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Have You Ever Had Chickenpox?

June 19, 2012

You Could be at Risk for Shingles

If you suffered through the itchy blisters associated with chickenpox as a child, you are at risk of developing a painful rash called shingles. You can get shingles at any age, but it's more common in people over age 50, according to Dr. Dianne Martin, a local internist and member of the Washington Hospital medical staff.

"We could end up seeing more cases as the population ages," she said. "It tends to be the 50 and over crowd, and that demographic is growing."

About one in three people will develop shingles, also known as herpes zoster, according to the Centers for Disease Control and Prevention (CDC). Shingles is caused by the varicella zoster virus, the same virus that causes chickenpox. After you recover from chickenpox, the virus stays in your body. Years later it can be reactivated, causing shingles.

Older adults, those with cancer, HIV, or organ transplant, or people who have a decreased ability to fight off infection due to stress or immune deficiency have a greater chance of getting shingles, according to the CDC.

"The immune system keeps the virus under control," Martin explained. "When your immune system is weakened by stress or a medical condition, it makes you more susceptible to getting shingles. The virus stays dormant in the spinal cord and when something activates it, the virus travels along a sensory nerve to the skin where it causes shingles."

Rash Forms Blisters

Shingles generally starts as a painful rash on one side of the face or body. The sensation can be itching, tingling, burning, constant aching, or a deep pain. The rash forms blisters that usually scab over in seven to 10 days.

The word "zoster" is derived from the Greek word for "belt" or "circling," which describes how the rash develops, Martin said. It often shows up as a single band that looks like a belt line. The rash generally occurs in an area that a single sensory nerve supplies in the skin, she explained.

"Often the pain starts several days before the rash breaks out, which can lead to a misdiagnosis," Martin added. "We've had people come in with chest pain or abdominal pain who actually had shingles."

The rash lasts from two to four weeks in most cases. The main symptom is pain, but other possible symptoms include fever, headache, chills, and upset stomach.

While the shingles rash can't be passed from person to person, the virus can spread through airborne or direct contact with fluid from the blisters. A person with active shingles can pass the virus to a person who has never had chickenpox, which could cause the infected person to get chickenpox, but Martin said it's not common.

"People who get shingles usually only have it once," she added. "But it is possible to have recurrent episodes."

Get Vaccinated

The only way to reduce your risk for shingles is through a vaccination, according to Martin. She recommends that people age 50 and over who have had chickenpox get vaccinated. The vaccine reduces the risk for shingles by about 50 percent, according to the CDC.

"Nothing is 100 percent," she said. "The shingles vaccine boosts your immunity to the virus, reducing the chances it will reactivate. The vaccine can also reduce the risk for developing postherpetic neuralgia in those who do get shingles by about 60 percent."

Postherpetic neuralgia or PHN is the most common complication from shingles. People who develop PHN continue to experience severe pain in the areas where they had the shingles rash after the rash is gone.

"The shingles cause scarring on the nerves, which causes the pain," Martin explained. "It can be very debilitating."

She said anyone who thinks they may have shingles should consult their physician. Several antiviral medications are available that help to shorten the severity and length of the outbreak, but they are most effective when started early.

"I really urge people who have had chickenpox to get vaccinated," Martin said. "Shingles can be very painful and some people get devastating cases depending on the nerve involved. I've seen shingles develop in the eye, which can be very dangerous. You can lose your eyesight. If you are 50 or older and had chickenpox, talk to your doctor about getting vaccinated."

To learn more about shingles, visit www.cdc.gov/shingles. For information about wellness programs offered by Washington Hospital, visit www.whhs.com.