Viruses

Shingles or Herpes Zoster: When Varicella Comes Back

Author Kimberly Hazel , 13-Jul-2022

Shingles, also known as herpes-zoster or herpes zoster virus, is a viral infection that causes a painful rash. It is caused by the same virus that causes chickenpox. The virus lies dormant in your body after you have chickenpox and can reactivate years later, causing shingles. It is unknown what exactly causes the virus to reactivate in those not exposed to someone with an active shingles infection. Shingles usually affect people over the age of 50. However, they can occur at any age. 

 

Outbreaks of shingles are rare, but they can occur, or rather only one outbreak of shingles has ever occurred. In 1990, there was an outbreak of shingles in the Manipur region of India. The outbreak affected primarily young adult males. It appeared to be linked to the outgoing outbreak of HIV at the time. The Indian government’s response to the outbreak was to provide free vaccinations to people affected by the virus. The government also set up mobile vaccination clinics to make it easier for people to get vaccinated. Thanks to these efforts, the outbreak was quickly contained, and no further cases were reported.

 

Herpes zoster Outbreaks Map from GIDEON Map 1990 - GIDEON

History

 

The name “shingles” comes from the Latin word for belt or girdle. This refers to the band-like nature of the rash. Shingles is sometimes called “zoster” or “zoster virus”. The history of shingles or herpes zoster is unclear. However, it is believed to be a virus that affects the nervous system. The rash typically starts as a cluster of red bumps that turn into blisters. These blisters eventually crust over and heal, but the process can take several weeks.

 

Epidemiology

 

Herpes zoster typically affects people over 50, although it can occur at any age. The incidence increases with age, peaking between 70 and 79. The disease is more common in women than men. However, the incidence is not the same as the prevalence. Prevalence is the number of people who have the condition at a given time. The prevalence of herpes zoster is typically considered relatively low compared to other infectious diseases. The prevalence is highest in older adults.

Morbidity measures how much the condition affects a person’s quality of life. The morbidity associated with herpes zoster can be significant, as the disease can cause severe pain and disability. In some cases, herpes zoster can also lead to serious complications, such as pneumonia and encephalitis. Although the mortality rate of herpes zoster is low, the disease can be fatal in some cases. There is no cure for shingles, but it can be treated with anticonvulsants, antivirals, and steroids. In most cases, the rash clears up within two to four weeks. 

 

How is it Spread?

 

Shingles can be spread to people who have never had chickenpox or been vaccinated against it. People with weakened immune systems are also at risk of developing shingles. However, the risk of spreading shingles is low if the rash is covered. 

Shingles is spread through direct contact with the rash or through contact with respiratory secretions from someone who has the virus. Anyone who has not had chickenpox or been vaccinated against it is at risk of developing shingles if they come into contact with someone who has it. It can also be spread indirectly through contact with objects contaminated with the virus (such as towels or clothing). However, once the rash has developed crusts, it is no longer contagious. 

 

Diagnosis

 

A healthcare provider can usually make the diagnosis based on the clinical presentation. It usually starts with a feeling of pain, itchiness, or tingling in one particular area of the body. This is followed by a painful rash that usually lasts two to four weeks. Shingles can be diagnosed based on these symptoms and by physical examination. The rash is typically distinctive.

Sometimes, polymerase chain reaction (PCR) testing or viral culture may be used to confirm the diagnosis. If there is uncertainty about the diagnosis, a skin biopsy may be performed. A biopsy involves taking a small tissue sample for examination under a microscope. This can help to rule out other conditions that may cause similar symptoms.

In some cases, a fluid sample from the rash may be collected and analyzed to confirm the diagnosis. Although shingles can be very painful, they are generally not considered serious. Most people recover from shingles within a few weeks with no lasting effects. However, some people may experience long-term pain (known as postherpetic neuralgia) after the rash has resolved. 

 

Symptoms

 

One of the most distinctive features of herpes zoster is the sudden onset of a rash that is often painful. The rash consists of small, fluid-filled blisters that tend to cluster together. It usually appears on one side of the body, most commonly in a band-like pattern along the torso or back. Other symptoms of herpes zoster can include:

  • Pain
  • Itchiness
  • Rash
  • Fever 
  • Headaches
  • Fatigue

 

Rarely, brain or spinal cord inflammation is possible and can lead to severe complications such as paralysis or blindness. Fortunately, herpes zoster is usually not life-threatening, and most people recover completely within a few weeks. However, some people may experience lingering pain for months or even years after the initial infection. The condition can be extremely painful and uncomfortable, so it is vital to seek medical treatment if you suspect you have it. Treatment focuses on relieving symptoms and preventing complications.

 

Treatment

 

There is no cure for shingles, but there are treatments that can help ease the pain and shorten the duration of the illness. Treatment typically consists of antiviral medication and pain relief. Anyone who has had chickenpox is at risk of developing shingles. Early diagnosis and treatment can help to prevent serious complications from developing.

Potential complications of shingles include pneumonia, hearing loss, and vision problems. Some people may experience postherpetic neuralgia, which is a condition that causes pain to linger even after the rash has gone away. Treatment for postherpetic neuralgia may include antidepressant medications and nerve blocks. With treatment, most people with herpes zoster will recover completely.

 

Prevention

 

Shingles is a virus that can be spread through direct contact with the rash or through contact with infected materials, such as clothes or towels. The best way to prevent the spread of shingles is to get vaccinated. The shingles vaccine is available for adults over 50 and can help reduce the risk of developing the condition. 

Another way to prevent the spread of shingles is to avoid exposure to the virus. If you are around someone with shingles, it is also important to avoid direct contact with their rash and to wash your hands afterward. If you have shingles, keeping the rash covered and washing your hands often is essential. You should also avoid touching or scratching the rash, as this can spread the virus to other parts of your body or other people.

References
Author
Kimberly Hazel

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