Shingles cases on the rise: Understanding this painful virus
THE WOODLANDS, TX -- It was a normal day, except I couldn’t stop itching my forehead. My right eye felt itchy, too, so I popped some Claritin and shrugged it all off as pesky autumn allergies.
That evening, numerous red bumps appeared on my forehead and the itch was now accompanied by electrocution-like bolts along the line where the bumps formed. My mother-in-law happened to be over, and she commented that it looked like shingles. I texted a picture to a friend in the medical field, and he told me to get to an emergency room right away. It appeared as if I had shingles. I was 31 years old.
“Shingles, also called Herpes Zoster or Varicella Zoster, is a viral infection”, Dr. Brent Allmon, M.D., F.A.A. F. P., of Woodlands Family and Community Medicine said. “This virus belongs to the Herpes family of viruses – these are all viruses that cause regional pain and blisters, and once infected, the virus never leaves your body. Instead, it goes into dormancy and often wakes up either at random or more commonly at a time of physical or emotional stress.”
In my isolation room at the ER, my case of shingles was confirmed. When I mentioned to the doctor my eye had also been itching, he ran some tests and confirmed I was one of the smaller number of shingles patients who had shingles along the line of nerves that ran right into the eye. Luckily, I had caught it early enough, and there was a chance I wouldn’t lose my vision.
After my diagnosis and a follow-up appointment with an eye doctor, I went to my children’s pediatrician. Was it possible for me to spread the indescribable pain on to my children, the smallest being a nine-month-old?
“Technically shingles is ‘round 2’ of chickenpox,” Dr. Allmon said. “In other words, you don't ‘catch shingles.’ You ‘catch’ chickenpox. Then, once the initial viral infection of chickenpox passes, the virus chooses a nerve root in your spine where it goes dormant, usually for decades. During a period of emotional or physical stress, or randomly, the virus reawakens.”
My three sons had been vaccinated against chickenpox, but since my daughter had not fully been vaccinated yet, she was at risk of getting the chickenpox virus from my shingles.
“How varicella zoster is transmitted and manifests are probably the most misunderstood aspects of the condition. The fluid from the blisters carries viral particles that are contagious. Again, however, people will not catch shingles from this fluid, but they could catch chickenpox from the fluid if they have no history of exposure/immunity. If somebody has had chickenpox in the past then they have immunity to the virus and would have no risk if exposed to somebody with active shingles (or chickenpox for that matter). For those over age 30, it is estimated that over 50 percent of adults in the U.S. have been exposed to chickenpox and are at risk for shingles. Most people under age 30 have had a vaccination against chickenpox (varicella vaccination) and are not at risk for catching chickenpox, and therefore, will not ever have shingles,” Dr. Allmon said.
So, shingles aren’t contagious?
“The only person that could get infected from someone with active shingles blisters would be the person who has never had the chickenpox illness and has never had the chickenpox vaccination (unexposed, non-immune). For example, if you have shingles right now, your husband who has a history of chickenpox will experience nothing, and your children who have had the varicella vaccination will experience nothing. But if your husband didn't have chickenpox or your kids weren't vaccinated, then they could catch chickenpox from your shingles.”
Vaccinations are a hot-button issue in the United States right now, with measles making a comeback after being declared eliminated here in 2000. Shingles cases are also on the rise. Dr. Allmon thinks it may be due to the aging population, but the exact reason is unknown. According to the Centers for Disease Control and Prevention, almost one in three people in the U.S. will get shingles in their lifetime.
Shingles is, in my opinion, one of the most painful things I have experienced. Dr. Allmon said for most who develop shingles it is a self-limited course of painful blisters that will last anywhere from one to two weeks.
“This is a condition where there is a persistent aggravation of nerve fibers affecting sensation of the skin that can cause a burning pain, sensitivity to light touch and/or itching/numbness that lasts long after the rash and blisters of shingles disappear. The area affected is usually limited to the area where the shingles was present. Factors that can affect the risk of developing postherpetic neuralgia include those who are ages 50 and older, severity of shingles, other chronic conditions or diseases, or delay in antiviral treatment for shingles after 72 hours from onset of rash. There are medications for postherpetic neuralgia, but it is a significant cause of disability for those who suffer from it,” Dr. Allmon said.
Early detection is one of the keys to managing shingles. Antiviral treatment, when given promptly, can speed up healing and prevent against postherpetic neuralgia.
There is a vaccination for those who have had chickenpox and are over age 50 called Shingrix.
It’s been two and a half years since my visit to the emergency room, and yet I’m reminded of my bout with shingles almost daily. When I brush my hair and the bristles glide across my scalp where shingles reared its ugly head, I’m reminded. I’m reminded when my children lightly pat my head. I’m reminded when the itch returns, and I rush to a mirror to see if the blisters are also returning. Shingles has left its mark on me, and it forced me to make lifestyle changes. I’ve had family members and friends debilitated by shingles as well. It’s a nasty virus, and one that shows no mercy. If you think you have shingles, it is best to seek treatment immediately.
A special thank you to Dr. Brent Allmon of Woodlands Family & Community Medicine for contributing to this article. Whether you have questions about shingles, chickenpox, vaccinations or anything else medical related, Dr. Allmon and his staff are happy to help. Woodlands Family and Community Medicine is located at 17521 St. Luke’s Way, Suite 190.