Shingles
Herpes zoster or shingles is a localised, painful rash caused by reactivation of the varicella zoster virus (VZV) which also causes chickenpox.
You can only develop shingles if you have already had chickenpox.
Shingles occurs in 10 to 20% of individuals, usually many years after the initial chickenpox illness and is more common in people who:
- are over 50 years of age
- have poor immune systems.
How it spreads
Shingles is not spread from person to person.
However, the blister fluid from the shingles rash is infectious and can cause chickenpox in a person who has not previously had chickenpox.
Shingles is less contagious than chickenpox and the risk of a person with shingles spreading the virus is low if the rash is covered.
Symptoms
Shingles usually presents as a blistering (vesicular) rash which is often painful and lasts for up to 2 weeks.
The rash:
- occurs in skin supplied by the affected nerve
- is usually on one side of the body
- is often on the trunk or neck and sometimes affects the eyes.
Often in the 48 to 72 hours before the rash appears, people complain of itching, tingling or severe pain in the area.
Headache, lethargy and photophobia (intolerance of light) may also occur.
Complications
The most common complication of shingles is chronic nerve pain (post-herpetic neuralgia or PHN) that may last for several months to several years in the affected area.
This occurs in 25 to 50% of shingles cases and is more common in people over 50 years of age. The pain is often difficult to control.
Other complications include:
- scarring
- secondary bacterial skin infection
- nerve complications such as nerve palsies
- pneumonia
- eye damage where the ophthalmic nerve has been affected.
People who are immune-compromised are more likely to develop shingles and may develop more widespread lesions.
Infectious period
Infection from blister fluid is possible until the lesions are dry and crusted over.
This can occur 5 to 7 days from when the rash appears.
Treatment
Anti-viral treatment can be used for shingles to reduce the severity and duration of pain and promote early healing.
Anti-viral treatment is most effective if started within 3 days of the onset of rash.
Discuss the use of antiviral treatment and pain management with your doctor as required.
Prevention
Through the National Immunisation Program (NIP), a free 'Shingrix' shingles vaccine is available for:
- people aged 65 years and over
- Aboriginal and Torres Strait Islander people aged 50 years and over
- immunocompromised people aged 18 years and over with the following medical conditions:
- haematopoietic stem cell transplant
- solid organ transplant
- haematological malignancy
- advanced or untreated HIV.
If you previously received a free 'Zostavax' shingles vaccine, you are not eligible for a free 'Shingrix' vaccine for at least 5 years.
If you purchased the Zostavax vaccine privately, you can receive 'Shingrix' for free if you’re eligible.
You should wait at least 12 months between receiving Zostavax and getting the Shingrix vaccine.
The Shingrix vaccine consists of 2 doses given:
- 2 to 6 months apart in immunocompetent (healthy) people, or
- 1 to 2 months apart in people who are immunocompromised.
Possible side effects of shingles vaccine
You may experience minor side effects following the vaccination.
Most reactions are mild and last no more than a couple of days and you will recover without any problems.
Common side effects that may present 1 to 3 days after the vaccination include:
- pain, redness and swelling at injection site
- tiredness, muscle aches, headaches and fever
- gastrointestinal symptoms.
Serious reactions to immunisation are rare.
Talk to your health professional about possible side effects of shingles vaccines, or if you have possible side effects that worry you.
Information for health professionals
To find out more, go to the Australian Government's Department of Health and Aged Care website.
Contact
Contact your nearest Centre for Disease Control on the NT Health website.