu-like symptoms.

            There have been recent studies suggesting that vaccination reduces the risk of dementia, possibly by preventing the re-emergence of the varicella-zoster virus dormant in the brain.

            Since most children are now vaccinated against chickenpox – the vaccine came out in 1995 – we can hope that shingles will follow polio and smallpox into “mostly of historical interest.”

            In the meantime, most older adults should get the shingles vaccine. If getting Shingrix, don’t schedule your shot the day or two before an important event.

            Edward Hoffer MD is Associate Professor of Medicine, part-time, at Harvard.

What Does The Doctor Say?

By Dr. Edward Hoffer

            It takes persistence, research and passion to be an author. Now toss into the mix a very curious mind, and you wind up with Kathleen Brunelle.

            Known by many as “Mrs. Brunelle” at Old Rochester Regional High School, Brunelle has written several books in the narrative, nonfiction style. Her latest effort titled “She’s Gone: Five Mysterious Twentieth-Century Cold Cases” came out in May. On July 30, the author gave a presentation at the Elizabeth Taber Library in Marion, in which she not only shared the processes she employs but the devotion to telling the lost women’s stories.

            Brunelle extensively researched the lives of five women who seemingly disappeared without a trace, leaving behind bewildered and bereft friends and family. She said more than once in her hour-long talk, “someone knows something.”

            In a follow-up, we delved a bit more deeply into how the lives of Dorothy Arnold (disappeared 1910), Jean Spangler (disappeared 1949), Anna Locascio (disappeared 1918), Agnus Tuferson (disappeared 1933), and Simone Ridinger (disappeared 1977) were researched and Brunelle’s desire to keep the women’s lives from slipping into oblivion.

            Of particular note, Brunelle said that the Ridinger family stays in contact with police authorities …”1977 wasn’t that long ago relatively speaking. … It’s still an open case for the Sherborn Police Department.”

            Inspiration for “She’s Gone …” came indirectly.

            “I was inspired to write the book when reading about Anna Locascio’s story in an old newspaper. I was researching material for a different book at the time. I then looked into Agnes Tufverson’s story and wrote a book about her before going back and deciding to use a series of cases for this book,” she said.

            The research Brunelle undertakes would be daunting for most but not for the author.

            “I spent years researching these women and their stories. Also, when possible, I spoke to their families. I came to know them and their lives on a very personal level, and I felt responsible to get their stories right and to do them justice in this book,” she said.

            We asked what Brunelle hoped would be the readers’ main takeaway. Given her intense feelings for her subjects, we weren’t surprised by her answer.

            “The first takeaway is that the women in these cases are more than victims. They were talented and accomplished women whose stories were ended and taken away,” she said. “I want to give their stories back. The second takeaway is that even in the face of unspeakable tragedy, people can find strength and persevere. Throughout my research, I was amazed by the families of these missing women, and I continue to be inspired by their resilience.”

            Given Brunelle’s busy schedule, which not only includes being an English teacher at ORR but also a mother with a family to care for, how does she find time to write?

            “Writing is a very important part of my life and who I am,” she said. “It defines me in many ways. That being said, I don’t often have a lot of time to write, so I write when I can. I am, however, always thinking about my books and whatever I am researching or writing at the time. I would also say that working as an English teacher inspires my writing, as I have the chance to work with and discuss literature (and) writing every day.”

            Brunelle is drawn to female subjects.

            “I wanted to focus on relationships as they related to each woman’s character and her case, also her family dynamic,” she said. “I focus on history, particularly women’s issues. I suppose I try to right the wrongs find the answers where I can. That was certainly the case with ‘Bellamy’s Bride’ and certainly is the case with ‘She’s Gone.’ I like to speak up for those who can no longer speak for themselves.”

            And what about those final segments of the writing/publishing process?

            “The hardest part is that final push to the writing deadline – when I am editing down and sending off years of research and writing in its final form,” Brunelle said. “The book has become like a part of you by that point, so it’s hard to narrow it down and it’s hard to let it go.”

By Marilou Newell