Saturday, February 24, 2024

What Causes The Shingles Virus To Reactivate

If You Get The Shingles Vaccine Does This Mean Youre 100% Protected From Getting Shingles

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No. Just like most vaccines, getting vaccinated with a shingles vaccine doesnt provide 100% protection from disease. However, getting the shingles vaccine reduces your risk of developing shingles.

Even if you do develop shingles, youll be more likely to have a mild case. Also, youll be much less likely to develop postherpetic neuralgia, a painful condition that can follow a shingles outbreak.

Can You Get Shingles If You Havent Had Chickenpox

No. You cant get shingles if youve never had chickenpox, but you can get chickenpox from someone who has shingles. If youve never had chickenpox and you come into direct contact with the oozing, blister-like rash of someone with shingles, the varicella-zoster virus can infect you and you would develop chickenpox.

Once youve had chickenpox, you could develop shingles at some point in your life. This is because the varicella-zoster virus never fully goes away after youve had chickenpox. It lies quietly inactive in your nerve tissue. Later in life, the virus may become active again and appears as shingles.

Can you get chickenpox more than once?

Its rare to get chickenpox twice in your life. Once youve had chickenpox, youre usually immune to it for the rest of your life. However, its not totally impossible. If you have a severely weakened immune system , you can get chickenpox a second time. If youve had chickenpox, you are more likely to get shingles at some point in your life than a repeat bout of chickenpox.

Is A Vaccine Available To Prevent Shingles

Two vaccines are available in the United States to reduce your chance of developing shingles and postherpetic neuralgia. One vaccine, Zostavax®, has been available since 2006. The second vaccine, Shingrix®, has been available since 2017. Shingrix is recommended as the preferred vaccine by the Advisory Committee on Immunization Practices, a group of medical and public health experts.

Shingrix is given as a two-dose shot in your upper arm. You should receive the second dose two to six months after receiving the first. Shingrix has been shown to be more than 90% effective in preventing shingles and postherpetic neuralgia. Its effectiveness remains above 85% for at least four years after receiving the vaccine.

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Herpes Zoster In People Who Received Varicella Vaccine

Although herpes zoster has always been uncommon among children, the rate of herpes zoster in U.S. children has been declining since the routine varicella vaccination program started. Varicella vaccine contains live attenuated VZV, which causes latent infection.

  • Children who have been vaccinated against varicella have lower rates of herpes zoster compared to children who had natural infection with varicella. The reason for this is that vaccinated children are less likely to become infected with wild-type VZV, and the risk of reactivation of vaccine-strain VZV appears lower compared with reactivation of wild-type VZV.
  • The number of older adults who have received varicella vaccine since it was licensed in 1995 is quite small. There is very little information on the risk of herpes zoster in people who got varicella vaccine as adults.

CDC continues to study the epidemiology of herpes zoster among adults and children and to monitor the effects of the U.S. varicella and herpes zoster vaccination programs.

How Are Chickenpox And Shingles Different

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When a person, usually a child, who has not received the chickenpox vaccine is exposed to VZV, he or she usually develops chickenpox, a highly contagious disease that can be spread by breathing as well as by contact with the rash. The infection begins in the upper respiratory tract where the virus incubates for 15 days or more. VZV then spreads to the bloodstream and migrates to the skin, giving rise to the familiar chickenpox rash.

In contrast, you cant catch shingles from someone else. You must already have been exposed to chickenpox and harbor the virus in your nervous system to develop shingles. When reactivated, the virus travels down nerves to the skin, causing the painful shingles rash. In shingles, the virus does not normally spread to the bloodstream or lungs, so the virus is not shed in air.

But a person with a shingles rashwhich contains active virus particlescan pass the virus to someone who has never had chickenpox or who has not been vaccinated. In this case, the person will develop chickenpox, not shingles. A person must come into direct contact with the open sores of the shingles rash. Merely being in the same room with someone who has shingles will not cause chickenpox. Children who develop chicken pox generally fully recover however, adults who develop chicken pox can become seriously ill.

Likewise, a person with chickenpox cannot give shingles to someone elsebut they can pass the virus to someone who has never had chickenpox.

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Where Does Shingles Come From

When you have chickenpox as a child, your body fights off the varicella-zoster virus and the physical signs of chickenpox fade away, but the virus always remains in your body. In adulthood, sometimes the virus becomes active again. This time, the varicella-zoster virus makes its second appearance in the form of shingles.

How Is Shingles Treated

Currently there is no cure for shingles, but attacks can be made less severe and shorter by using prescription antiviral drugs such as acyclovir, valacyclovir, or famcyclovir as soon as possible after symptoms begin. Early treatment can reduce or prevent severe pain and help blisters dry faster. Antiviral drugs can reduce by about half the risk of being left with postherpetic neuralgia, which is chronic pain that can last for months or years after the shingles rash clears. Doctors recommend starting antiviral drugs at the first sign of the shingles rash, or if the telltale symptoms indicate that a rash is about to erupt. Other treatments to consider are anti-inflammatory corticosteroids such as prednisone. These are routinely used when the eye or other facial nerves are affected.

Most people with shingles can be treated at home.

People with shingles should also try to relax and reduce stress eat regular, well-balanced meals and perform gentle exercises, such as walking or stretching to keep active and stop thinking about the pain . Placing a cool, damp washcloth on the blistersbut not when wearing a topical cream or patchcan help blisters dry faster and relieve pain. Keeping the area clean can help avoid a secondary bacterial infection.

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Who Is At Risk For Getting Shingles

People who have had chickenpox who are more likely to develop shingles include those:

  • With a weakened immune system .
  • Over the age of 50.
  • Who have been ill.
  • Who have experienced trauma.
  • Who are under stress.

The chickenpox virus doesnt leave your body after you have chickenpox. Instead, the virus stays in a portion of your spinal nerve root called the dorsal root ganglion. For the majority of people, the virus stays there quietly and doesn’t cause problems. Researchers aren’t always sure why the virus gets reactivated, but this typically occurs at times of stress.

When To See A Healthcare Provider

How Can You Prevent Shingles
  • If you suspect shingles
  • Within 3 days of getting the rash, to prevent lasting nerve pain
  • If the rash and pain are near an eye, which can cause permanent eye damage
  • If you’re over age 60 due to an increased risk of complications
  • If you have a weakened or suppressed immune system or someone close to you does

Shingles Doctor Discussion Guide

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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.

What Triggers A Shingles Outbreak

Experts do not know what exactly triggers a shingles outbreak, but it is theorized that high levels of stress and a weakened immune system are two major factors that may play a role in VZV reactivation. In addition, the following risk factors have been shown to put you at higher risk of developing a shingles outbreak:

  • Weakened immune system this may be the case after taking immunosuppressive medication after an organ transplant, undergoing chemotherapy, contracting HIV or AIDS, developing diabetes, or after a bone marrow transplant
  • Older age, particularly over 50
  • Experiencing high levels of physical or emotional stress
  • Cancer, especially leukemia and lymphoma

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Previous Occurrence Of Chicken Pox

The same virus that causes chickenpox also causes shingles. If you’ve ever had chickenpox, even as a child, then you have the shingles virus already in your body. The shingles virus will remain dormant in nerve tissue until something causes it to reactivate. The virus is considered opportunistic in that it strikes when your immune system is weakened.

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The Link Between Crohns Disease And Shingles

What Is Shingles?

If you’ve never had chicken pox, as a child or as an adult, and you’re exposed to the virus let’s say you touch someone at the contagious, blister stage of shingles transmission could occur and you’d get chicken pox.

If you haven’t had chicken pox, you can’t get shingles. But someone who has never had chicken pox or been vaccinated for it can contract chicken pox through close contact with someone who has shingles.

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Can You Get Shingles More Than Once

VZV usually remains dormant in the body, but about 1 in 3 people who have had chickenpox will have a shingles outbreak in their lifetime. Most people develop shingles at one time in their lives, but it is possible to have more than one outbreak, especially if you have one or more risk factors predisposing you to VZV reactivation.

Medications That Suppress The Immune System

Drugs that suppress the immune system can reactivate the shingles virus. Medications used to counteract autoimmune disorders also put the patient at greater risk for developing the painful rash. Likewise, drugs that prevent rejection of a transplanted organ can increase the change of developing shingles.

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What Is The Outlook For People With Recurring Shingles

Shingles usually clears up within two to six weeks.

In a small number of cases, the pain can remain once the rash has healed. This is called postherpetic neuralgia . Up to 2 percent of people who get shingles have PHN for five years or more. The risk increases with age.

Recurring shingles isnt preventable. You can reduce your risk by getting the shingles vaccine, even after youve had shingles.

A showed that people who had the shingles vaccine had 51 percent fewer cases of shingles. For people 50-59 years old, the shingles vaccine reduced the risk of shingles by 69.8 percent.

People who received the shingles vaccine generally had less severe cases of shingles. They also had

What Are The Complications Of Shingles

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Symptoms of shingles usually dont last longer than 3 to 5 weeks. However, complications can happen. The main complications that can result from shingles include:

  • Postherpetic neuralgia . The most common complication of shingles is called postherpetic neuralgia . This continuous, chronic pain lasts even after the skin lesions have healed. The pain may be severe in the area where the blisters were present. The affected skin may be very sensitive to heat and cold. If you had severe pain during the active rash or have impaired senses, you are at increased risk for PHN. The elderly are also at greater risk. Early treatment of shingles may prevent PHN. Pain relievers and steroid treatment may be used to treat the pain and inflammation. Other treatments include antiviral drugs, antidepressants, anticonvulsants, and topical agents.
  • Bacterial infection. A bacterial infection of the skin where the rash happens is another complication. Rarely, infections can lead to more problems, such as tissue death and scarring. When an infection happens near or on the eyes, a corneal infection can happen. This can lead to temporary or permanent blindness.

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When Should I See My Doctor

See your doctor as soon as possible if you are experiencing any symptoms of shingles. Starting treatment with antiviral medicines within 3 days of the rash appearing should reduce the severity of symptoms and the risk of further complications, including post-herpetic neuralgia.

See your doctor straight away if you have symptoms of shingles and are experiencing the following:

  • symptoms that affect your eye area
  • a temperature of 38°C or higher

You should also see your doctor if you are pregnant, or have a weakened immune system due to medicine that suppresses the immune system, or a condition that weakens your immune system.

Are There Complications Of Shingles

Shingles can have complications that last long after the rash is gone, including:

  • Brain inflammation or facial paralysis if it affects certain nerves
  • Eye problems and vision loss if your rash was in or around your eye
  • Pain that lasts long after the outbreak, called postherpetic neuralgia. It affects up to 1 in 5 people who get shingles.

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What Is The Varicella

The word varicella is derived from variola, the Latin word for smallpox. Zoster is the Greek word for girdle shingles often produces a girdle or belt of blisters or lesions around one side of the waist. This striking pattern also underlies the conditions common name: shingles comes from cingulum, the Latin word for belt or girdle.

VZV belongs to a group of viruses called herpesviruses. This group includes the herpes simplex virus that causes cold sores, fever blisters, and genital herpes. Like VZV, HSV can hide in the nervous system after an initial infection and then travel down nerve cell fibers to cause a renewed infection. Repeated episodes of cold sores on the lips are the most common example.

Most adults in the United States have had chickenpox, even if it was so mild as to pass unnoticed, and they are at risk for developing shingles later in life. In the original exposure to VZV , some of the virus particles settle into nerve cells of sensory ganglia , where they remain for many years in an inactive, hidden form. The neurons in the sensory ganglia have nerve fibers that supply the skin and relay information to the brain about what the body is sensingheat, cold, touch, pain.

Causes And Risk Factors Of Shingles

Why Does Shingles Cause More Pain Than Chickenpox?

The varicella-zoster virus the virus that causes chicken pox and shingles is part of a group of viruses called herpes viruses. This group also includes the viruses that cause cold sores and genital herpes.

But the varicella-zoster virus is not the same virus that causes cold sores and genital herpes. The viruses that cause oral and genital herpes are herpes simplex 1 and herpes simplex 2.

If youve had chicken pox, you can get shingles. After the chicken pox is over, varicella-zoster lies inactive, mainly in spinal or cranial nerves. Sometimes the virus reactivates, and thats when it travels along the nerves to erupt as a rash on your skin, causing shingles.

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What Research Is Being Done

The mission of the National Institute of Neurological Disorders and Stroke is to seek fundamental knowledge about the brain and nervous system and to use that knowledge to reduce the burden of neurological disease. The NINDS is a component of the National Institutes of Health, the leading supporter of biomedical research in the world.

The NINDS funds and conducts research on a wide range of neurological disorders, such as shingles, to understand their causes and to develop and improve ways to diagnosis, treat, and prevent them.

Medical research on shingles has two main goals. The first is to develop drugs to fight the disease and to prevent or treat its complications. The second is to understand the disease well enough to prevent it, especially in people at high risk. To achieve these goals, scientists need to learn much more about VZV and its effects, including how it becomes latent in nerve cells , what induces it to become active again, and how such reactivation can lead to postherpetic neuralgia and other complications..

Research on postherpetic neuralgia includes studies in animal models of the condition, to better understand cellular changes that lead to persistent pain. These changes may represent future targets in the form of improved vaccines, new medicines, or even gene therapy.

Where Can I Find More Information About Research On Shingles

In addition to the NINDS, several other NIH organizations support research relevant to understanding, treating, or preventing shingles and its complications, including the National Institute of Allergy and Infectious Diseases and the National Institute on Aging .

  • NIH RePORTER is a searchable database of current and previously funded research supported by NIH and some other federal agencies. RePORTER also includes links to research results such as patents and publications citing support from these projects.
  • PubMed allows users to search millions of journal article abstracts in biomedical research fields. The full text of many articles describing research funded by NIH and other sources is also freely available through PubMedCentral

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