Click here for a pdf version of the Shingles Factsheet

What are shingles?

Shingles (Herpes Zoster) is an infection involving the nerve root. An itchy and often painful blisterlike skin rash appears, usually on one side of the body. It can also appear on the face and neck. You can only get shingles if you had chickenpox at some time in the past.

What causes shingles?

Shingles is caused by the varicella-zoster virus, the same virus that causes chickenpox. After a person has chickenpox, the virus lays dormant (stays quiet) in certain nerve cells. It can reactivate if the body is stressed due to an unrelated illness or if the immune system is low. Shingles usually occurs in adults over 50, but children can develop the illness in rare situations. The risk of getting shingles increases with age.

Who is at risk?

People who have medical conditions that keep the immune system from working properly are at greater risk. People with cancer or HIV, those on immunosuppressive drugs, such as steroids and drugs given after organ transplants are at greater risk for developing shingles.

What are the symptoms?

1. An itchy, raised, blister-like rash that is often painful appears in a band or patch on one area of the body (usually on one side of the face or torso).
2. Before the rash develops, there is often pain, itching, or tingling in the area where the rash will appear.
3. You may also feel unwell with chills, upset stomach, fatigue, and fever for a day or two before the rash is visible.
4. The blisters will dry and scab over in about five days.

What treatment is available?

Antiviral drugs may provide some relief, but these drugs need to be taken within 48 hours after the rash appears or they will not work. Medication may shorten the length and intensity of the illness. You will need a prescription from your doctor for antiviral medication. If pain is severe, a pain medication may also be required.

Are shingles contagious?

You can't get shingles from someone who has shingles. Shingles is a dormant chickenpox virus that has come to life. You can only get shingles from your own chickenpox virus, not from someone else.

However, the fluid from the shingles rash contains the chickenpox virus and may cause chickenpox in a person who hasn't had chickenpox before. The infected person can no longer spread the virus once the rash is dry and crusted over.

Are there any possible complications?

Most people recover without any problems. Occasionally there is scaring from the rash blisters. Very rarely shingles causes pneumonia, hearing problems, blindness, and encephalitis (swelling of the brain). About one in five people have severe pain that continues for weeks, months, or years after the rash goes away. This complication is called post-herpetic neuralgia.

Is there any way to prevent shingles?

If you have not had chickenpox you may get a vaccine to help prevent chickenpox. Research from the Canadian Medical Association Journal, (2005) states that people who have been vaccinated against chickenpox are less likely to get shingles, and if they do, they have less pain than people who have had natural chickenpox. The risk of spreading the chickenpox virus is low if the shingles rash is kept covered while oozing. People with shingles should not scratch the rash and should apply any creams or lotions with a swab or gauze pad. Swabs and pads should be thrown in the garbage immediately after use and hands should be washed thoroughly.

How often can people get shingles?

The Centers for Disease Control & Prevention, 2006 states that, “Usually people only have one episode of shingles in a lifetime. Although rare, a second or even third case of shingles can occur.” People with immunity problems such as leukemia, cancer, or HIV can have repeated attacks.

References:
Centers for Disease Control & Prevention (2006, October). Shingles (herpes zoster). Retrieved January 25, 2007, from
http://www.cdc.gov/nip/diseases/shingles/faqs-disease-shingles.htm

Heymann D.L. (Ed.). (2004). Control of communicable diseases manual, (18th ed.). Washington, DC: American Public
Health Association

Caring for Kids (2005, August). Facts about chickenpox. Retrieved January 19, 2006, from http://www.caringforkids.cps.ca/immunization/ChickenpoxFacts.htm#shingles

Gold, R. (2002). Your child’s best shot: A parent’s guide to vaccination. Ottawa, ON:Canadian Paediatric Society.

Canadian Medical Association Journal (2005, August). Vaccination boosts adult immunity to varicella zoster virus.
Retrieved January 25, 2007 from, http://www.cmaj.ca/cgi/content/full/173/3/249?maxtoshow=&HITS=10&hits=
10&RESULTFORMAT=&fulltext=shingles+vaccine&andorexactfulltext=and&searchid=1&FIRSTINDEX=
0&sortspec=relevance&resourcetype=HWCIT