Shingles
What are shingles?
Shingles (also called Varicella Zoster) represents a reactivation of the Varicella virus. Anyone who has had chicken pox or who has been vaccinated against chicken pox has been exposed to the chicken pox virus (Varicella) and can therefore potentially experience a reactivation (Shingles). The virus never actually leaves the body. The virus ‘hides’ in our nerve roots until it is reactivated.
Reactivation of the Varicella Virus is typically associated with some immune compromise often related to stress, an illness, a shift in the immune system or sometimes for no apparent or identifiable reason. Most often shingles is seen in the adult population.
Do I have shingles?
Shingles (Zoster) usually starts with red patches on the skin that subsequently develop fluid filled blisters. Some people also notice pain or the feeling of a muscle strain in the involved area even before the rash appears. Usually the symptoms of shingles appear on the chest or abdomen, and sometimes the face. The redness and blisters are usually clustered into stripes or bands that correspond to the nerve root involved. Perhaps the most distinctive sign of shingles is that symptoms are unilateral, or confined to only one side of the body.
Is shingles contagious?
Shingles is caused by a virus and when you have it you ARE contagious. However, you are only contagious to people who have never had chicken pox. You will not give those people “shingles”, rather they will catch chicken pox from you. Shingles is always caused by your own varicella zoster virus that has been living inside you since you had the chicken pox.
When a person has the chicken pox, he or she is contagious through respiratory droplets (coughing, sneezing, etc.). Shingles, on the other hand, are only contagious through direct contact to the rash or the virus shed from the rash. Hand-washing is important to prevent transmission. You are contagious until the entire rash has “crusted over.” Until that time you should avoid other people and rest at home. Especially important is to avoid pregnant women or people who are immunocompromised (from AIDS, cancer, etc.). A case of the shingles for these people can be devastating, even deadly.
Is shingles dangerous?
Healthy patients typically enjoy a full recovery from an episode of shingles. Patients who are very elderly and patients who have an impaired immune system might have far more severe, widespread and painful symptoms.
What is post-herpetic neuralgia?
Some patients suffer from persistent pain for months and even years after the shingles rash subsides. This is called “post-herpetic neuralgia.” The nerve that the virus traveled along remains irritated from all of the inflammation that the infection caused. The symptoms can range from a nagging tingle that lasts a few weeks to outright pain that lasts for months and requires treatment from a neurologist. There are effective new medicines for post-herpetic neuralgia, but the most effective treatment is to prevent the problem in the first place. Get vaccinated!
Is there a shingles vaccine?
There is a shingles vaccine called zostavax and it is very effective at preventing the shingles. It is recommended for people over the age of 60 because the older you are the more likely you are to get shingles and the symptoms are generally more severe. Zostavax is typically administered by your primary care provider.
Is there treatment for Shingles?
Oral antiviral pills (Valtrex, Famvir) are helpful in reducing the duration of a shingles episode. These antiviral medications can also reduce the risk for post-herpectic neuralgia. These medications are most effective when started as soon as symptoms first appear.
