Pregnant women are susceptible to shingles. Fortunately, shingles in pregnancy is very rare. The antiviral medications described previously are considered safe to use in pregnant women, as are most pain-relieving drugs. Women should not take nonsteroidal anti-inflammatory medications such as ibuprofen (Advil) or naproxen (Aleve) in the later stages of pregnancy, but acetaminophen (Tylenol) is considered safe. Having chickenpox during pregnancy has the potential to cause birth defects, depending upon when in the pregnancy the infection occurs. The risk of birth defects is believed to be lower with shingles than with primary chickenpox infection.
^ Schmader K, George LK, Burchett BM, Hamilton JD, Pieper CF (1998). “Race and stress in the incidence of herpes zoster in older adults”. J. Am. Geriatr. Soc. 46 (8): 973–77. doi:10.1111/j.1532-5415.1998.tb02751.x. PMID 9706885.
When the rash is absent (early or late in the disease, or in the case of zoster sine herpete), shingles can be difficult to diagnose. Apart from the rash, most symptoms can occur also in other conditions.
Shingles is an infection caused by the varicella-zoster virus, which is the same virus that causes chickenpox. Even after the chickenpox infection is over, the virus may live in your nervous system for years before reactivating as shingles. Shingles may also be referred to as herpes zoster.
Immunization with the varicella vaccine (chickenpox vaccine) is now recommended and routine in the U.S. It is a two-dose vaccine, given once between the age of 12 and 15 months and again between 4 and 6 years.
A dose of varicella vaccine has 1,350 plaque forming units (PFUs) of varicella vaccine virus, MMRV contains 9,800 PFUs (7 times higher than varicella vaccine), and live zoster vaccine contains 19,400 PFUs (14 times higher than varicella vaccine) at the date of expiration. RZV does not contain live varicella zoster virus.
^ Yih WK, Brooks DR, Lett SM, Jumaan AO, Zhang Z, Clements KM, Seward JF (2005). “The incidence of varicella and herpes zoster in Massachusetts as measured by the Behavioral Risk Factor Surveillance System (BRFSS) during a period of increasing varicella vaccine coverage, 1998–2003”. BMC Public Health. 5: 68. doi:10.1186/1471-2458-5-68. PMC 1177968 . PMID 15960856.
Most people get chicken pox when they are young, but the symptoms can be more severe among people who catch the infection in an older age. They include loss of appetite, fever, headache, tiredness and rashes, all of which can be more taxing on the health of elderly adults.
Longo DL, et al., eds. Varicella-zoster virus infections. In: Harrison’s Principles of Internal Medicine. 19th ed. New York, N.Y.: McGraw-Hill Education; 2015. http://accessmedicine.mhmedical.com. Accessed May 9, 2017.
Shingles, which is also referred to as herpes zoster, is characterized by a blistering skin rash that occurs on one side of the body. People above the age of 50, or those with a weak immune system are more likely to get affected by this condition. For this reason, people who are taking immunosuppressant drugs for the treatment of a chronic illness are vulnerable.
ACIP does not recommend routine ZVL vaccination of people 50 through 59 years of age. However, ZVL is approved by the FDA for persons age 50 through 59 years and clinicians may vaccinate persons in this age group without an ACIP recommendation. Notwithstanding FDA’s licensure, ACIP prefers RZV over ZVL.
Yes, but not in the way you may think. Your shingles rash will not trigger an outbreak of shingles in another person, but it can sometimes cause chickenpox in a child. People who’ve never had chickenpox, or the vaccine to prevent it, can pick up the virus by direct contact with the open sores of shingles. So keep a shingles rash covered and avoid contact with infants, as well as pregnant women who have never had chickenpox or the varicella vaccine.
Ramsay Hunt syndrome: If shingles affects the nerves of the face, this uncommon complication can lead to facial paralysis, and the characteristic rash can affect the ear and the ear canal, and rarely the mouth. Symptoms may include ear pain, ringing in the ears, hearing loss, and dizziness. Though most people recover fully with treatment, some individuals may have permanent facial weakness and/or hearing loss.
RZV was studied in 2 pre-licensure clinical trials. Efficacy against shingles was 97% for persons 50-59 years of age, 97% for persons 60-69 years of age, and 91% for persons 70 years and older. Among persons 70 years and older vaccine efficacy was 85% 4 years after vaccination.
Shingles is a painful itching rash caused by the varicella zoster virus, the same bug behind chickenpox. The virus lies dormant in the nerve tissue of people who’ve had chickenpox, and years later can reactivate as shingles.
The shingles vaccine has been tested on thousands of people to ensure its efficacy and safety. Most of the time, the vaccine is safely administered without any side effects. When it does cause reactions, they’re usually mild. People have reported side effects including redness, swelling, itching, or soreness in the area of skin where they were injected. A small number of people have complained of a headache after being vaccinated.
Anyone who has already had chicken pox is at risk of developing shingles later on in life. Both are caused by the same virus, the varicella-zoster virus. This virus stays dormant in the body after a chicken pox infection, but can become active again years later and trigger shingles (also called herpes zoster). It causes an often very painful rash with blisters that usually forms a band across the skin, but normally only affects one side of the body.
The virus that causes shingles, the varicella zoster virus, can be transmitted from person to person by direct contact with the fluid from the active blistering rash. Therefore, susceptible individuals should avoid contact with people who have active shingles, especially pregnant women who have never had chickenpox and immunocompromised individuals. It cannot be transmitted by coughing or sneezing, and it is not contagious before the blisters appear. Once the shingles rash has dried and developed crusting, it generally is not considered to be contagious.
^ a b Steiner I, Kennedy PG, Pachner AR (2007). “The neurotropic herpes viruses: herpes simplex and varicella-zoster”. Lancet Neurol. 6 (11): 1015–28. doi:10.1016/S1474-4422(07)70267-3. PMID 17945155.
This wording was added to the package insert because a Merck study showed that the varicella antibody titer in people who received ZVL and PPSV vaccines at the same visit were lower than when people received the vaccines a month apart. However, there is no known serologic correlate for protection against shingles so the importance of this observation is not known. ACIP has not changed its recommendation on the simultaneous administration of these two vaccines. ZVL and PPSV can be given at the same time or any time before or after each other.
Shingles, also known as herpes zoster, is a viral disease characterized by a painful skin rash with blisters in a localized area. Typically the rash occurs in a single, wide stripe either on the left or right side of the body or face. Two to four days before the rash occurs there may be tingling or local pain in the area. Otherwise there are typically few symptoms though some may have fever, headache, or feel tired. The rash usually heals within two to four weeks; however, some people develop ongoing nerve pain which can last for months or years, a condition called postherpetic neuralgia. In those with poor immune function the rash may occur widely. If the rash involves the eye, vision loss may occur.
PHN causes strong skin sensitivity, especially when being touched, tingling and burning that can persist in some extreme cases for years. However, usually after about four weeks most people are symptom-free.
ACIP recommends the use of RZV or ZVL in persons taking low-dose immunosuppressive therapy (less than 20 mg/day of prednisone or equivalent or using inhaled or topical steroids), or low doses of methotrexate, azathioprine, or 6-mercaptopurine.
Senior citizens with shingles are more likely to experience complications than the general population, including more extensive rashes and bacterial infections from open blisters. They are also more susceptible to both pneumonia and brain inflammation, so being seen by a doctor early on for anti-viral treatment is important.
Shingles is contagious to people who have not previously had chickenpox when there are new blisters forming and old blisters healing. Like with chickenpox, the time prior to healing or crusting of the blisters is the contagious stage of shingles. After all of the blisters are crusted over, the contagious period is over and the virus can no longer be spread.
For the pain, dissolve a soluble aspirin tablet in about a cup of water. Saturate a face cloth in the aspirin solution, then wrap this in plastic and put it in the freezer for a half an hour before applying.
Some doctors only treat symptoms of shingles, such as pain, when the disease is diagnosed later than 72 hours after the rash develops. Pain relievers, such as acetaminophen (Tylenol, for example), ibuprofen (Advil, for example), naproxen (Aleve), or tricyclic antidepressants are examples of some pain medications that may be used. Topical creams (for example, calamine lotion) may help reduce itching.