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Because our goal is to minimize your policy risk, we think it’s important to provide as much information as possible about different conditions our employer groups encounter.
Feel free to share this page with your clients, or use it as a helpful resource for any condition you’re looking into.
What you should know about: Shingles
By Sara Winand, RN | Director of Medical Management
Shingles is a reactivation of the varicella-zoster virus, a type of herpes that causes chickenpox. After you have had chickenpox, the virus lies dormant
in your nerve roots and remains inactive until it flares up. If the virus becomes active again, you may develop a rash that occurs only in the area
of the affected nerve. This rash is called shingles.
Who is at risk for getting shingles?
– Anyone who has had chickenpox
- – Those who have a weakened immune system, such as people with cancer or HIV
– People over 50 years old
– People who have been ill, suffered physical trauma or are under significant stress
– Those taking medication that affects the immune system, such as steroids
– Pregnant women who get chickenpox (A baby will have a high risk for shingles during the first two years of life.)
– Babies who get chickenpox in the first year of life
It is not clear why the virus reactivates in about 20% of those who have had chickenpox, but there is evidence to suggest a weakened immune system may
cause the virus to reactivate, multiply and move along nerve fibers to the skin.
What are the symptoms?
– Itching, stabbing or shooting pain with tingling under the skin
– Flu-like symptom such as fever, chills, headache or upset stomach
– Helplessness and depression
– Rash that develops into blisters on one side of the body, often around the waistline or face. (These fluid-filled blisters usually dry and crust within
seven to 10 days.)
How is it diagnosed?
– By associated symptoms such as presence of rash, blisters on one side of the body, pain, itching, or fever
– Lab analysis from scraping or swabbing of the fluid-filled blisters
Is there a treatment?
There is no cure for shingles, although it is important to seek medical evaluation early as treatments can help with associated pain and discomfort.
- Antiviral medications such as Zovirax, Valtrex & Famvir may shorten the duration of the symptoms.
- Pain medications, antidepressants and topical creams are also options to ask about.
Is it contagious?
– People who have never had chickenpox and have not been vaccinated against the disease can develop chickenpox if exposed to shingles.
– Someone who has shingles can expose you to the virus if you have come into contact with the fluid in the shingles blisters.
- – If you are have an outbreak of shingles, you can prevent the spread of the virus to others by covering any fluid-filled blisters that are not covered
by clothes with a dressing that absorbs fluid and protects the sores.
– Delaying or not getting medical treatment may increase your risk for complications.
– Postherpetic neuralgia, or a pain that does not go away within 30 days after the shingles rash heals
– Disseminated zoster, where the blistery rash spreads over a large area of the body and can affect heart, lungs, liver, pancreas, joints and GI tract
– Scarring and/or skin discoloration
– Bacterial infection of the blisters
– Cranial nerve complications (if shingles affects these nerves), which cause impaired vision, intense ear pain, loss of movement of facial nerves and
inflammation of blood vessels that may lead to stroke
– Muscle weakness in the area of the infected skin before, during or after the episode of shingles
Who should take the shingles vaccine?
The vaccine, Zostavax, decreases your chances of getting shingles by 51% and lasts about five years.
– People age 60 and older (The vaccine is FDA-approved for those age 50 and over.)
– If you already have had shingles (The vaccine may lower your risk of getting it again.)
– If you have never had chickenpox (You should talk to your doctor as there is a good chance that you don’t remember having chickenpox. Studies show that
99% of Americans over 40 had chickenpox at some point.)
You should not take the vaccine if you are allergic to gelatin or neomycin (an antibiotic) or have a weakened immune system.
Women who are or might be pregnant should not take the vaccine.
Got a topic you’d like more info on? Let Sara Winand, our Director of Medical Management (and registered nurse!) know what hot topics people are talking about. E-mail Sara directly at email@example.com.
Medscape News & Perspective
Centers for Disease Control and Prevention