The topic this month is Shingles (herpes zoster) an infection that causes a painful rash. People get shingles when the varicella-zoster virus (VZV), which causes chickenpox, reactivates in their bodies later in life after they have already had chickenpox. About 1 in 3 people in the United States and Canada will develop shingles in their lifetime. Your risk of having shingles increases as you get older or if you have a weakened immune system. Most people who have shingles only have it once, however, you can have shingles more than once if your immune system has a hard time keeping the virus in check.
About half of all shingles cases are in adults aged 60 or older. The chance of getting shingles becomes much greater by age 70. It’s rare to get shingles before 40 years of age. Scientists are still studying why this happens. It’s likely that your immune system keeps the virus dormant. When the immune system starts to weaken, which may start in your 50’s, the virus can “wake up.”
After having chickenpox, the virus stays in the nerve cells of your body but is not active. Shingles occurs when the virus becomes active again usually many years later, the virus may be reactivated by stress, illness, immuno-suppression, older age, trauma, and radiotherapy. But shingles often occurs for no known reason.
A person cannot get shingles from a person who has shingles. But, the virus that causes chickenpox and shingles can be spread from a person with active shingles to a person who has never had chickenpox or the chickenpox vaccine. Shingles can spread when a person comes into contact with fluid contained in the rash blisters. The virus can spread by direct contact with the lesions or by touching any dressings, sheets or clothes soiled/moistened with discharge from the open lesions. Once the shingles’ blisters have popped and have a “crush” over the shingles sites it usually is no longer contagious. If you are living with someone who is immuno-suppressed, you’ll need to avoid being around them for the first few days until the blisters are no longer fluid filled. You can get chickenpox from someone who has shingles if you never had chickenpox or never got chickenpox vaccine. You could then develop shingles later in life.
If you have shingles, it will probably take two-six weeks for your illness to run its course. Shingles pain can be mild or intense. Some people have mostly itching; some feel pain from the gentlest touch or breeze. Shingles appears as a group of red spots on a pink-red background which quickly turn into small fluid-filled blisters. Shingles usually shows up on one side of your body, usually in one specific area. The most common spot for shingles is on your trunk, but it can appear on your “butt” and spread down your leg. Some of the blisters burst, others may fill with blood or pus. You may notice that the skin beneath the blisters is inflamed. If you have brown or black skin, inflammation may cause a purplish color beneath the blisters or no noticeable discoloration. The blisters usually dry out and crust over within seven-ten days. Shingles can be a very painful condition, and sometimes the pain lingers even after the rash has clear.
Shingles can lead to serious complications. The most common shingles complication is long-term nerve pain called postherpetic neuralgia, or PHN. If the shingles rash appears on your face, it requires prompt action, and you should see a doctor right away. The virus could damage your eyesight or the nerves in your inner ear (hearing loss – balance problems). There is no cure for shingles. Antiviral medicines may help to make the attack shorter and less severe. They may also help prevent PHN. The medicines are most effective if you can take them within a few days after the rash appears. So if you think you might have shingles, contact your provider as soon as possible. Discuss with your physician if a shingles vaccine is indicated in your unique health situation.
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