Shingles is a very common condition worldwide. It is an alarming condition in many ways. Therefore, people often ask, “is the disease shingles contagious”?
People need to know if shingles is contagious, because many have seen an affected person. Or they may have had the condition, and be worried about the possibility of passing it to their loved ones.
Shingles is at the very least uncomfortable. It is frequently painful; sometimes VERY painful. This is one of the reasons for so many people to seek shingles info.
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WHAT IS SHINGLES?
Shingles is an infectious disease caused by a virus. The virus is one of a group of six viruses, called the Herpes viruses.
The Scientific name of shingles is HERPES ZOSTER.
The starting point of shingles though, is a common viral infection called Varicella Zoster (VSV) or Chicken pox. Chicken pox affects the majority of its victims in childhood, usually resulting in a mild disease. It is common for many people not to know that they have had chicken pox.
When chicken pox abates or settles down, like the other five Herpes viruses, it stays in the body of the affected individual FOR LIFE. It “hides” in the nervous system, in nerves called dorsal roots. And it confers LIFELONG immunity to chicken pox.
For the majority of people, the Varicella Zoster Virus will cause no further problems. Antibodies in the blood may be the only sign of a previous infection with VSV. Some people could have had scarring though.
In a minority of people, after many years, the VSV hiding in the nervous system, reactivates. It does not return as chicken pox again, but as SHINGLES / HERPES ZOSTER. This typically presents as a collection or band of blisters of sudden onset (usually overnight).
The reactivation of the VSV is thought to be caused by a weakening of the body’s defences or immune system. That is why for centuries, shingles has been known to affect mostly people over the age of 65. This is when their bodies will have weakened due to the normal ageing process.
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The reactivation of the VSV in the nervous system, happens in one nerve root, or maybe two, or maybe three adjacent nerve roots. This causes the characteristic distribution of the skin lesions on the skin supplied by the nerve root(s).
Apart from older persons above the age of 65, shingles has been known to affect people with other causes of immunosuppression. These include people with
. cancer (especially cancer with immunosuppressive treatment),
. Human Immunodeficiency Virus (HIV).* * In recent decades, there was a global surge of shingles cases due to HIV. This has lessened with antiretroviral treatment that boosts white blood cells.
To summarise, shingles symptoms are the following:
– general feeling of malaise and being unwell
– there may be fever
– discomfort or mild pain may be felt at the site of the impending eruption
– sudden eruption of a cluster of blisters or what may look like a rash. This is usually surrounded by redness
– pain, worsening, at the site of the eruption of blisters
IS SHINGLES CONTAGIOUS?
This is one question that should probably not be answered with “Yes” or “No”. Such an answer can only cause confusion. Dear Reader please remember the natural history just laid out above.
And, let us break it down for you, to enhance understanding and memorisation:
* Can you get Shingles from Chicken pox?
. Yes, if you have had chicken pox in the past i.e. from your own chicken pox infection. But this takes many years.
. No, in the case of the chicken pox being in another person. You cannot “contract” shingles, as outlined above
* Can you get Shingles from Shingles?
* Can you get Chicken pox from Shingles?
. Yes, coming into contact with the fluid from the shingles blisters of another person, can cause you to develop chicken pox. This will happen if you have never had chicken pox in the past, or prior vaccination. You are however much less likely to get chicken pox from shingles, than from a case of chicken pox itself.
. You cannot develop chicken pox from your own shingles, because you would have had chicken pox before.
HOW LONG IS SHINGLES CONTAGIOUS?
As long as there are wet, weepy or raw skin lesions, shingles remains contagious. The lesions form scabs at different rates and depending on the supportive treatment a patient gets.
When the last shingles forms a complete scab, shingles ceases to be infectious. This usually happens in days, not in hours and rarely in weeks.
Covering shingles lesions is a very important Public Health measure. It prevents transmission of the virus.
When assisting patients with shingles, who are frequently our elderly or weak patients, it is vital to WEAR GLOVES.
Early, aggressive treatment of shingles, as advocated in this article, is also a good Public Health practice. It cuts down on the eruption of new lesions, and aids the healing of established ones.
Other supportive treatments that accelerate the healing of shingles lesions include:
. Vitamin C
. Good protein intake
. Collagen (expensive though!)
. Cloxacillin antibiotic (prevents superimposed bacterial infection). (Other antibiotics like Erythromycin can be used in the case of Penicillin allergy.)
WHAT TO DO FOR SHINGLES
The most important message, as already mentioned above, is to take PROMPT ACTION.
Antivirals by mouth, include Acyclovir and Valaciclovir. These should be commenced as soon as possible, ideally within 24 hours of the first skin lesions. They are of no use after 72 hours (3 days and 3 nights).
Please note that topical applications (applied to the skin) DO NOT WORK FOR SHINGLES.
Pain management is crucial. As the virus has reactivated right inside nerve root(s), this causes severe, burning pain. It is one of the worst pains on Earth.
Painkillers that can help include Nonsteroidal Anti-inflammatory Drugs (NSAIDs), alone or in combination with Paracetamol. Opioid painkillers may be needed as the treatment goes up the WHO Analgesic Ladder. But opioids should not be used for a long time because of the risk of dependence and abuse.
Explanation, reassurance and Supper are important, because the pain of shingles can continue even after the skin lesions have healed. This is called “post-herpetic neuralgia.” Post-herpetic neuralgia is a nightmare. It lasts:
. days if you are lucky
. usually weeks
. rarely, it can take months
Medications that act on the nervous system may sometimes need to be deployed. These are frequently much more effective than painkillers. Such medications include
. the antidepressants AMITRIPTYLINE (or Imipramine)
. the anti-epileptic agent, Carbamazepine
Other medications are given in the above section. Vitamin C, protein ± collagen, help prevent chicken pox scarring, which can be unsightly just like that of (the now globally eradicated) smallpox.
Esteemed Reader we have tackled the important and often pressing question, “is the disease shingles contagious?”
We have said, it is important to protect ourselves from cases of shingles. This is especially important when there are wet or weeping lesions. We must protect our loved ones when we have shingles.
People who have never had chicken pox or the vaccine thereof, can get chicken pox from a person with shingles. But shingles cannot be contracted from shingles.
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