SHINGLES

The information on shingles on this website is not designed to provide medical or professional advice. It is designed to provide information only and if you have any health questions or problems please consult a medical doctor.

What is shingles?

Shingles is an infection of the nerve cells caused by a virus called varicella zoster. This virus is the same virus that causes chickenpox. The first time the virus infects you, it causes you to develop chickenpox. After you recover from the chickenpox infection, the virus does not leave your body rather it remains in your body and "goes to sleep" or lies dormant in one of your nerves.  Later on in life, in some people (in about 10 to 20 per cent of people who have had chickenpox) the virus can "wake up" or get reactivated and travels to the nerve endings in the skin causing an infection called shingles. Therefore if you have had chickenpox in the past, you can develop shingles. If you do develop shingles it is very rare to get it more than once in your life time. If you never had chickenpox in your life you can catch it from someone with a chickenpox infection or a shingles infection. You always develop chickenpox first before you can develop shingles.

Symptoms of shingles

• Generally, the first indication that you have shingles is often a very painful area of the skin which may be described as burning, tingling or itchy. You may also have a feeling of being unwell, feeling tired, develop a headache, eyes may becoming sensitive to light and sometimes you can develop a fever.
• Shortly after, usually a few days later, this painful area of the skin develops a red rash which normally spreads like a band or stripe across one side of the body or face. It always occurs on one half side of the body and it takes the form of a band or shape of a belt because the virus infects and follows one of the nerves that branch out from the spinal cord.
• This shingle rash consists initially of small red bumps or pimples which then gets filled with fluid to form fluid-filled blisters. The fluid in these blisters becomes murky and the blisters ruptures and they become crusty and dry and start to excoriate. After about five days no further blisters develop and all blisters that would have developed burst and dry out.
• The rash normally lasts about 10 to 15 days but it may take up to 5 weeks for the skin to completely heal and return to normal but sometimes the skin remains scarred or develop a bacterial infection.
• The rash can be very painful and very sensitive such that even a gentle breeze or a light touch can cause strong pain.

How do you get shingles?

Shingles are not contagious meaning that you do not get shingles from someone else who has shingles. You get shingles only if you have had chickenpox infection in the past. After you develop chickenpox, it is very rare for you to get chickenpox again but is possible for you to develop shingles at some time in the future. If someone has not had chickenpox in the past or vaccinated against it, they can get it from someone with shingles or chickenpox through direct contact with the skin lesions or by touching anything such as dressings contaminated with the discharge from shingles or chickenpox lesions.

At present we do not know what causes the chickenpox virus to "wake up" or become active again to cause shingles. The current theory is that the chickenpox virus "wakes up" or gets activated if your immune system becomes weaker for whatever reason, for example, during a cold, stress or other medical conditions that lower the immune system.

Risk factors

The risk of getting shingles increases with;

• Age - in particular the age of over 50years old. This is due to the natural decline in your immunity as you get older.
• Illnesses - some illnesses, in particular, when they are severe such as cancer, AIDS can weaken your immune system making you more likely to have shingles infection.
• Medications - some medications such as chemotherapy can suppress your immune system and make it easier for you to develop shingles.

Shingles, chickenpox and pregnancy

If you are pregnant and you develop shingles there won't be any harm to you unborn baby as you already have the virus that causes shingles in your system. This is so because you would have had chickenpox in the past. There is no increased risk of passing it on to the unborn child. However if you develop chickenpox whilst you are pregnant, this can be very serious and you need to get urgent medical care.

Complications of shingles

There are several complications that can occur if you have shingles. Generally younger people do not develop complications with shingles infection as they are generally health and have a strong immune system. After the age of 50years, complications can occur and may include any of the following or in combination:

• Post-herpetic neuralgia (PHN): This occurs in about 50% of those over 50 years and PHN is characterized by ongoing severe pain after the shingles rash has cleared. The pain can be debilitating making it very difficult to function in life and can cause you to become depressed. This condition can last from a couple weeks to years. The pain is very difficult to manage and control as it may not respond to normal pain medications and generally alternative pain medications are used.
• Eyesight: If you develop shingles that affect your eye you will need to see an eye specialist immediately as the shingles can cause temporary or permanent loss of sight in that eye.
• Hearing: If you develop shingles that affect your ear, you can lose your hearing completely or partially.
• Death: In rare cases shingles can spread to some of your organs resulting in complications that are so severe and life-threatening.

Treatment for shingles

There is no medication to cure shingles but fortunately it is a self-limiting condition. Anti-viral medications are used to help reduce the pain as well as shorten the duration of the shingles flare up and minimize complications. Anti-viral medications really work well if they are given sooner rather than latter, in particular, if they are given within 72hours though ideally within 24hours of the onset of the rash. In addition, pain-killers can be used to help with the pain. Antibiotics can be included as well if there is bacterial infection on the skin. Other medications can also be used if there are complications such as prolonged pain.

Shingles and vaccination

The shingles vaccine is available for those aged 50 years and over. The National Immunization Program (NIP)  provides a free shingles vaccine for anyone  turning the age of 70 years old and a free catch-up shingles vaccine for those aged between 71 to 79 year old until the end of 2021 (that is the catch up program will be completed by 2021).  Those between the ages from 50 to 69 years and from 80 years and beyond can have the shingles vaccine on a private prescription. If you already had the shingles infection in the past and you are over 50 years old, it is still recommended that you have the shingles vaccination at least a year after recovery. Vaccination certainly does not guarantee that you won't get shingles rather it reduces the chances of you developing shingles and if you do develop shingles it may not be as severe. The vaccine can reduce your chances of getting shingles by 50% for those between the ages of 50 to 80 years old. At present the vaccination gives you protection for about 10 years.

Help

You are able to get help if you have shingles from various professionals and organizations such as:

1. Doctor
2. Immunization center e.g. your local council
3. National Immunization Infoline Tel. 1800 671 811
4. Report unexpected or significant adverse events after vaccination to SAEFVIC on 1300 882 924

Summary

• Shingles is a painful skin rash with blisters that occurs on one side of the body in a band-like pattern.
• Shingles is caused by a virus called varicella zoster. It is the same virus that causes chickenpox.
• Shingles virus can be  spread to a person who has not had chickenpox or vaccinations and that person will develop chickenpox.
• You cannot get shingles from someone with shingles.
• Shingles treatment is most helpful if it is started within 72hours of the rash happening.
• A shingles vaccine is available for people aged 50 years and over.
• The National Immunization Program provides a free shingles vaccine for people aged 70 to 79 years.