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Shingles: The Encore Performance of Chickenpox
Chickenpox – its itching, oozing blisters made many of us miserable as children – is capable of a second and nastier act in adulthood.
Shingles, or herpes zoster, is a painful, weeping rash caused by the varicella zoster virus (VZV), the same bug that causes chickenpox. Once you’ve had chickenpox, VZV remains with you for the rest of your life, quietly residing in your body’s nerve cells until for some reason – advancing age and compromised immune systems seem to be triggers – it reactivates. According to the Centers for Disease Control and Prevention (CDC), one out of every three adults will have an encounter with shingles. The disease appears with increasing frequency starting around the age of 50 – half of all cases occur in people over the age of 60 – and is a prevalent health issue among seniors. Half of all people living to age 85 have had or will get shingles.
Shingles starts with pain, itching and tingling followed by bands of blisters erupting on one side of the body. The blisters usually appear on the middle of the back and stretch around to the breastbone. Frequently accompanied by fever, headache and upset stomach, these lesions scab over within three to five days and usually clear in two to four weeks. Sometimes, there are lingering complications. Chronic, sharp, jabbing nerve pain – postherpetic neuralgia – afflicts one in every five shingles sufferers. In rare cases, pneumonia and hearing problems are complications.
If you become ill, your family and co-workers cannot catch shingles from you. However, VZV is contagious, so adults who have never had chickenpox could come down with chickenpox through direct contact with the shingles blisters. If you have shingles, keep the blisters covered and wash your hands often. Your health care provider can prescribe antiviral medications to lessen the severity and duration of shingles.
Shingles can be avoided. Vaccinating your children for chickenpox will not only protect them from one of childhood’s more unpleasant rites of passage, but also, once they are adults, from shingles. For adults who were not vaccinated as children and have had chickenpox, Zostavax, a vaccine available since 2006, will – in at least half of cases – keep the zoster virus from re-emerging as shingles.
The CDC recommends that all people age 60 and older who have had chickenpox get this shingles vaccine. It is listed in the CDC Recommended Adult Immunization Schedule under “zoster.” Adults who have not had chickenpox should receive the chickenpox vaccine, which is listed under “varicella.”
Additional information about vaccination schedules for these and other diseases can be found on the CDC schedule.
[Janet Lubman Rathner]