Causes Symptoms And Who Should Get The Shingles Vaccine
Before there was a vaccine to prevent chickenpox, it was a common childhood illness. According to the Center for Disease Control and Prevention , one in three people who had chickenpox will develop a related illness called shingles as an adult. There are an estimated one million cases of shingles in the United States per year.
Shingles is a viral infection caused by the varicella zoster virus, the same types of herpes virus that causes chickenpox. Varicella is chickenpox, while zoster is shingles. In this video, San Diego Health host Susan Taylor talks about shingles with , a family medicine physician at Scripps Clinic Rancho Bernardo.
Who gets shingles?
Shingles develops in people who already have the varicella zoster virus in their body. After an outbreak of chickenpox, the virus lies dormant in the spine, If it reactivates, it will cause shingles.
The longer its been since youve had chickenpox, the higher the likelihood of shingles, says Dr. Shalauta. It affects people of any age but is most common after age 50, and the older you are when you get shingles, the more painful it tends to be.
Its unknown what triggers the virus to reactivate. People who have a compromised immune system, or who are being treated with chemotherapy, have a higher risk of a shingles outbreak. Stress may be another contributing factor.
What are the symptoms of shingles?
Is shingles contagious?
Who should get the shingles vaccine?
How Is Shingles Spread
A person must have already had chickenpox in the past to develop shingles. A person cannot get shingles from a person that has shingles. However, 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 had the chickenpox vaccine. The person exposed to the virus would develop chickenpox, not shingles. A person with shingles can spread the virus when the rash is in the blister-phase. The blister fluid is filled with virus particles. The virus is spread through direct contact with the rash or through breathing in virus particles that get mixed in the air. Once the rash has developed crusts, the person is no longer contagious. A person is not infectious before blisters appear or if pain persists after the rash is gone .
Are Chickenpox And Shingles Serious Illnesses
The symptoms may be more severe in newborns, persons with weakened immune systems, and adults. Serious problems can occur and may include pneumonia , brain infection , and kidney problems. Many people are not aware that before a vaccine was available, approximately 10,600 persons were hospitalized, and 100 to 150 died, as a result of chickenpox in the U.S. every year.
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Should Someone With Shingles Stay Home From Work Or School
In general, as long as the lesion can be covered, a person with shingles does not need to stay home from work or school.
Health care workers and others working with high-risk individuals should remain home from work until the blisters have scabbed over.
Anyone who cannot keep their blisters covered should stay home from work or school until all blisters have scabbed over.
Who Should Be Vaccinated With Shingrix
The Shingrix vaccine is recommended for those 50 years of age and older who are in good health.
You should get the Shingrix vaccine even if:
- You have had shingles already.
- You have been previously vaccinated with Zostavax .
- You do not know for sure if youve ever had chickenpox.
Ask your healthcare provider, who knows your entire health history, if getting this vaccine is right for you.
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Is The Zostavax Vaccine Still Being Used
Yes. It is still recommended for preventing shingles and postherpetic neuralgia in healthy people age 50 and older. Zostavax is given as a single-dose shot versus the two-dose shot for Shingrix. Zostavax is less effective than Shingrix in preventing shingles and postherpetic neuralgia .
Zostavax can be considered if you are allergic to Shingrix or if Shingrix is unavailable due to supply shortage and you want some immediate protection from a possible case of shingles and/or postherpetic neuralgia. Because it is a weakened live vaccine, it may be dangerous if you have cancer, HIV, or take steroids, chemotherapy or other medications that suppress your immune system. Ask your healthcare provider if the Zostavax vaccine is an option for you.
What Can Be Done To Prevent The Spread Of Shingles
A vaccine for chickenpox is available and it is hoped that individuals immunized against chickenpox will be less likely to develop shingles in later life.
The risk of spreading the virus that causes shingles is low if the rash is covered. People with shingles should keep the rash covered, not touch or scratch the rash, and wash their hands often to prevent the spread of shingles. Once the rash has developed crusts, the person is no longer contagious.
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Key Points About Shingles
- Shingles is a common viral infection of the nerves. It causes a painful rash or small blisters on an area of skin.
- Shingles is caused when the chickenpox virus is reactivated.
- It is more common in people with weakened immune systems, and in people over the age of 50.
- Shingles starts with skin sensitivity, tingling, itching, and/or pain followed by rash that looks like small, red spots that turn into blisters.
- The rash is typically affects just one area on one side of the body or face.
- Treatment that is started as soon as possible helps reduce the severity of the disease.
Various Stages Of Shingles
Shingles generally develops quite slowly in stages. Majority of shingles cases are identified when the rash develops. Rashes associated with shingles occur at a later stage when the virus has become fully reactivated. It might take several days to couple of weeks for the rash to develop on the skin indicating a shingles outbreak.
In the initial stages, the virus travels within the nervous system. This is called the prodromal stage. The virus tends to target a particular side of the body where nerves branching out from the spinal cord connect skin tissues. During this stage, you may experience symptoms similar to flu-like infection. Some of the initial symptoms resembling a flu infection include headache, tiredness, body pain, swelling in the lymph nodes, as well as sensitivity to light.
During the secondary stage, you may experience as if ants are walking on your body which is then followed by persistent itching and burning sensation. After couple of days, patches of red raised rash appear causing severe pain with stinging sensation.
This is the stage where the virus is at the peak where the rash turns into blisters causing severe irritation and pain. This is also considered the active stage and may extend up to several weeks. The blisters formed on the skin tend to weep fluids during this period and slowly scab over and heal.
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What Serious Side Effects Should I Watch For After Getting The Shingrix Vaccine
Serious side effects from vaccines are extremely rare. However, call 911 or get to a hospital right away if you experience any of the following within minutes to hours after receiving Shingrix:
- Swelling of the face or throat.
- Difficulty breathing.
- Fast heartbeat.
- Dizziness, lightheadedness, weakness.
How Does Shingles Spread
If you have never been exposed to chickenpox, contracted the varicella-zoster virus, or received the chickenpox vaccination, you can contract it after exposure to active shingles blisters. This usually occurs through direct, physical contact with the open sores of an active shingles rash. When the shingles rash is covered, however, the risk of spreading the varicella-zoster virus is low. To further prevent the potential spread of the varicella-zoster virus to others, avoid touching the shingles rash and wash your hands often. Until your shingles blisters fully scab over, its best to consider your condition contagious and also avoid physical contact with othersespecially people at risk of infection.
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Who Is Most At Risk Of Getting Shingles
Although any person who has had chickenpox can get shingles, most people who do so are older than 50 or have a weakened immune system. For example, a person might be susceptible if they have cancer, take medicines that weaken their immune system, or have HIV or AIDS, even if they are younger than 50.
What Should I Do About An Exposure To Varicella
If you have been in contact with someone with chickenpox or shingles, or if you have a rash-associated illness that might be chickenpox or shingles, discuss your situation with your healthcare provider. Blood tests may be done to see if you have become infected with the virus or have had the disease in the past. If you are pregnant and not immune and have been exposed to chickenpox or shingles, call your healthcare provider immediately. Your provider may choose to treat you with a medication called varicella-zoster immune globulin , but in order for this medication to be most helpful, it needs to be given as soon as possible after your exposure to varicella.
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Shingles And Chickenpox Vaccination
The National Immunisation Program provides a free shingles vaccine, Zostavax® at 70 years of age . There is also a free catch-up program for 71 to 79 year olds until the end of 2021. The Zostavax® vaccine is available on prescription for people aged 50 to 69 years and from 80 years but it must be paid for by the patient.
Zostavax® vaccine contains live attenuated varicella-zoster virus, containing 14 times more virus than childhood varicella vaccines and is contraindicated in immunocompromised people. Zostavax® vaccine should not to be used in people with compromised immune function due to the risk of disseminated disease from the vaccine virus.
- Safety advisory – Zostavax® vaccine for health professionals and consumers
Vaccination is still recommended for people who have had shingles infection in the past. It is recommended to wait at least a year after recovery.
The NIP provides a free chickenpox vaccine to children aged 18 months of age and as catch-up for children up to 20 years of age as part of the No Jab No Pay legislation. People aged 14 years and older require two doses of the chickenpox vaccine, one to two months apart. People from 20 years of age must purchase the vaccine privately.
Im Pregnant And Have Had A Blood Test For Chickenpox What Do The Results Of This Test Show
The blood test can show that you:
- Are immune and have no sign of recent infection. You have nothing further to be concerned about.
- Are not immune and have not yet been infected. You should avoid anyone with chickenpox during your pregnancy.
- Have or recently had an infection. You should discuss what the risks are for your stage of pregnancy with your healthcare provider.
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Who Should Get The Shingles Vaccine
At this time, Shingrix is recommended for healthy adults who are 50 years of age or older. Individuals should receive the vaccine whether or not they recall having had chickenpox, as data shows that more than 99% of Americans over 40 years of age have had chickenpox, even if they do not remember having had it. Shingrix is also recommended for individuals who have already received the Zostavax vaccine, as Shingrix has demonstrated superior efficacy and longer-lasting protection.
Shingrix is not indicated for the prevention of primary varicella infection. The CDC recommends the varicella vaccine for healthy people who do not have evidence of immunity to varicella, including children, adolescents, and adults.
How Is Shingles Diagnosed
Your healthcare provider will do a complete physical exam and ask about your medical history, specifically about whether you have ever had chickenpox.
Your healthcare provider will likely know right away that it is shingles based on the unique rash. The rash usually appears one area on one side of the body or face. It appears as red spots, small fluid- or pus-filled vesicles, or scabs.
The healthcare provider may also take skin scrapings for testing.
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What Is The Outcome For Someone Who Has Shingles
Most people get shingles once, but its possible to get it again.
If you have a healthy immune system, the blisters tend to clear in 7 to 10 days. The rash tends to go away completely within 2 to 4 weeks. The pain may last longer, but usually stops in 1 or 2 months.
For some people, the pain will last longer than the rash. When it does, its called postherpetic neuralgia , which can come and go or be constant. PHN can last for months, years, or the rest of your life. Treatment can help reduce the amount of pain you feel.
Be sure to tell your doctor if you continue to have pain. Treatment can help you feel more comfortable.
For anyone who has a shingles rash, the right self-care can help ease your discomfort. Youll find out what dermatologists recommend at, Shingles: Self-care.
ReferencesCenters for Disease Control and Prevention . About shingles. Page last reviewed 10/17/2017. Last accessed 4/1/2019.
Dooling KL, Guo A, et al. Recommendations of the Advisory Committee on Immunization Practices for Use of Herpes Zoster Vaccines. Morb Mortal Wkly Rep 2018 67:103-8.
Madkan V, Sra K, et al. Human herpes viruses. In: Bolognia JL, et al. Dermatology. . Mosby Elsevier, Spain, 2008: 1204-8.
Straus SE, Oxman MN. Varicella and herpes zoster. In: Wolff K, Goldsmith LA, et al. Fitzpatricks Dermatology in General Medicine . McGraw Hill Medical, New York, 2008: 1885-98.
Symptoms And Gestation Period
Shingles begins with pain in the area that will ultimately develop a rash. The affected person may experience burning, itching, or stinging pain, as well as flu-like symptoms such as headaches, low-grade fever, and fatigue. A physician can investigate further to determine whether shingles is the cause. The incubation period of shingles â the time it takes from transmission to the first symptoms â is usually about two weeks, so it can be difficult to trace one’s infection back to the source.
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Other Forms Of Shingles
Shingles do not only develop on the skin. Ophthalmic shingles occurs when the virus affects the trigeminal nerve that controls the muscles, sensation, and movement of the face. This form of the infection requires immediate treatment. It can present as conjunctivitis or pink eye, which is highly contagious. Other symptoms of this eye infection include throbbing pain in the eye, blurry vision, and redness around and in the eye.