What is Shingles? What are symtpoms of Shingles? Is Shingles contagious? How does Shingles spread?
Shingles or Herpes Zoster is a painful condition with rash in a limited area of the body, caused by a virus known as Varicella-Zoster virus. It usually happens in late adulthood or old age, and is often associated with periods of stress, or falling immunity of the body.
Symptoms of Shingles
- Shingles begins with general symptoms that are somewhat similar to flu, like fever, headache, fatigue and problems with digestive system and stomach, in varying combinations. There can be sudden chills too.
- About 2-5 days after the generalized flu like symptoms appear, irritation, itching, unpleasant sensations and pain begin to appear in an area typically supplied by a particular nerve, or a few adjoining nerves.
- Small painful rash or blisters begin to appear in the affected area. These are the characteristic feature of Shingles. Most common sites affected in Shingles are one side of abdomen or back in the form of a horizontal ‘band’ like distribution that spreads across from the center to the flanks. Other common sites of Shingles include one side of upper face that may also include an eye. Pain is also present in that same affected area and may vary from dull, gnawing ache to episodes of sharp, stabbing pain.
- Blisters gradually become soft, as the skin around them becomes reddish and inflamed. In Shingles, new blisters may keep on appearing for up to a week.
- The blisters either open up, or begin to dry. Either way they are converted to dry crusts or scabs which gradually disappear after some time. In some cases, there may be slight scarring left at the affected sites.
- Pain of Shingles usually subsides completely. In some cases, pain may continue even after the rash and blisters have disappeared, a condition known as “Post Herpetic Neuralgia”.
Shingles, Varicella Zoster Virus and Chicken Pox : One Virus, two diseases
Shingles is not the only disease caused by the Varicella Zoster virus. In fact, the first and foremost condition that results from Varicella Zoster virus infection, is not Shingles, but Chicken Pox.
Chicken Pox is a very common viral rash that affects most of the people, usually in childhood. It is caused by Varicella Zoster virus, the same virus that also causes Shingles in later life. Chicken Pox is characterized by fever, itching and skin rash or fluid filled blisters that subside in a week or two. The Varicella Zoster virus spreads from one patient of Chicken Pox to another through air – by sneezing and coughing as well as from direct physical contact involving blister fluids or drying crusts. Chicken Pox is highly contagious and the virus begins to spread from an infected even before the symptoms appear.
The symptoms of Chicken Pox usually appear in an infected person around three weeks after the infection with Varicella Zoster virus. The symptoms subside in a week or two and thereafter the infected person becomes absolutely normal. This happens as the body develops a life life-long immunity against the Varicella Zoster virus. While the immunity is able to keep the virus at bay, the virus is not totally eliminated from the body. It survives in the neural cells of the spine, where it continues in a dormant form for the rest for one’s life.
In most people with Chicken Pox, the Varicella Zoster virus remains fully inactive till the end, but in some, it does get reactivated, leading to ‘Shingles’. Thus, Shingles always affects persons who have had Chicken Pox earlier in their life. In some cases, especially those who have received the Varicella Vaccine, it might have happened in a very mild form, yet, they are still prone to have Shingles later in life. As one would expect, this reactivation of dormant Varicella Zoster virus within the body is often associated with a fall in body immunity, as in cases of physical or emotional stress, other illnesses, AIDS, cancers or treatment with immune-suppressive medication.
Is Shingles contagious ?
To answer this question, one needs to appreciate the fact that it is the Varicella Zoster virus that spreads from one person to another and that the diseases, both Shingles and Chicken Pox are only the clinical manifestations of that infection.
The Varicella Zoster virus causes both Chicken Pox and Shingles, and can spread from a patient of either of these conditions to another. In Chicken Pox, it spreads through both the physical contact with blisters as well as through air (as it is present in respiratory tract of Chicken Pox patients and spreads through their sneezing, coughing etc). In a case of Shingles, however, it can spread only through direct contact with blisters fluid and crusts, and generally not through air. There is some evidence that Varicella Zoster is present in the saliva of the infected person, but not much is known whether it can spread through kissing.
So Shingles can be contagious in the sense that the Varicella Zoster virus can spread from a patient of Shingles to an uninfected person who comes in contact with blisters. The contagious period coincides with the onset of blisters and continues till the Shingles blisters completely scab and disappear.
It is important to remember that contact with a person with Shingles will NOT affect those who have already been affected with Chicken Pox as they are immune to Varicella Zoster virus and are actually harboring the same virus inside themselves. However, physical contact, directly or through towels, linen etc. with a person suffering from Shingles and having blisters can spread the Varicella Zoster virus to those who have never been infected – especially prone are children – and may lead to Chicken Pox in them, around three weeks after the infection. In same persons, Shingles may also happen, though not necessarily, after a gap of several decades.
Thus, Shingles does not spread from one person to another like other contagious diseases, even though the Varicella Zoster virus can spread from a person suffering from Shingles to an uninfected person, leading to Chicken Pox a few weeks after infection, and possibly Shingles too, after a gap of several decades. Since most of the people are already infected with the virus (and already had Chicken Pox), Shingles is not contagious for them.
Precautions to avoid spread of virus infection
Shingles patient are a far less important source of spread of Varicella Zoster virus, simply because patients of Chicken Pox, which are also far more common, spread it far more aggressively, even before they begin to exhibit any symptoms or the disease is identified in them – a reason why it is very difficult to control the spread of Chicken Pox in society.
However, a person having Shingles should still take necessary precautions to ensure that he does not spread the virus to others who are not infected. It is preferable to be resting indoors than enter into social activities that may create opportunities for spread of virus. Simply covering the blisters with non-adhesive dressing is usually enough to prevent contagious spread, if a person with blisters wishes to work or enjoy social activities. Till blisters disappear, one should stay away from community swimming pools, contact sports like Rugby and avoid sharing towels, linen, bedding etc. with those who might be uninfected, especially children or young adults.