Childhood chickenpox can become shingles in adults
By: Erin Louks-Smith, M.D.
As children, many of us had the chickenpox and were probably told that most people who have had chickenpox will be immune to it for the rest of their lives. While you may be immune to chickenpox, the virus itself never leaves your system. It lies dormant in your nerve roots and may reactivate later in life, causing herpes zoster, more commonly known as shingles.
Shingles is an infection characterized by a painful skin rash that appears in a band or small area on one side of the face or body – most often on the back or chest.
Anyone who has had chickenpox can get shingles, but it is most common in older adults. About 50 percent of all cases occur among men and women 60 years old or older. Other people at higher risk are those who have weakened immune systems because of stress, injury, certain medications and medical conditions. An estimated one million cases of shingles occur each year in the U.S.
The first symptoms of shingles include pain, tingling, burning and/or numbness in the area where the characteristic rash will later occur. A person may also experience flu-like symptoms, but usually without a fever as well as swelling and tenderness of the lymph nodes.
The distinctive, painful, shingles rash appears several days or weeks after the first symptoms occur. The rash can appear anywhere on the body, but will be on just one side – left or right. Blisters, filled with clear liquid, will form. This fluid may become cloudy after a few days. The blisters may break open and crust over after about five days, with the rash healing within about two to four weeks.
Other symptoms of the virus can include headache, chills and upset stomach.
Some people continue to experience pain even after the rash has healed. This condition, known as Postherpetic neuralgia (PHN), causes sensitivity to touch along with an aching, burning and stabbing pain in the area where the shingles rash had been. The pain can make it difficult for a person to eat, sleep and complete daily activities. The symptoms of PHN can remain for at least 30 days, but can last for years.
Other complications can occur from the virus. Disseminated zoster is a rash that spreads over a large portion of the body and can affect the organs, including the heart, liver and lungs. If shingles affects nerves originating in the brain, cranial nerve complications can occur. This can threaten vision, hearing and taste as well as cause ear pain and a loss of movement in the facial nerves.
Treatment often includes a combination of antiviral medication, topical antibiotics and medication for pain, which can be over-the-counter or prescription, depending on the severity of symptoms. If you think you have shingles, you should contact your health care provider as soon as possible. Early treatment can help to reduce pain and prevent complications.
Shingles cannot be passed from one person to another, but the virus can pass to a person who has never had chickenpox or received the chickenpox vaccine. In this case, the person may develop chickenpox. The shingles virus spreads through direct contact with the fluid from rash blisters, not through sneezing, coughing or casual contact. A person is not infectious before the blisters appear, and one the rash has crusted over, the person is no longer contagious.
To prevent spread of shingles, keep the rash covered. Avoid touching or scratching the affected area. Wash your hands often.
The best way to prevent shingles is to get the shingles vaccine. The Center for Disease Control recommends the vaccine for everyone age 60 or older – unless they have one of the following conditions: a severe allergy to gelatin, neomycin or any other component of the shingles vaccine, a weakened immune system, currently ill with a fever of 101.3° or higher. Women who are pregnant or might become pregnant should also avoid the vaccine, as well as close contact with an active shingles infection.
Research shows the vaccine decreases risk of getting shingles by about 50 percent, and is even more effective for people ages 60 to 69. Also, if you do contract shingles after getting the shot, it is likely you will experience less pain and the duration of the illness will be shortened.
As a child, you probably weren’t able to avoid chickenpox, because there wasn’t a vaccine available. Luckily, we don’t have to say the same about shingles. Talk to your physician to see if the shingles vaccine is right for you. And, if you do experience symptoms of shingles, contact your doctor right away. Starting treatment as soon as possible can help to lessen symptoms and decrease the risk of nerve damage and other complications.
Dr. Louks-Smith is a family practice physician at Raiter Clinic in Cloquet.