What Is Shingles And What Causes It
The varicella-zoster virus that causes chickenpox is the same virus that causes shingles. When you’ve had chickenpox as a child or teenager, the physical signs disappear as your body fights off the virus. However, the virus always remains in your body and can reactivate as you age.
For some, the virus stays in the body quietly in a portion of your spinal nerve root called the dorsal root ganglion. For others, the virus can become reactivated and develop into shingles.
Other Complications Some Severe Include:
- Bacterial infection of the rash
- Herpes zoster ophthalmicus causes eye problems when shingles is severe on the face, near the eyes, impacting sight. When very severe, blindness can occur
- Ramsay Hunt syndrome causes problems within the ear’s auditory canal or external parts. It is accompanied by ear pain, internal or external blisters, and one-sided facial paralysis
How You Catch The Varicella
Shingles is not contagious. You cant catch shingles from someone. However, a person with shingles can pass along VZV to people who have never contracted chickenpox.
VZV can be transmitted from a person with shingles to someone who has never had chickenpox via direct contact with fluid from shingles rash or blisters. Its not possible to pass along VZV before shingles blisters appear or after lesions crust over.
However, shingles is a lot less contagious than chickenpox. By covering up your rash, you can prevent the spread of the virus.
Shingles usually happens many years after an initial chickenpox infection. The first signs of a reactivation of the virus are malaise, fever, a localized tingling or burning sensation, and pain. Within a few days a one-sided rash forms on the face or body. It can takes up to 10 days for the rash and blisters to crust over. It will clear up entirely several weeks later.
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How Long Does A Shingles Outbreak Last
It can take three to five weeks from the time you begin to feel symptoms until the rash totally disappears.
Can I Go To Work With Shingles
You can go to work if you have shingles and are no longer contagious. However, you may need to wait until youre feeling better. Shingles can be excruciating and debilitating.
Youre no longer contagious when the rash and blisters begin to scab over. This is typically 10 days after the rash first crops up.
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Once You’ve Had Shingles Can It Come Back
Reoccurrence is relatively uncommon. Only a small percentage of patients may have a second episode, more commonly in women. “Three or more shingles episodes in the same person is considered extremely rare,” says Dr. Mohring. “In this case, it would prompt us to investigate other potential diseases that may be going on. Those with higher risk factors, especially weakened immune systems or autoimmune disease, are the most at risk for reoccurrence.”
Primary School And Childrens Services Centre Exclusion For Chickenpox Or Shingles
Primary school and childrens services centre exclusion differs according to case or contact status:
- Cases should be excluded until all blisters have dried. This is usually at least 5 days after the rash appears in unimmunised children, but may be less in previously immunised children.
- Any child with an immune deficiency or receiving chemotherapy should be excluded for their own protection. Otherwise, contacts are not excluded.
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How Is Postherpetic Neuralgia Treated
Treatments include lotions or creams and/or other medications not specifically used for pain, such as antidepressants or drugs for epilepsy. Regular pain relievers are not usually effective for this type of pain.
If your pain doesnt lessen, you might try therapies like nerve blocks or steroid injections near the area where the nerves exit the spine. Your provider might suggest an implantable nerve stimulator device for severe, ongoing pain that hasnt responded to other treatments.
Are Shingles Contagious Yes Or No
If you had chickenpox when you were a child, you are at risk for shingles. Shingles occurs when the varicella-zoster virus that caused your chickenpox re-emerges after lying dormant in your nerve cells from the time of your original illness. When this occurs, you are contagious, but you can’t give someone shingles.
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What Is Herpes Zoster
Herpes zoster, also called shingles, is an infection caused by the varicella virus. This is the same virus that causes chickenpox. Herpes zoster only develops in people who have had chickenpox in the past. After your chickenpox are gone, the varicella virus stays in your body as an inactive virus. This means that you may not feel symptoms, but the virus is still in your body. When the varicella virus becomes active again, it causes herpes zoster.
Stay Away From Certain Groups Of People If You Have Shingles
You cannot spread shingles to others. But people who have not had chickenpox before could catch chickenpox from you.
This is because shingles is caused by the chickenpox virus.
Try to avoid:
- pregnant people who have not had chickenpox before
- people with a weakened immune system like someone having chemotherapy
- babies less than 1 month old unless you gave birth to them, as your baby should be protected from the virus by your immune system
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Specific Complications Of Chickenpox
Aside from itching, the complications described below are usually rare.
Intense itching is the most common complication of chickenpox. It can be very distressing, particularly for small children. Many home remedies can help relieve the discomfort. It is important not to scratch the scabs because this can lead to scarring.
Bacterial Skin Infections
In some cases, a secondary bacterial infection may develop at sites that were scratched. If the skin around the scab becomes red, swollen, or warm, this may be a sign of a secondary bacterial infection. If you or your child develops these symptoms contact your health care provider because in rare cases, serious bacterial complications can occur.
Varicella pneumonia is an uncommon but serious complication of chickenpox. It usually develops 1 to 6 days after the chickenpox rash appears. Fever and cough may be signs of varicella pneumonia. Pregnant women, people who are immunocompromised, and smokers are at increased risk for this lung complication.
Encephalitis and Meningitis
Encephalitis and meningitis are rare but serious neurological complications of chickenpox. Meningitis is inflammation of the lining of the spinal cord and brain. Encephalitis is the inflammation of the brain itself. Signs and symptoms include:
- Nausea and vomiting
- Sensitivity to light
In encephalitis, seizures and coma can occur. Meningitis and encephalitis are very serious conditions that require immediate medical treatment.
Risk Factors For Shingles
Anyone who has had chickenpox is at risk for shingles later in life. Certain factors increase the risk for such outbreaks.
The Aging Process
The risk for herpes zoster increases as people age. Postherpetic neuralgia is persistent nerve pain and is the most common severe complication of shingles. The risk for PHN also increases after age 50.
Chronic medical conditions that weaken the immune system increase the risk for shingles and for getting shingles at a younger age. These conditions may include:
- Cancer, especially Hodgkin disease and lymphomas, and treatments such as bone marrow transplant.
- Autoimmune disorders such as rheumatoid arthritis, systemic lupus erythematosus, and inflammatory bowel disorders.
- Type 1 diabetes and chronic kidney disease.
- Chronic obstructive pulmonary disease and asthma.
Sometimes, the drugs used to treat these conditions suppress the immune system and increase the risk for shingles. Drug treatments that may increase risk include:
- Immune suppressing drugs used for treating autoimmune conditions such as rheumatoid arthritis, lupus, Crohn disease, and ulcerative colitis. These medications include disease-modifying anti-rheumatic drugs , steroids, and biologic drugs such as tumor necrosis factor inhibitors.
- Immune-suppressing drugs given after organ or bone marrow transplantation.
- Prednisone and other corticosteroids if they are used for extended periods of time.
- Protease inhibitors used for treatment of AIDS.
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How Is Shingles Treated
While there is no cure for shingles, see a doctor quickly to discuss your treatment options. Typically, oral antivirals are used, which can be prescribed by your primary care or an urgent care doctor. An anti-inflammatory drug may be prescribed if the rash affects your eyes or other parts of the face. In rare incidences, hospitalizations can occur in very severe, complicated cases.
Recommendations For Healthcare Institutions To Prevent Varicella And Nosocomial Spread
- have documented evidence of immunity for all healthcare personnel readily available at the healthcare personnels work location
- alert healthcare personnel without evidence of immunity to varicella about the risks of possible infection and offer those without evidence of immunity 2 doses of varicella vaccine, administered 4 to 8 weeks apart, when they begin employment
- establish protocols and recommendations for screening and vaccinating healthcare personnel and for managing healthcare personnel after exposures in the work place
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Which Shingles Vaccine Is Best
Eventually, your doctor will start mentioning the shingles vaccine which can help prevent shingles from developing, as well as reduce its severity if it does still develop. The shingles vaccine can also reduce your risk of postherpetic neuralgia, one of the most common complications of shingles.
“Because shingles becomes increasingly more common as a person ages, the shingles vaccine is currently recommended for people over the age of 50. There are two vaccine options, Shingrix and Zostavax, with Shingrix being the newer of the two vaccines and the preferred choice as it is more effective.”
When it comes to how the shingles vaccine works, Shingrix is a shot that requires two doses administered six months apart. There are temporary side of effects of this shingles vaccine that can be unpleasant, however. Shingles vaccine side effects typically don’t last more than three days, but include:
- Redness or swelling
How Do You Get Shingles
You don’t catch shingles from other peopleinstead it’s caused by the reactivation of the virus that causes chickenpox. You can only develop shingles if you had chickenpox when you were younger. You can’t get shingles if you’ve never had chickenpox.
After you recover from chickenpox, the varicella-zoster virus can enter your nervous system and lie dormant there for years. Someday, it might reactivate and cause shingles to appear. Doctors arent exactly sure why this happens, but it tends to happen to older people and/or those with weakened immune systems .
You can’t catch shingles from someone else, but if you have it, you can transmit the virus to others, giving them chickenpox.
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Susceptibility And Resistance To Chickenpox Or Shingles
Chickenpox is highly infectious herpes zoster much less so. More than 80 per cent of nonimmune household contacts of a case of chickenpox will become infected. Nonimmune people exposed to shingles cases will develop chickenpox if they become infected.
Second attacks of chickenpox are rare but do occur.
Infection remains latent in some individuals and can recur years later as shingles.
Patients who are at high risk of severe disease/complications if they do not have immunity include:
- infants less than 1 month old
- immunosuppressed individuals, including those with haematological malignancies, those on chemotherapy or high-dose steroids, or those with HIV infection.
When Should People Seek Medical Care For Shingles
If people develop pain and/or a rash in a band on one side of the body or face, they should seek medical care is as soon as possible as treatments may reduce the pain and any possible further nerve or eye problems. If the rash occurs near the nose or eyes, they should seek emergency medical care. Individuals with a medical problem or taking medication that decreases their immune response should seek help immediately if they suspect they may be developing shingles.
Children should be vaccinated against chickenpox and older individuals should discuss the shingles vaccine with their doctors to reduce the risk of developing shingles.
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How To Avoid Spreading Shingles
The most effective way for people with shingles to prevent the spread of VZV is to:
- Frequently wash hands
- Avoid scratching
Additionally, you should avoid contact with vulnerable people if you develop shingles. Until the rash begins to heal and crust over, you should avoid people at higher risk for VZV complications, including people with compromised immune systems and pregnant people.
A person with shingles is contagious until their rash crusts over.
Can Shingles Come Back
Given that shingles results from the varicella zoster virus reactivating some amount of time after having chickenpox, you may be wondering if the virus can…re-reactivate after having shingles.
“Once shingles clears up, the virus simply goes back into hiding and, unfortunately, it can reactivate again in the future,” says Dr. Brown. “As far as the likelihood of shingles reoccurring, that’s still largely up for debate. One study found that the chance of getting shingles a second time is about 5%, but other studies show this number to be lower.”
One way to reduce your risk of getting shingles twice is the same preventive measure that helps prevent you from ever getting it in the first place: the shingles vaccine.
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Is There A Treatment For Shingles
Several antiviral medicines, acyclovir , valacyclovir , and famciclovir , are available to treat shingles. These medications should be started as soon as possible after the rash appears and will help shorten the illness and decrease how severe the illness is. Pain medicine may also help with pain caused by shingles. Call your provider as soon as possible to discuss treatment options.
Home Remedies For Chickenpox Relief
Chickenpox is uncomfortable and unpleasant, but most cases in children are relatively mild and resolve within 7 to 10 days. If you or your child has been exposed to chickenpox, contact your health care provider. In otherwise healthy people who have a low risk for complications, home remedies can help provide relief from itching and fever.
- Oatmeal baths can help relieve itching.
- Calamine lotion can help dry out blisters and soothe skin.
- Acetaminophen can help reduce fever.
- Antihistamines may relieve severe itching and aid sleep.
Most important, do not scratch! Scratching the blisters can cause scarring and lead to a secondary infection.
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Check If You Have Shingles
The first signs of shingles can be:
- a tingling or painful feeling in an area of skin
- a headache or feeling generally unwell
A rash will appear a few days later.
Usually you get the shingles rash on your chest and tummy, but it can appear anywhere on your body including on your face, eyes and genitals.
The rash appears as blotches on your skin, on 1 side of your body only. A rash on both the left and right of your body is unlikely to be shingles.
Evidence Of Immunity To Varicella Includes:
- Documentation of age-appropriate varicella vaccination:
- Children age 12 months to 4 years: 1 dose of varicella vaccine.
- Children age 4 years and older, adolescents, and adults: 2 doses of varicella vaccine.
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Should I Get The Shingles Vaccine
“Because the vaccine has been shown to reduce the risk of developing herpes zoster and shingles complications, getting the vaccine is highly recommended,” says Dr. Mohring. “I strongly recommend it for all patients 50 years or older and those who are immunocompromised. It’s safe and effective and reduces severity if you have a breakthrough episode.”
The Shingrix vaccine is a two-dose series given two to six months apart. It’s been shown to be over 90% effective in preventing shingles and postherpetic neuralgia and remains over 85% effective for at least four years afterward. You will not get shingles from this vaccine, and it is generally safe for those with weakened immune systems.
If You Have More Than One Area Of Blisters What Can You Expect If You Go To The Hospital
Its important to note that most people with shingles dont need to be in a hospital, but if you do:
- Youll be in a contact isolation room.
- The door will be kept closed.
- A sign on your door will remind people who have never had chickenpox or the vaccine not to enter.
- The sign will also remind staff to wear gowns and gloves when entering the room.
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