Prophylaxis
Since zoster oticus can only break out if an infection with the varicella zoster virus has already occurred, vaccination against chickenpox is very useful. The vaccination is one of the standard vaccinations for children and adolescents. Women of child-bearing age should be vaccinated in any case, since a possible infection during pregnancy damages the child.
However, vaccination during pregnancy should be avoided. The vaccine is a live vaccine (Zostavax) which contains attenuated viruses. The body’s defense system forms antibodies against the pathogens, kills them and thus becomes immune to the disease. In patients with a weakened immune system, especially bone marrow transplant patients, acyclovir should be taken as prophylaxis during the period of the strongest immune deficiency.
Prognosis
The prognosis for zoster oticus is usually favorable, but the prognosis for its complications is poor. 2/3 of infections heal without consequences and a relapse of the disease is rare. Zoster neuralgia occurs in 10 to 15% of cases, in every second case in people over 60 years of age, and lasts for months or even years.
The facial paralysis and the hearing disorders often regress only incompletely. In immunocompromised persons, the course of the disease is severe and the prognosis poor. Fatal forms of the disease and complications can occur. Early or timely antiviral therapy significantly improves the prognosis.
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