The Shingles Story

Shingles is like Act II of the play “Chicken Pox.” You can’t get shingles unless you have had chicken pox. Both diseases are caused by the same virus, varicella zoster.  The first time around it causes chicken pox. When it reemerges, it causes shingles. After chicken pox occurs, the virus doesn’t disappear, but rather hides in nerve cells, perhaps forever or until it is reactivated. The mechanism by which this occurs is not totally clear. Stressors thought to contribute to the emergence of shingles include injury, infection, immune system deficiency (which naturally occurs as people age) and/or emotional distress.  Whatever the cause, when it does resurface, it results in shingles.

   The patient information about shingles does not begin to describe how painful and debilitating this condition can be. If you have ever had shingles or known someone who has had shingles, you have witnessed first-hand that this is such a painful disease that even the slightest touch can be excruciating. Shingles generally causes a rash that may last for several weeks. The classic rash appears as a single stripe on one side of the torso. It can also appear on the face. In rare instances, it can occur all over the body, similar to the chicken pox. Prior to developing the rash, the skin may feel pain, itch or tingle for 1-5 days. Then a rash will appear with blisters which should scab over within 7-10 days.  Over time (about 2-4 weeks) the rash should disappear. Other symptoms can include fever, headache, chills and upset stomach.

Unfortunately for some, the pain that accompanies shingles can drag on for months or even years. This lasting pain is called postherpetic neuralgia (PHN), which occurs in 10-20% of cases.  There are some treatments that can be tried, such as small doses of antidepressants, antiseizure medications and some topical creams but they are often not effective.  

            There are three important things to understand about the relationship between chicken pox and shingles:

• You can’t get shingles unless you have had chicken pox. Essentially, you get shingles from your own chicken pox virus awakened by some stressor on your body.  
• Shingles does not pass from person to person.
• You do not get shingles from persons with chicken pox, but you can get chicken pox from person with shingles, if you have never had natural chicken pox or the chicken pox vaccine.

            If you suspect that you have shingles, you should see your healthcare provider right away, as there are some medications (antivirals) that can be effective if taken within the first 48 to 72 hours.  Over the counter pain relievers may help.  Sometimes people need prescription pain relievers to obtain comfort.

The Shingles Vaccine There is a vaccine available that can reduce the risk of shingles. It is recommended for use in persons 60 and older. (It is licensed for persons 50 and over, but there is no recommendation for routine use.) The vaccine was first used in 2006. Studies since its inception show that the vaccine reduces the risk of shingles by 51% and reduces the risk of PHN pain by 67%. Studies also show that if you do get shingles despite having the shot, the condition is usually less severe. The protection from the vaccine is estimated to last about 5 years, although there is currently not a recommendation for a booster. Note: Having shingles does not give you immunity to future occurrences. Therefore you can get a shingles shot even if you had shingles. Some people should NOT get shingles vaccine: A person who has ever had a life-threatening or severe allergic reaction to gelatin, the antibiotic neomycin, or any other component of shingles vaccine; a person who has a weakened immune system because of HIV/AIDS or another disease that affects the immune system; treatment with drugs that affect the immune system, such as steroids, or cancer treatment such as radiation or chemotherapy; cancer affecting the bone marrow or lymphatic system, such as leukemia or lymphoma; or women who are or might be pregnant.

Not all health care providers will have this vaccine available at their office as it requires being kept frozen. However, many pharmacies carry this vaccine. You can call your insurance company to see if they will cover the shot or check with the pharmacy.  

For a packet of written information on shingles, District residents (Bethany, Hamden, North Haven and Woodbridge) can call Quinnipiack Valley Health District, 203 248-4528. You can also visit www.cdc.gov/shingles.