By Martha A. Simpson, D.O., M.B.A.
Associate Professor of Family Medicine
Ohio University College of Osteopathic Medicine

CAN’T CATCH SHINGLES FROM SIBLING, BUT IT MIGHT RUN IN FAMILIES

Question: Are shingles contagious? If four out of six members of a family have had shingles, does that mean the other siblings will be susceptible for shingles? Is there a shot you can get for shingles?

Answer: Shingles, called herpes zoster in medical lingo, is fairly common in people over 50. If you have ever had chickenpox, you are at risk for this disease. This is because shingles is caused by a reactivation of the same virus that originally gave you chickenpox. It’s called the varicella-zoster virus (VZV), and it has remained in your system ever since you had chickenpox as a child.

Doctors and scientists don’t know exactly why this virus reactivates. We do know it is more likely to happen when a person is under stress, is over 50 years old or has a disease that weakens the immune system, such as some forms of cancer and HIV. Having transplant surgery or cancer chemotherapy can also put you at greater risk. Though not conclusive, there is some research showing that those with a family history of shingles are more likely to develop it themselves.

Generally, a person will only get shingles once in his or her lifetime, if at all. While it’s possible to get shingles two or three times, this is quite rare.

The signs and symptoms of shingles follow a classic pattern that is easily recognized by an experienced practitioner. The first symptom is usually a burning pain, or tingling and itching in the affected area with no visible rash. Within a few days a rash starts to develop. At first it is just a reddened area, then clear vesicles, or blisters appear, usually in a tight cluster. The distribution of the rash follows a nerve root and is confined to one side of the body.

The most common location for this rash is on the trunk or buttocks. It may be associated with a fever and general malaise. It usually take about ten to 14 days to get over a case of the shingles. If diagnosed early, however, it can be treated with antiviral medications that reduce the healing time and help limit the spread. Also, if the VZV infection affects the area around the nose or eye, you should seek immediate medical attention as this can very serious. The virus can spread to the cornea or the retina and threaten your vision.

Shingles are not contagious and cannot be spread from one person to another. However, if a person who has never had chickenpox or has not been immunized against it comes in direct contact with the shingles rash, he or she can catch chickenpox. Keeping the shingles rash covered can prevent the spread of VZV.

The most common complication of shingles is pain after the rash has disappeared -- a condition called postherpetic neuralgia. This is seen most often in older people and can last for up to a year and, in rare cases, longer. The use of antiviral agents can help prevent this complication. Shingles can also, in rare cases, lead to meningitis and encephalitis.

There is now a shingles vaccine on the market. It is recommended for people over 60, even if you have had shingles in the past. It is a one time vaccine that you can get from your primary care physician. Also, if you have never had chickenpox, ask your doctor about the chickenpox vaccine. This two shot series is especially important for those who work with children, such as teachers, daycare workers and health care workers.

Family Medicine® is a weekly column. To submit questions, write to Martha A. Simpson, D.O., M.B.A., Ohio University College of Osteopathic Medicine, P.O. Box 110, Athens, Ohio 45701, or via e-mail to readerquestions@familymedicinenews.org. Medical information in this column is provided as an educational service only. It does not replace the judgment of your personal physician, who should be relied on to diagnose and recommend treatment for any medical conditions. Past columns are available online at www.familymedicinenews.org.