Shingles

Overview of Shingles

Primary infection with the varicella zoster virus (VZV) causes chickenpox. Primary varicella zoster virus is human herpes virus 3. Some individuals who have had chickenpox will have a recurrence of the infection at some point later in life, which is then known as herpes zoster or shingles. This can happen because during primary infection with VZV, the virus spreads from sensory nerve endings to the dorsal root ganglion of the spinal cord, where the virus remains latent. What causes reactivation of the virus is not known. 

Signs & Symptoms

  • Pain, which can precede the development of a red, small blister-like rash
  • The rash presents along the distribution of a sensory nerve on one side of the body
  • The rash may be associated with fever and flu-like symptoms
  • The rash crusts/dries out in approximately 2 weeks; may become itchy at this time
  • Residual pain may remain for awhile after the resolution of the rash
  • A potential complication, more common in persons over 50 yrs. old, is persistent pain that may last months to years. This is called post-herpetic neuralgia. 

Prevention

The varicella virus vaccine can prevent chickenpox in most people. It has become a routine childhood immunization given between 12 & 18 months old. This same vaccine is recommended for older children and adults who have not had chickenpox.

For people who have already had chickenpox, a live attenuated varicella zoster vaccine is available for individuals over the age of 60 years old. This vaccine decreases by 67% the incidence of post-herpetic neuralgia, a chronic painful condition that can occur at the site of shingles. Post-herpetic neuralgia occurs in 15% of patients who develop shingles and when it occur it tends to occur in the elderly. The vaccine also prevents shingles by 50%.

Persons with shingles can cause chickenpox in anyone who has not had chickenpox previously. This infection can be dangerous especially in pregnant women (& their developing baby), newborns, and immune compromised persons. Therefore, until the shingles lesions crust over/dry out, avoid close physical contact with the aforementioned persons. 

Treatment

  • Prescription anti-viral drugs should be started within 72 hrs. of the rash presentation
  • Oral pain medication
  • Anti-itching drugs if necessary
  • Apply cool, wet compresses
  • Corticosteroids sometimes also used to reduce inflammation 

How We Can Help

  • If you would like to be seen by our medical staff, please contact our Appointment Desk to schedule an appointment.
  • Also, our Advice Nurse service is available at no charge for all UC Davis students to discuss health concerns and the need for medical care.

 

Resources