This is one of the hallmark symptoms of shingles, also called herpes zoster. “Shingles is always on one side of the body,” says Randy Wexler, MD, a family physician at the Ohio State University Wexner Medical Center. “It never crosses the midline.” If you find a rash on both sides of your body, use these home remedies for rashes to get relief. (Dermatologists say you should never ever do these 12 things to your skin.)
It is important to stay in the clinic for 15 minutes after getting any vaccine because there is an extremely rare possibility, less than 1 in a million, of a life-threatening allergic reaction called anaphylaxis. This may include hives, difficulty breathing, or swelling of the throat, tongue or lips. Should this reaction occur, your health care provider is prepared to treat it. Emergency treatment includes administration of epinephrine (adrenaline) and transfer by ambulance to the nearest emergency department. If symptoms develop after you leave the clinic, call 9-1-1 or the local emergency number.
RZV can be administered in this situation. ZVL can also be administered, with one qualification. A diagnosis of an autoimmune condition such as lupus or rheumatoid arthritis is not a contraindication to ZVL. However, the treatment of these conditions may involve the use of an immunosuppressive drug, which could be a contraindication.
Anyone who has had chickenpox can develop shingles. That’s because the virus that’s already in their body can reactive. People of any age can get it, but it’s most common in people who are in their 60s and 70s.
Even if you have had shingles, you can still receive shingles vaccine to help prevent future occurrences of the disease. There is no specific length of time you must wait after having shingles before receiving shingles vaccine, but generally you should make sure the shingles rash has disappeared before getting vaccinated. The decision on when to get vaccinated should be made with your healthcare provider.
Theoretically, it may be possible to spread VZV to other individuals during a zoster outbreak because VZV has been reportedly detected in saliva and nasal secretions in individuals with chickenpox and/or shingles. However, there is little or no data about the frequency of secretion transmission. Such spread of VZV to others is considered to occur rarely.
Home remedies for shingles are mainly concerned with reducing the pain caused by this disease. Cold compresses (some containing aluminum acetate), colloidal oatmeal baths, starched baths, and some topical creams may help reduce pain for some people.
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Although a fever technically is any body temperature above the normal of 98.6 F (37 C), in practice, a person is usually not considered to have a significant fever until the temperature is above 100.4 F (38 C). Fever is part of the body’s own disease-fighting arsenal; rising body temperatures apparently are capable of killing off many disease-producing organisms.
The deep pain associated with post-herpetic neuralgia is caused by damage to the nerve during the shingles attack. In these cases, the nerve can no longer send the correct signals to the brain. Signals are amplified and confused, causing the sensation of pain, even though there is no longer injury to the skin.
Shingles is the common name for herpes zoster, the painful rash that results from reactivation of varicella virus in adulthood. Most of us are infected by varicella virus as children, when it causes chickenpox. After we recover from chickenpox, varicella doesn’t disappear, but rather goes dormant, hiding inside nerves under our skin for years. Later in life, varicella can erupt on the skin to cause the painful rash called herpes zoster or shingles. (Varicella is in the herpes virus family, but is distinct from HSV-1 and HSV-2, the herpes viruses that commonly affect the lips and genitals.)
Unfortunately even after the rash clears up after about two to four weeks, pain might still be experienced for up to several more weeks as the nerves recalibrate and recover from the virus. This is called “postherpetic neuralgia” (PHN) and is considered to be the most common complication of shingles. The rate of PHN is almost 30 percent higher in people older than age 50 compared with younger individuals. (4)
Registered nurse Shannon Haskell administers H1N1 vaccination to an elderly woman in Lakefield, Ont., in 2009. Advocates for seniors are calling for a new vaccine to protect against shingles that will be available across Canada in mid-January to be provided for free. (Fred Thornhill/Reuters)
The rash and pain usually subside within three to five weeks, but about one in five people develop a painful condition called postherpetic neuralgia, which often difficult to manage. In some people, shingles can reactivate presenting as zoster sine herpete: pain radiating along the path of a single spinal nerve (a dermatomal distribution), but without an accompanying rash. This condition may involve complications that affect several levels of the nervous system and cause many cranial neuropathies, polyneuritis, myelitis, or aseptic meningitis. Other serious effects that may occur in some cases include partial facial paralysis (usually temporary), ear damage, or encephalitis. During pregnancy, first infections with VZV, causing chickenpox, may lead to infection of the fetus and complications in the newborn, but chronic infection or reactivation in shingles are not associated with fetal infection.
Pain medication can be used to help relieve the discomfort caused by the rash, which can sometimes be severe. For some individuals with mild shingles pain, over-the-counter analgesics such as acetaminophen (Tylenol) or the anti-inflammatory drug ibuprofen (Motrin or Advil) may be all that is needed. Individuals with more severe pain may require stronger opioid pain medication.
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.
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.
Pregnant women can get shingles, but it is rare. While chickenpox can pose a very serious risk to a fetus, there is almost no risk to the fetus if the mother gets shingles. The symptoms of shingles are the same in pregnant and non-pregnant women. Any area of skin that has pain, tingling, itching or burning — even without a rash or blister — should be brought to the attention of a doctor, as this could be the early stages of shingles.
Though most people will experience only one episode of shingles during their lifetime, recurrence can occur in certain individuals. In order to help prevent recurrent episodes of shingles, individuals with no contraindications can receive the zoster vaccine (Shingrix), which can prevent recurrent episodes of shingles. Otherwise, people who do experience a recurrent case of shingles should see their doctor as soon as the rash appears to promptly receive antiviral medication.
Stress also has been shown to alter a person’s perception of pain. People who are under stress are likely to feel the physical symptoms of a disease more acutely. The itching, burning, and aching normally associated with shingles becomes even more intolerable when a person is under stress
The Zostavax package insert says that clinicians should consider administering live zoster vaccine and pneumococcal polysaccharide vaccine (PPSV) at least 4 weeks apart. What does ACIP say about this?