Shingles (herpes zoster)

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What is shingles?

  • Shingles is a painful rash due to the same virus that causes chickenpox.
  • After a chickenpox infection, the virus does not leave the body but hides along the nerve paths of the skin.
  • Shingles occurs when the dormant chickenpox virus becomes active again.

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Who gets shingles?

  • Everyone who has had chickenpox can get shingles. This happens to about 1 in 5 people. Why the virus becomes active again in some people and not others is unknown.
  • The disease is mostly seen in adults over age 50, but can occur in children.
  • The risk of shingles increases with advancing age. People with weakened immune systems, such as the elderly and those with certain medical conditions, are more likely to get shingles.

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What are the symptoms of shingles?

  • The following may occur a day or 2 before other symptoms:
    • chills
    • fever
    • fatigue
    • upset stomach .
  • The first symptom is often a tingling feeling on the skin, itchiness or a stabbing pain followed several days later by a rash.
    • The rash is in a line-like pattern that follows the nerve path and is on one side of the body.
    • 1 - 2 days later the rash changes to fluid-filled blisters called "vesicles" that look like chickenpox. When the rash is at its peak, symptoms range from mild itching to extreme and intense pain.
    • About the fifth day, the vesicles dry and scab.

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How do I know I have shingles?

  • Diagnosis is based on the symptoms, how the rash looks, and a history of chickenpox in the past.

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Can shingles be spread?

  • A person must have had chickenpox in the past to get shingles.
  • The virus that causes shingles is in the fluid of the vesicles.
  • It can be passed through direct contact with the vesicle fluid or by with articles soiled by the fluid of the vesicles. When the virus is moved into the eyes, nose or throat of someone who has never had chickenpox, that person can get chickenpox.
  • It takes 10 – 21 days from the time of with the virus for chickenpox to appear.

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How long is it contagious?

  • Once all the vesicles have scabbed, the person is no longer able to spread the virus.

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Can shingles be treated?

  • Most cases get better on their own.
  • However, anti-viral medications can shorten the length of the disease and reduce symptoms. The anti-viral medications work best when given very soon after the symptoms first appear.

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Are there complications?

  • Shingles is not usually dangerous to healthy people.
  • Anyone with shingles on the upper half of their face no matter how mild, should seek medical care at once. There is some danger that the virus could spread to the eye and cause damage.
  • The open vesicles could become infected with bacteria. This could lead to serious illness. Covering the rash and washing hands carefully after touching the area or soiled bandages will reduce the risk of infection.
  • Pain at the site of the healed rash has been known to last for months or years, usually in the elderly.
  • Scarring can occur.

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Can I get shingles again?

  • Most people who have shingles have only one bout of the disease in their lifetime.
  • However, people with immunity problems, such as leukaemia, cancer, or AIDS, may suffer repeated attacks.

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What can be done to prevent the spread of shingles?

  • Chickenpox must be prevented in order to prevent shingles. Remember, you cannot get shingles if you have never had chickenpox.
  • There is a vaccine to prevent chickenpox. Immunized people are unlikely to develop shingles. However, if a person has already had chickenpox, the vaccine will not stop them from getting shingles.
  • Covering the rash and careful hand washing after touching the area or soiled bandages will reduce the risk of spreading the virus.

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When should I see a doctor?

See a doctor as soon as you can if:

  • You think you have shingles. Anti-viral medications work best when given very soon after the symptoms appear.
  • You have already been diagnosed with shingles and you get a high fever or begin to feel very ill.
  • The vesicles are spreading to other areas of your body.

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