In rare instances, your doctor may need to test a sample of your skin or the fluid from your blisters. This involves using a sterile swab to collect a sample of tissue or fluid. Samples are then sent to a medical laboratory to confirm the presence of the virus.
Shingles can be spread when a person comes into contact with fluid contained in the blisters. The virus can be spread by direct contact with the lesions or by touching any dressings, sheets or clothes soiled with discharge from the spots.
According for the Centers for Disease Control and Prevention, shingles is not contagious, but the virus that causes shingles can be spread through skin-to-skin contact if a rash is present. An individual may develop chickenpox after physical contact with a person affected by the shingles rash.
The term shingles has nothing to do with a shingle on a roof or the small signboard outside the office of a doctor but is derived from the Latin cingulum meaning girdle, the idea being that shingles often girdles part of the body.
Wart/plantar wart Heck’s disease Genital wart giant Laryngeal papillomatosis Butcher’s wart Bowenoid papulosis Epidermodysplasia verruciformis Verruca plana Pigmented wart Verrucae palmares et plantares
Shingrix, manufactured by GlaxoSmithKline, is more than 90 percent effective in preventing shingles, a painful skin disease that afflicts about one of every three people in the United States during their lifetime.
From October 2016, the Australian Immunisation Register will record the vaccines given for all people living in Australia. This means that if you see another health service anywhere in Australia, then your vaccine history can be checked on the register.
The vaccine against the varicella-zoster virus has been shown in large studies to be effective in reducing the risk of older people developing shingles. The vaccine has been shown to be safe with very few side-effects.
In pre-licensure clinical trials of RZV the most common adverse reactions were pain at the injection site (78%), myalgia (45%), and fatigue (45%). Any grade 3 adverse event (reactions related to vaccination which were severe enough to prevent normal activities) was reported in 17% of vaccine recipients compared with 3% of placebo recipients. Grade 3 injection-site reactions (pain, redness, and swelling) were reported by 9% of vaccine recipients, compared with 0.3% of placebo recipients. Grade 3 solicited systemic events (myalgia, fatigue, headache, shivering, fever, and gastrointestinal symptoms) were reported by 11% of vaccine recipients and 2.4% of placebo recipients. The occurrence of local grade 3 reactions did not differ by vaccine dose. However systemic grade 3 reactions were reported more frequently after dose 2.
Tests aren’t usually needed to diagnose shingles, because the type and location of the rash is very easy to spot. However, sometimes scrapings may be taken from a blister and analysed under a microscope, or you may need a blood test to identify the virus and confirm the diagnosis.
Zostavax (herpes zoster vaccine) questions and answers. U.S. Food and Drug Administration. https://www.fda.gov/BiologicsBloodVaccines/Vaccines/QuestionsaboutVaccines/UCM070418. Accessed Sept. 29. 2017.
Recombinant zoster vaccine (RZV, Shingrix, GlaxoSmithKline) was licensed by the FDA in October 2017. It is a subunit vaccine that contains recombinant varicella zoster virus (VZV) glycoprotein E in combination with a novel adjuvant (AS01B). RZV does not contain live VZV. It is approved for persons 50 years and older. RZV is administered as a 2-dose series by the route. The second dose should be given 2 to 6 months after the first dose.
The committee also recommended Shingrix for adults who’ve previously gotten Zostavax, since a smaller study in people over age 65 demonstrated effectiveness and safety in those already vaccinated. The Food and Drug Administration approved Shingrix last month.
Dr. William Schaffner, preventive disease specialist at the Vanderbilt University School of Medicine, said, “This vaccine has spectacular initial protection rates in every age group. The immune system of a 70- or 80-year-old responds as if the person were only 25 or 30.”
ACIP has not specifically addressed the use of RZV in this situation but it is prudent to defer RZV until the patient’s immune system has recovered from the treatment. If the patient was receiving cancer chemotherapy, wait 3 months after therapy is discontinued before administering ZVL. If they were receiving high-dose steroids, isoantibodies, immune-mediators, or immunomodulators, wait 1 month after therapy is discontinued to administer ZVL.
Tests showed that the vaccine significantly reduced the incidence of shingles in older adults. The single-dose vaccine was shown to be more than 60% effective in reducing shingles symptoms, and it also reduced the incidence of post-herpetic neuralgia (PHN) by at least two-thirds. Even if you have had shingles, you can still have the vaccine to help prevent future outbreaks.
Adults with latent VZV infection who are exposed intermittently to children with chickenpox receive an immune boost. This periodic boost to the immune system helps to prevent shingles in older adults. When routine chickenpox vaccination was introduced in the United States, there was concern that, because older adults would no longer receive this natural periodic boost, there would be an increase in the incidence of shingles.
“Shingrix is more expensive and not yet covered by insurance,” Swartz said. “Pending official endorsement from the Centers for Disease Control, insurance companies will likely begin covering Shingrix.”
When the rash affects three or more dermatomes, it is called disseminated, or widespread zoster. In these cases, the rash may look more like chickenpox than shingles. This is more likely to happen if you have a weakened immune system.
Antiviral medication can help reduce the impact of shingles if given within 3in the first three days from the start of the rash appearing. Over-the-counter medications, such as paracetamol or non-steroidal anti-inflammatories, can be used for pain relief. If over-the-counter medicines do not control your pain, your doctor may prescribe other medicines. These could include opioids, anti-depressants or anticonvulsants, which may help control nerve pain.
Children’s Hospital of Philadelphia. “A Look at Each Vaccine: Varicella (Chickenpox) Vaccine.” http://www.chop.edu/service/vaccine-education-center/a-look-at-each-vaccine/varicella-chickenpox-vaccine.html. Accessed June 2014.
On occasion, shingles blisters can become infected with bacteria, resulting in cellulitis. Cellulitis is a bacterial infection of the skin. When cellulitis occurs, the skin area turns reddened, warm, firm, and tender.