Shingles; A Painful, Blistering Rash
What is shingles?
Shingles, or Herpes zoster, is a viral infection of the nerves which can cause a painful rash on one side of the body. Shingles usually attacks the elderly and those who have a weakened immune system from illness or certain medications. Most patients have a full recovery, although this can be a slow process.
How is shingles transmitted?
Shingles is not a contagious illness. This disease is a unique example of a virus that can go undercover for decades. Shingles is caused by the chicken pox virus, a common childhood illness prior to the availability of the chicken pox vaccine. After the child recovers from chicken pox, the virus remains in the nerves in a dormant state. Amazingly, it can ‘sleep’ there for half a century until the person’s immunity is compromised. Then, the virus awakens and causes shingles, an entirely different disease than the original chicken pox. All shingles patients had chicken pox infection earlier in life.
While shingles is not contagious in the traditional sense, shingles patients could transmit chicken pox to a person who has never had chicken pox disease or vaccination. Therefore, shingles patients should avoid contact with newborns, pregnant women and those with weakened immune systems, while their rash is active.
What are the symptoms?
Initial symptoms may not suggest the diagnosis. Patients can initially complain of a headache and light sensitivity. Later, patients may notice an area of a burning skin sensitivity which can become quite painful. Afterwards, a blistering rash typically develops, which is restricted to either the left or right side of the body. This curious distribution of the rash is because the shingles virus is present in nerves on one side of the body only. For example, if doctors examine a rash that extends to both sides of the body, then shingles is not the diagnosis. Some patients complain of persistent pain even after the rash has disappeared.
How is shingles diagnosed?
Doctors routinely diagnose shingles based on the appearance and location of the rash. If necessary, a sample of the rash can be analyzed under the microscope to establish the diagnosis.
Is treatment available?
There are medicines available to reduce the intensity and the duration of the symptoms, although there is no medical cure for shingles. These medicines are most effective when taken early in the disease course. There are also special medicines available for patients who develop prolonged pain after healing of the rash.
Can shingles be prevented?
Definitely! Two important vaccines can prevent shingles. The chicken pox vaccine (Varivax) is now administered to children between and 12 and 18 months and to older individuals who have not had chicken pox. While this vaccine is not 100% effective, those who do contract chicken pox or shingles will have a less severe course. There is also a shingles vaccine (Zostavax) that is recommended to adults age 60 and over.
Do international travelers need to be vaccinated?
International travelers should be up to date on all routine vaccinations, in addition to any recommended or required travel vaccines. Many travelers face unnecessary risk by going abroad without available protection against chicken pox or shingles. Consult with a travel doctor before departure to discuss necessary vaccinations.