Part of an ongoing series dedicated to raising health and safety awareness across the Temple community.
What is shingles?
Shingles is a disease that affects an estimated 4 million Americans per year. It is caused by a virus called varicella zoster, also known as herpes zoster, the same virus that causes the common childhood disease chickenpox. The term herpes zoster is also used since varicella is one of many herpes viruses. Shingles, however, is not the same as the virus commonly referred to as herpes, or herpes simplex virus, which can cause both cold sores and genital herpes.
The word “zoster” is Greek for belt or girdle and describes the characteristic band-like pattern of the rash that accompanies varicella zoster infection. The more common name, shingles, is also a reference to the fact that the rash often has a rectangular appearance.
After a person has recovered from chickenpox, the varicella virus lies dormant in the sensory nerves. While the person is young and healthy, the virus usually remains quiet. However, in persons with weaker immune systems, such as the elderly or people with cancer, people who have had organ transplants, or people on immune-suppressing medications, the virus awakens. It travels to the ends of the nerve in which it was hiding and leads to a rash over the skin supplied by that nerve. Since sensory nerves of the skin do not cross the middle of the body, shingles only affects one side of the body.
What are the symptoms of shingles?
Shingles usually presents as a rash on one side of the face or body. The rash appears initially as little bumps on the skin that progress to blisters. Eventually the blisters scab over and heal. The rash can last up to a month. Throughout the course of the rash, and in some cases, before the rash appears, sharp or shooting pains occur in the affected region. This pain, called post-herpetic neuralgia, may even persist after the rash is healed and may persist for weeks or months.
Is shingles contagious?
If you have had chickenpox, you cannot get shingles from someone who has an active shingles rash. If you have not had chickenpox, you can get chickenpox from someone with an active shingles rash, since, as mentioned before, the same virus causes both diseases.
How is shingles treated?
Shingles can be treated with anti-viral medications. They are most helpful early in the course of the disease. Some doctors also prescribe steroids such as prednisone, but it is not clear that they help.
How can I avoid getting shingles?
A vaccine called Zostavax has been shown in scientific studies to reduce the chance of getting shingles by 50 percent in people who receive it. Zostavax contains live, attenuated virus; it exposes the body to a weakened varicella virus in order to stimulate the immune system. A person who has had chickenpox in the past cannot get shingles from the vaccine, even though the weakened virus is present in the vaccine.
If I get the vaccine, can I still get shingles?
Yes. Although Zostavax will reduce the chances of developing shingles, you can still get the disease even if you get the vaccine. However, studies have shown that people who have received the vaccine but later develop shingles often have milder cases and are less likely to have persistent pain.
Who should receive the vaccine?
Zostavax was only studied in persons 60 years of age and older. Therefore, it is only indicated for people who are 60 or older. If you have not had chickenpox, you should not receive Zostivax. There is, however, a vaccination to prevent chickenpox, called Varivax. Varivax can reduce the chances of developing chickenpox and subsequently help to prevent getting shingles.
Who should not receive the vaccine?
Zostavax should not be given to people who are allergic to any components of the vaccine, have weakened immune systems (e.g., those with certain cancers or AIDS, or those taking immune-suppressive medications), are pregnant, or may be in contact with pregnant women who have not had chickenpox.
Where can I receive Zostavax?
Either through your primary care provider or, if you are a Temple employee, call Employee Health Services at 215-204-2679 to set up an appointment and to see if your insurance covers this vaccine.
For more information, visit the Centers for Disease Control and Prevention’s web site at www.cdc.gov/vaccines/vpd-vac/shingles/default.htm.
~Written by Joshua Rosenzweig, and employee health physician at Temple, as part of an ongoing series of health and safety articles aiming to raise awareness among Temple University employees, faculty and students about a range of health and safety issues. The initiative was developed by Temple’s Health and Safety Awareness Committee, comprising members from across the university community. If you have health and safety questions, concerns and/or suggestions, please contact the Health and Safety Committee at healthandsafety@temple.edu.