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The Informed Parent


by Shanna R. Cox, M.D., F.A.A.P.
Published on Dec. 10, 2012

There are many things that can be confusing about shingles, from its name to the way it evolves as an illness. However, with a few key facts it will be clear how to distinguish this condition.

Shingles, also called zoster, or herpes zoster, is a reactivation of the chickenpox virus within a nerve root. The key here is: first, a person must have had chickenpox to develop shingles; and second, that “having” chickenpox may have occurred by natural infection or previous immunization. Chickenpox immunization (medically referred to as varicella) is standard of care for children and recommended by both the American Academy of Pediatrics and Centers for Disease Control. It is believed that although it is possible for a person that has been vaccinated to develop chickenpox or shingles that these would be more limited illnesses in both severity and duration than in an individual with a natural or “wild” type infection. In fact, there is now an adult shingles vaccine (a weakened chickenpox/vermicelli strain) recommended for those over sixty years of age. This again speaks to the idea that the stronger the immunity against the virus, the less severe its effects should be. Those who are immune compromised from disease or medication, young or old age are especially at risk for shingles infection.

Shingles may start with cold type symptoms and a feeling under the skin of itching, burning or pain that is on one side of the body. The red and blister type lesions usually start within a few days to two weeks, appearing in a band that follows a dermatome of the nerve root affected. The appearance of new lesions and the changing character of present lesions occur over the next several days to weeks. These are followed by crusting and scabbing with a resolution typically occurring in approximately three weeks. There are more severe complications ranging from secondary bacterial infections to ear or eye infections that can cause permanent damage. But these are rare occurrences. There are up to twenty percent of affected individuals that may develop a continuing or recurring nerve pain that is called post herpetic, or zoster related neuralgia. This phenomena tends to occur in those over age sixty.

A child affected by shingles cannot give another person the virus. However, it is possible for the child to pass along the chickenpox (varicella), the virus causing the shingles, to someone who has not been infected with the virus before, such as a newborn or a child who has not been vaccinated. The affected child is generally considered not to be contagious once all lesions are dry and scabbed.

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