DR MARTIN SCURR answers your health questions

A month after my second AstraZeneca jab, I started exhibiting ‘spots’ on the back and right side of my head, my ear and neck — my GP told me this was shingles. I received amitriptyline, painkillers and were advised to discontinue them.

The right ear and neck are still sensitive to me. My 63-year-old neighbour had shingles after her first AstraZeneca jab — is it a coincidence? I am 70.

Ross Pert Newcastle upon Tyne

Shingles can occur when the chickenpox virus, also known medically by the varicella zoster virus, is activated after it has been locked in nerve cells very close to the spine.

Reactivation occurs usually after a fall in immunity. It causes the herpes virus, also known as herpes Zoster (herpes virale zoster), to spread along the nerves, causing painful blisters. These blisters can be found anywhere on the body.

One in four of us over the age of 50 will suffer shingles — it is much less common in younger people because as we age our immune system weakens.

There is usually an obvious trigger such as a bout of flu or pneumonia, or stress, surgery or chemotherapy — i.e. Things that could affect immunity

For weeks to months, you may feel burning, itching or discomfort. Acute post-herpetic nervegia, also known as burning and discomfort due to nerve injury can lead to severe pain.

There is currently no evidence to support the claim that Covid vaccines cause shingles. However, we are sure to learn more in the future. [File photo]

A low dose antidepressant such as the one you received from your doctor, is the best treatment. It helps to suppress symptoms and reduce nerve damage. 

Although there are no evidence to support the claim that Covid vaccines cause shingles at this time, we will soon learn more.

However, the fact that shingles is so common in people in your and your neighbour’s age range means it’s more likely to be a coincidence that you both suffered from it, rather than the jab causing the shingles.

Since several months, my husband has been suffering from a persistent cough that only gets worse in the evening. He feels as if he has catarrh in his throat and several prescriptions haven’t helped. This is very bothersome for him, and it is disrupting his (and mine) sleep. This could be a sign of something more.

C. Mulligan, Glasgow.

Your husband’s symptoms suggest he has chronic rhinosinusitis, where the lining of the nose and sinuses becomes infected or inflamed — most often due to allergy — not least as his symptoms are worse in the evening and at night.

This is the typical sign of allergic rhinosinusitis. Common triggers include dust, animal dander and household allergens.).

Even people with no previous allergies can sometimes develop this type of allergy response following a severe cold — possibly because the allergic tendency has somehow been ‘switched on’.

You may also experience non-allergic nasalitis. This could result from an old infection of the sinus tissues.

The coughing is the result of the lining of the nose and sinuses becoming inflamed and secreting more mucus, causing the congestion or ‘catarrh’ your husband has.

Your husband’s symptoms suggest he has chronic rhinosinusitis, where the lining of the nose and sinuses becomes infected or inflamed — most often due to allergy — not least as his symptoms are worse in the evening and at night

Your GP has prescribed two medications in attempts to treat this already — acetylcysteine and a nasal spray (I imagine the latter contains a steroid).

I am not sure why this was done. This is because it is meant to remove mucus from the lungs.

The nasal spray hasn’t worked either, so I would suggest using more potent steroid nose drops — ideally, betamethasone. They must be used at least two times daily with your head facing forward and downwards.

It should relieve symptoms within a few weeks. Your husband may then switch to milder steroid nasal sprays, such as one that I think he used first.

Even non-allergic rhinosinusitis usually improves after this — hopefully relieving your husband’s symptoms and both of your disturbed nights.

Speak to Dr Scurr

Write to Dr Scurr at Good Health, Daily Mail, 2 Derry Street, London W8 5TT or email: drmartin@dailymail.co.uk — include contact details. Dr Scurr is unable to enter into any personal correspondence. Please respond within a broad context. For any concerns regarding your health, you should consult your doctor.   

In my view: Here’s how to fix the crisis on the care front line 

Retired healthcare workers could be a possible solution to the staffing shortage in care homes.

This could have been, however, for most of those in the group, it was a slow process due to training requirements and Disclosure and Barring Service checks on criminal records.

This is because they are professionals who have been working as older people and could be suffering from health issues.

A second suggestion is that you recruit employees from the Care Quality Commission. This independent regulator oversees quality care in UK health care.

CQC employees often came from the healthcare sector anyway so they already have the background check and training.

Also, it would make sense to stop the time-consuming CQC Inspections. In healthcare, the same should apply: The inspection body should temporarily be suspended and staff with the appropriate qualifications requested to assist on the frontline.