Shingles is caused by the varicella zoster virus (VZV), the same virus that causes chickenpox. Instead of being cleared from the body as most viruses are, VZV remains dormant long after recovery from chickenpox. In some people, the virus may resurface as shingles years later. According to the Centers for Disease Control and Prevention (CDC) one in three people who have had chickenpox will develop shingles during their lifetime.
Signs and Symptoms
The signs and symptoms of shingles include sharp, shooting, burning or tingling sensations that precede the development of a rash with fluid-filled blisters. The rash usually presents on one side of the body or face. There may also be feelings of malaise (exhaustion), photophobia (light sensitivity), headache and chills.
Those at Highest Risk
Anyone, including children, may develop shingles subsequent to recovery from chickenpox. CDC reports those at highest risk for developing shingles include people over the age of 50 and those with impaired immune systems.
The CDC reports complications of shingles may include eye or hearing impairment, encephalitis (brain inflammation) and postherpetic neuralgia, a chronic, painful condition affecting your nerve fibers and skin. It may last for months or even years.
Shingles itself is not contagious, but the chickenpox virus may be transmitted from a patient with shingles to a person who has never had chickenpox. The fluid-filled blisters are the source of transmission so it is recommended they be covered until dried and scabbed over. Hand washing is also very important in preventing transmission to a person at risk. Pregnant women who have never had chickenpox should avoid contact with a shingles patient; if the virus is transmitted and chickenpox develops there is risk of birth defects during the first trimester of pregnancy. Once the blisters have resolved and are dry, the shingles patient is no longer considered contagious.
Management of Symptoms
People with symptoms of shingles should contact their physicians for medical management. Anti-viral and pain medications may be ordered to lessen the discomfort and severity of symptoms associated with the disease and patients should be monitored for complications.
Preventing shingles is not easily done since it is a manifestation of the original varicella zoster virus that has been resting in the body since infection with chickenpox. Prevention of the primary varicella zoster virus (chickenpox) through vaccination became available in 1995; The Advisory Committee on Immunization Practices (ACIP), an agency of the federal government, makes recommendations regarding vaccination of children and adults. The chickenpox vaccine is recommended beginning at 12 months of age; the vaccine has dramatically reduced the number of cases since becoming available, also reducing the number of potential shingles cases. In 2006, a vaccine for shingles became available as well; it is usually recommended for those over 60 years of age or those at high risk due to immunity status.