Shingles (Herpes Zoster)
Shingles (herpes zoster) is a disease caused by the varicella-zoster virus, which is the same virus that causes chickenpox. After someone has chickenpox, the virus stays in the body, even when the person no longer has symptoms. The virus can then reactivate years later and cause shingles.
Shingles is not a reportable disease in North Carolina, so statewide case numbers are not available.
Signs and Symptoms
The most common sign of shingles is a rash that can be painful, itchy, or cause a tingling sensation. The rash usually appears on only one side of the body and sometimes affects only a small section of the face or torso.
For some people, the shingles rash can be very painful, and the pain can last for weeks or months. This pain can continue even after the rash goes away. Other symptoms of shingles can include:
- Fever
- Fatigue
- Headache
Anyone who has had chickenpox is at risk for shingles because, after a chickenpox infection, the virus stays in the body. This is called a “latent infection.” People who received the chickenpox vaccine can also get shingles, but it is less common than getting shingles after a natural chickenpox infection.
Later in life, the varicella-zoster virus can reactivate. Adults age 50 and older and people with compromised immune systems are at highest risk for shingles. Shingles can also affect younger adults or children, but this is less common.
How It Spreads
If someone is immune to chickenpox, they cannot get shingles from someone who has a shingles infection. Shingles is caused by a reactivation of the latent varicella-zoster virus within the body, not exposure to the shingles rash.
People who are not immune to chickenpox can get chickenpox after being exposed to someone with shingles. Infection can happen through direct contact with the shingles rash or by breathing in virus particles from the rash.
A person with shingles can spread the varicella-zoster virus when the shingles 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.
People with shingles should cover the rash as well as possible to prevent spread of the virus. This is especially important in health care and infant care settings, where employees with shingles can potentially spread the virus to babies who are too young to be vaccinated.
Treatment
Antiviral treatment for shingles works best when started within three days after the rash appears. Treatment can shorten how long the disease lasts and reduce pain from the skin lesions. Antiviral medicines require a prescription from a health care provider.
Prevention
Two doses of the shingles vaccine are recommended for adults age 50 and older, and for other adults who have a compromised immune system.