Shingles is the common name for herpes zoster, the disease that results from reactivation of the virus that causes chickenpox. According to the Centers for Disease Control and Prevention, one million people in the United States develop shingles each year. However, almost all of them are over 40. Causes of shingles in young children include exposure to chickenpox in utero or during infancy, diseases that affect the immune system and immune-suppressing drugs. According to a 2010 article in the "Pediatric Infectious Disease Journal," prognosis depends on the cause. Children exposed in utero or during infancy usually experience a single, self-limited episode of shingles during childhood. Children with immune system diseases and those who require immune-suppressing drugs often face recurrent episodes of shingles accompanied by severe symptoms and complications.
Neonatal Chickenpox
In a 2009 article published in "Seminars in Fetal and Neonatal Medicine," Stanford obstetricians Candace K. Smith and Ann M. Arvin explain that infants born to mothers who develop chickenpox up to 21 days before or five days after delivery frequently acquire the infection from their mothers. These newborns often develop life-threatening disease because the neonatal immune system is ill prepared to deal with chickenpox. Almost all require aggressive treatment with intravenous antiviral drugs and pre-made antibodies supplied in a purified blood product called intravenous immunoglobulin IgG, or I.V.I.G. Since the addition of I.V.I.G. to routine care, most infants survive; however, many develop shingles during early childhood or even later in infancy.
Immune System Disease
According to the National Institute of Neurological Disorders and Stroke, shingles is thought to result from deficits in a specific type of immunity known as cell mediated immunity that occurs with aging or other health problems. Some acquired diseases, such as AIDS, and some genetic diseases, such adenosine deaminase deficiency, create severe deficits in cell-mediated immunity, according to the 2010 edition of "Current Diagnosis and Treatment: Pediatrics." Children with these kinds of problems usually survive chickenpox, only to suffer severe, recurrent episodes of shingles. The prognosis is particularly bleak for children with lymphoma, explains University of Alabama Medical School professor of pediatrics, Richard J. Whitely, M.D. in the 2008 edition of "Harrison's Principles of Internal Medicine," because almost half develop disease that affects the entire body.
Immune-Suppressing Drugs
Doctors use immune suppressing drugs, such as prednisone and cyclosporine, to treat autoimmune diseases and prevent rejection in children who have undergone organ or bone marrow transplantation. Unfortunately, suppressing the immune system increases the risk of shingles in children who have already been exposed to chickenpox, just as it does for adults who take immune suppressing drugs, according to NINDS. Young children who take immune-suppressing drugs after a bone marrow transplant are particularly susceptible to shingles. According to Whitely, 30 percent develop shingles within one year after the procedure. Of these, up to 10 percent die, mainly from shingles-related complications.
References
- "Harrison's Principles of Internal Medicine, 23rd Edition"; A.S. Fauci et al.; 2008
- "Seminars in Fetal and Neonatal Medicine"; Varicella in the Fetus and Newborn; C.K. Smith and A.M. Arvin; 2009
- Centers for Disease Control and Prevention: Herpes Zoster Disease: Q & As for Providers
- National Institute of Neurological Disorders and Stroke: Shingles
- "Current Diagnosis and Treatment: Pediatics, 19th Edition"; W.W. Hay et al.; 2010
