SHINGLES NOT CONTAGIOUS FOR MOST

Question: Recently my 15-year-old daughter got shingles while we were on vacation visiting relatives. Everyone was worried about catching it; they thought every bug bite was the beginning of shingles. We were forced to return home early, because no one wanted to be around us. No one else got shingles, and my child is fine now. Did we do the right thing by leaving early to keep the grandparents and others from getting shingles?

Answer: Although your family’s concern was doubtlessly well-intended, the only people potentially at risk at your family gathering would have been any children who have never had chickenpox and never been vaccinated against chickenpox -- not the grandparents.

The herpes zoster virus that causes shingles is related to chickenpox, or the varicella zoster virus (VZV). Though shingles is not contagious to people who have had chickenpox before, it does originate in people –- usually adults -- who have had chickenpox. That is because the VZV permanently stays in your system after you recover from the chickenpox, typically in a dormant stage that does not make you sick. When the VZV reactivates, it causes shingles. It is not known what stimulates the virus to reactivate, but it is most likely to occur in people over the age of 50, and in people whose immune system is weakened by either chronic disease or chemotherapy. There is also a remote possibility that the tendency to develop shingles runs in families.

Shingles is not, itself, contagious. However, someone who has never had chickenpox and never received the chickenpox vaccine may catch chickenpox from a person with active shingles. The virus can spread through airborne droplets either from the rash itself or from sneezing or coughing, much like any viral illness.
Shingles does not usually start as a rash, but it is when the rash appears that most people go to the doctor. Like many viral illnesses, the person becomes ill and can spread the virus before they notice any specific symptoms. Shingles usually starts out with mild flu-like symptoms: headache, fatigue and sometimes a mild fever. Pain or abnormal sensations usually precede the appearance of the rash by a day or so. The rash is most common on the trunk and is limited to one side of the body, however, the rash can appear anywhere on the body.

If begun early enough, antiviral medication can help the rash heal more quickly than it would without any treatment. However, medication is not very helpful when started more than 72 hours after the appearance of symptoms.

There is a vaccine on the market to help prevent shingles, and it is recommended for people over the age of 60. Once someone gets shingles, they should avoid unvaccinated children who have never had chickenpox. If children are around, keep the rash covered and follow the rules regarding the spread of any virus: cover your mouth when you sneeze, and frequently wash your hands to help prevent the virus from spreading to a chickenpox-susceptible person.