+Introduction:
Shingles also called herpes zoster, is an infection of the nerve caused by varicella-zoster virus, the same virus which causes chickenpox. When the virus first attacks a person, it manifests as chickenpox. After the chickenpox infection has run its course, the virus stays dormant (passive) in the nerves close to the spinal cord. After a few years or decades, when certain conditions (like low immunity) make the conditions favorable, the virus gets reactivated to cause another disease known as Shingles.
Is Shingles Contagious?
Although the varicella-zoster virus (VZV), which causes shingles, can spread to people who have not had chickenpox or the vaccine, it is not directly contagious. The fluid-filled blisters that form on a person with shingles are caused by the virus. The fluid from these blisters can carry the virus and cause chickenpox, not shingles, in someone who does not have the disease or the vaccination.
What are the Signs and Symptoms?
Shingles usually manifest as distinct symptoms that frequently fit into a predetermined pattern. The severity of these symptoms can vary, with some people possibly experiencing more severe symptoms than others. Common indications and symptoms of shingles consist of:
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Pain and Tingling: Pain, tingling, or burning in a particular area of the skin is the initial sign of shingles. This usually affects one side of the body and may be confined within the dermatome, which is a particular skin area that is supplied by a single spinal nerve.
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Rash: A red, itchy rash appears a few days after the first pain or discomfort. Like chickenpox, the rash usually manifests as tiny blisters filled with fluid. The rash resembles a dermatome and is frequently confined to one side of the body.
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Blisters: These painful, fluid-filled blisters have the potential to burst open and develop sores. Containing the varicella-zoster virus, the fluid inside the blisters is infectious.
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Itching: The affected area may be extremely itchy.
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Fever: Some people with shingles experience a low-grade fever.
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Headache and Fatigue: Headaches and fatigue are common accompanying symptoms.
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Sensitivity to Light: In some cases, individuals with shingles may experience sensitivity to light.
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Flu-Like Symptoms: Some people may experience flu-like symptoms such as muscle pain and shivers.
How do Shingles Progress?
Shingles typically progress through several stages:
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Prodromal Stage: Early symptoms like headache, sensitivity to light, and flu-like symptoms may occur.
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Pre-Rash Stage: Pain, itching, or tingling often precede the appearance of the rash.
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Active Rash Stage: Characterized by the development of a red, painful rash with fluid-filled blisters, usually on one side of the body.
- Post-Herpetic Neuralgia: Pain may persist even after the rash has healed, known as post-herpetic neuralgia.
What Could Be the Cause?
The varicella-zoster virus causes shingles. The virus that causes chickenpox as well. The virus may persist in dormant form in nerve cells close to the brain and spinal cord even after a person has recovered from chickenpox. The virus may reactivate later in life and result in shingles. So, this means only those who previously had chickenpox disease or the vaccine can get shingles.
What are the Risk Factors?
Although the exact cause of reactivation is unknown, several circumstances and factors are thought to play a role in the onset of shingles:
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Age: As people age, their chance of getting shingles rises. Most cases involve people aged 50 years or older. This is probably due to the immune system becoming less effective as they age, making the virus harder to control.
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Poor immunity: The risk of shingles can be elevated by a weakened immune system, which can be brought on by aging, certain medical conditions (like HIV/AIDS), or medications (like immunosuppressive drugs).
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Stress: Studies indicate a higher risk of shingles due to psychological stress. Excessive levels of stress can impair immunity and cause the varicella-zoster virus to reactivate.
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Exposure to the Varicella-Zoster Virus: Individuals who have not had chickenpox or received the vaccine are susceptible to contracting the virus and develop shingles through direct exposure to the varicella-zoster virus. This is a less frequent way that shingles can develop.
Is it Possible to Get Shingles Twice?
Although it is not common, getting shingles more than once is possible. A person's immune system typically develops some immunity to the varicella-zoster virus, which causes both chickenpox and shingles, after they recover from a shingles episode. This immunity could lessen the chance of shingles recurrence.
How to Reduce the Transmission?
Those with active shingles are advised to do the following to manage their symptoms to lower the risk of transmission:
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Keep the rash covered to help stop the blister fluid from coming into contact with other people.
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Maintain proper hygiene by not touching or scratching the rash and by washing your hands often. This may aid in stopping the spread.
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Those with compromised immune systems, expectant mothers who have never received the vaccine or chickenpox, and infants are more likely to experience serious consequences should they come into contact with the virus. Those suffering from shingles should stay away from these groups until their blisters have crusted over.
How are Shingles Prevented?
Vaccination is an effective way to reduce the risk of developing shingles and its complications. The shingles vaccine is recommended for individuals who are older than 50 years of age. Two vaccines are helpful here - the chickenpox (varicella) vaccine and the shingles (varicella zoster) vaccine.
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Chickenpox vaccine is recommended if you are not already vaccinated for chickenpox or never had chickenpox disease.
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Varicella vaccine is recommended for the elderly who are prone to shingles.
How is the Diagnosis Made?
Clinical evaluation, in which a medical practitioner looks at the patient's symptoms and performs a physical examination, is the main method used to diagnose shingles. Here is a summary of the usual process for making the diagnosis:
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Medical History: The physician will inquire about the patient's past medical history, encompassing any recent illnesses, history of varicella-zoster virus exposure (e.g., chickenpox), and any conditions or drugs that may impact the immune system.
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Symptoms: Burning or tingling sensation along with pain, fluid-filled blisters, and rashes confined to a particular area on the skin indicates the presence of Shingles.
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Investigations for Viruses (If Necessary):To confirm the diagnosis or rule out other conditions, the doctor may occasionally order additional tests. This could consist of:
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Viral Culture:The process of confirming the presence of the varicella-zoster virus in a blister sample by analyzing it in a lab.
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The Polymerase Chain Reaction (PCR) Test: The Polymerase Chain Reaction (PCR) test is a molecular technique that can identify the virus's genetic material in a sample.
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Blood Tests: Presence of antibodies to the varicella-zoster virus, which may be a sign of an infection that has occurred recently or in the past.
How is Shingles Managed?
There is no cure for shingles and treatment primarily involves the management of pain and itching. Antivirals such as Acyclovir, Famciclovir, and Valacyclovir are prescribed in certain circumstances to reduce pain and speed up the healing process. Symptomatic relief can be obtained with the following steps.
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Lacto calamine can be applied to help soothe the blisters.
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Keep rashes dry.
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Wear loose cotton clothes.
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Antihistamines and painkillers provide respite from itching and pain.
Conclusion:
In conclusion, shingles are a painful viral infection caused by the varicella-zoster virus, which is also responsible for chickenpox. A characteristic rash along a particular nerve pathway is the condition's initial manifestation. Clinical evaluation is the basis for diagnosis, and early detection is essential for successful treatment. Antiviral drugs are used in treatment to lessen symptoms, and supportive care is given to promote healing and pain management. Extra care may be needed if the rash resolves but the pain persists, a condition known as post-herpetic neuralgia. For people 50 years of age and above, vaccination is advised to prevent shingles. If symptoms appear, getting medical help quickly is important for a proper diagnosis and course of treatment. Precautions should also be taken to stop the virus from spreading, especially to people who have not received the varicella-zoster vaccination.