Shingles is a very painful condition that mostly affects adults. It is more common as people age, especially those over 50.
According to the US Centre for Disease Control and Prevention, the risk of developing shingles increases with age and is also higher in individuals with weakened immune systems.
Herpes zoster, commonly known as shingles, occurs when a virus in a nerve cell becomes active again.
It’s not just a painful rash; it’s a nerve-based reactivation of the chickenpox virus. So, where and how does the virus first enter your body?
Let’s unpack all about this virus, its connection with chickenpox and more.
THE VIRUS HIDES INSIDE THE BODY?
Shingles is caused by the varicella-zoster virus – the same virus that causes chickenpox. If you have had chickenpox in your lifetime, the virus stays in the body in an inactive state.
It is not a new infection. It’s a reactivation of a virus that was already living inside your body.
Even long after you recover from chickenpox, the virus does not leave your body. It retreats to the nerve tissues near your brain and spinal cord, and it stays there for decades in an inactive mode [called the dormant phase].
But it can reactivate, often in older age, to cause shingles. The reason it returns in old age is a weakening immune system, which may be due to underlying conditions or a general weak immunity against viruses.
Age and chronic diseases put people at an elevated risk of developing shingles.
So is it contagious? “Shingles can spread from skin-to-skin contact with fluid from blisters to someone who has never had chickenpox or the chickenpox vaccine, but transmission occurs via direct contact and not from coughing or sneezing,” explained Dr Jatin Ahuja, Senior Consultant Infectious Diseases at Apollo Hospitals.
“These antivirals reduce viral replication and also shorten the disease duration,” he said.
While there is no absolute cure, antivirals speed up the healing process and reduce the risk of complications. “It is advisable to start antivirals within 72 hours of the rash appearing or developing pain.
Early treatment reduces the severity of the virus and the risk of long-term complications,” said Dr Arora.
When asked about the precautions, he suggested, “Maintaining good hand hygiene, keeping the rash covered, and avoiding contact with newborns, pregnant women, and anyone who is immunocompromised.”
Shingles usually take 7–10 days to heal. The rash develops into blisters after the first three to four days. The blisters dry out and turn into scabs in ten days or so and sometimes may take several weeks for the scabs to fully disappear.
Once the blisters have crusted, they are no longer contagious.
HOW EFFECTIVE ARE VACCINES?
Getting the recombinant zoster vaccine called Shingrix can greatly reduce the risk of shingles. In India, Shingrix manufactured by GlaxoSmithKline (GSK) Pharmaceuticals Ltd at a cost of around Rs 10,999 per dose.
According to the CDC, “Shingles vaccination is the only way to protect yourself against this painful disease.”
Dr Arora explained that the shingles vaccine is safe and highly effective and is the best way to prevent shingles and its complications.
“All those who are at risk of getting shingles, like adults above 50 years of age, chronic kidney disease patients, diabetic patients and immunocompromised individuals, should get vaccinated,” he added.
Shingrix is considered up to 90% effective in preventing shingles. It’s a two-dose series, usually taken 2 to 6 months apart, and is recommended for adults ages 50 and over and anyone above 18 who has a weakened immune system.
The vaccine provides at least 10 years of protection against shingles.
Another vaccine, Zostavax, is also available in India, but its effectiveness decreases significantly over time, and unlike Shingrix, it is not recommended for individuals with immunosuppression or immune system diseases.
– Nabeela Khan
