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A free online accredited CPD program for healthcare professionals

Herpes Zoster Update: Walkthrough of a Complex Case

1.00 Mainpro+ Credit(s) / / / / /

Program available online until: December 05, 2019

This Self-Learning program has been certified by the College of Family Physicians of Canada for up to 1.00 Mainpro+ Credit(s).

Cert+ Program ID#: 188837

Herpes Zoster : Complex Cases


Herpes zoster is caused by reactivation of the latent varicella zoster virus and usually occurs in patients aged 50 and older. Incidence increases with age, as cell-mediated immunity decreases. Each year, there are an estimated 130,000 new cases of herpes zoster in Canada, and 20 deaths. Up to 3% of patients with herpes zoster require hospitalization. The risk of recurrence is 4-7% after 8 years. Herpes zoster diagnosis, treatment and complications, cost the Canadian healthcare system approximately $68 million annually. This program will cover the clinical impact of Herpes Zoster (HZ), the importance of being vaccinated to prevent HZ, herpes zoster complications and complex cases, the efficacy of vaccinations available in Canada and treatments for post-herpetic neuralgia for patients with HZ.

Planning Committee

  • Robert Tanguay, MD, FRCPC, CISAM, CCSAM.
  • Chandi Chandrasena, MD, CCFP, FCFP.
  • David Greenberg, MD.
  • Ted Jablonski, MD, CCFP, FCFP.

Learning Objectives

Upon completion of this program, participants will be able to:

  1. Discuss the clinical impact of herpes zoster and its related complications on older adult patients
  2. Identify patients who would benefit from herpes zoster vaccination based on current evidence
  3. Detail practical strategies to engage patients in the prevention of herpes zoster
  4. Identify and manage post-herpetic neuralgia in patients that develop herpes zoster
  5. Manage complex situations such as herpes zoster ophthalmicus, herpes zoster in pregnancy, and possible viral transmission to unimmunized contacts

Ask the Expert

Rob Tanguay, MD, FRCPC:

  1. On average, how long does post-herpetic neuralgia last in the patients you’ve seen?
  2. What have you found most effective in treating post-herpetic neuralgia?
  3. What are some personal strategies you use when counselling patients about vaccines? What are some challenges you have faced?

Chandi Chandrasena, MD, CCFP:

  1. Is it necessary to vaccinate if a patient already had shingles?
  2. How long should you wait after a herpes zoster infection before vaccinating?
  3. If a person has never had chicken pox (confirmed by negative serology), do they need to be vaccinated?

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