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Shingles – Herpes Zoster

Chickenpox is a well-known illness to most parents. The majority of children used to pick up this contagious disease from friends or classmates, but now a childhood vaccine is available.

A main concern today is the occurrence of an after-effect of chickenpox. Few people realize that years after a person gets chickenpox, the virus that caused it may reactivate and affect areas surrounding a particular nerve. This condition is known as Herpes Zoster, or shingles, and results in pain and blistering in the affected nerve area.

Although chickenpox and its effects may clear up, the virus stays in the body. It becomes dormant (inactive) and hides away in the brain or spinal cord. If a person is ill or weakened, the virus may reactivate (after many years) and multiply. This can also happen for no apparent reason. The virus shows its presence by causing pain and general discomfort along the course of the affected nerve (the dermatome).

When susceptive children or adults are exposed to someone with shingles, they may develop a chickenpox. Children or adults who have acquired immunity (i.e., have already had chickenpox) will suffer no ill effect from the virus.

The first signs and symptoms of shingles may be a slight fever and chills, accompanied by fatigue, deep pain, and occasionally digestive problems. The skin over the area looks red, feels warm, and begins to hurt. Within 4 to 5 days, a group of blisters break out in clusters, forming a band or line in the area supplied by the nerve. ("Shingles" comes from the Greek word for "girdle," since the disease often affects the waistline, from back to navel). Classically, the eruption does not cross the midline.

The fluid in the blisters ranges from clear to cloudy, and the blisters then form crusts which slough away, leaving mild scars in some cases. Although pain usually diminishes as the blisters disappear, it may persist for several weeks, or indefinitely (post-herpetic neuralgia).

A shingles vaccine is now available. The Center for Disease Control (CDC) recommends Zostavax® for use in people 60 years old and older to prevent shingles. This is a one-time vaccination. Zostavax does not treat shingles or post-herpetic neuralgia once it develops. The FDA has licensed the vaccine as safe.