Shingles and Chickenpox
Shingles is the common name for herpes zoster. Herpes zoster is not caused by the herpes simplex virus but by the varicella-zoster virus (VZV), which also causes chickenpox. Herpes simplex virus and VZV are closely related viruses.
VZV is an alphaherpesvirus and, like herpes simplex virus, causes an initial infection (primary varicella, also called chickenpox) usually in childhood, though it is now largely preventable by vaccination with the vaccine Varivax.
After the initial infection, VZV becomes latent and rests in the cranial nerve, dorsal root and nerves in the peripheral nervous system, producing very few proteins or other signs of its existence.
VZV Reactivation Causes Shingles
After a certain amount of time, from a few years to decades, VZV can reactivate and produce a localized infection with a pustular rash and pain called herpes zoster or shingles. The virus travels from the nerve where the latent virus was hiding for all those years to the skin.
There are many theories about how the virus is kept suppressed and why it reactivates. Most theories center on a lack of response to VZV from the immune system, usually due to a lack of exposures to the virus.
While the pustular rash is unattractive, the most common complication of herpes zoster is post-herpetic neuralgia--shingles pain. The pain can be debilitating and persist for years after the herpes zoster outbreak, especially if the patient did not seek medical treatment for shingles right away.
Can Shingles Be Transmitted?
Shingles itself cannot be transmitted, but a person with shingles can produce infectious varicella-zoster virus and transmit it to a non-immune person. That person would contract chickenpox.
A healthy person who has had chickenpox or been vaccinated against it is in no danger of contracting either chickenpox or shingles from a person with shingles. Indeed, being mildly exposed to the virus may even act as a sort of booster shot and stimulate the immune system, thus preventing or at least delaying shingles.
Shingles Prevention and Care
If you suspect you have shingles, immediately see your doctor. Patients treated with antiviral medications within the first 72 hours have much less shingles pain. It is imperative to be accurately diagnosed and treated if you think you have shingles.
A shingles vaccine is available that can prevent or delay infection. The vaccine, called Vostavax, is a larger dose of the well-studied Varivax chickenpox vaccine. It is recommended for people over 60. You should not be vaccinated if you are allergic to the vaccine components or are immunocompromised due to advanced HIV or immune system-suppressing drugs.
