Shingles (Herpes zoster)
Shingles (or Herpes zoster) is a condition caused by the chickenpox (varicella-zoster) virus and can only occur in people who have previously had chickenpox.
When a person recovers from chickenpox, the virus does not completely disappear from the body but stays dormant in the nerves close to the spine.
However, as a person gets older, it is possible for the virus to reappear in the form of shingles.
Shingles is uncommon before the age of 12 years with most cases occurring in people over the age of 40 years. Second or subsequent episodes of shingles are uncommon with most people only experiencing one bout of the disease in their lifetime. However individuals with weakened immune systems, such as people with symptomatic HIV infection or cancer, may suffer repeated infections.
Signs and symptoms
Early signs of shingles include a burning sensation or stabbing pain and tingling or itching on the skin. After a few days, a rash or blisters appear usually on one side of the body or face. When the rash is at its peak, symptoms can range from mild itching to extreme and debilitating pain.
The rash or blisters usually last from 1 to 14 days but can be longer.
Pain and tingling associated with the rash may persist for months to years after the rash has cleared. This occurs in about 1 in 10 cases and is called post-herpetic neuralgia.
Treatment
Shingles can be treated with antiviral drugs. However treatment should be started within 72 hours of the rash appearing for the most benefit. If you think you have shingles, seek prompt medical attention.
Most treatment is aimed at reducing the initial pain and rash. Other drugs that may be used to help ease symptoms include pain killers and topical ointments.
Shingles to the upper half of the face may cause serious damage to the eye, and medical assessment should be sought immediately.
It is important that the affected skin site be kept clean to avoid secondary bacterial infections. Avoid pricking or scratching the blisters.
Transmission
Direct contact with the fluid in the blisters may cause chickenpox (but not shingles) in people who have not previously had chickenpox. This is because both diseases are caused by the same virus. In addition to direct contact, shingles can also be spread via the air through coughing and sneezing if the blisters are present in the mouth of the infected person.
People with shingles and who have blisters should not have contact with people who have not had chickenpox or who are unsure if they have had chickenpox.
Prevention
A single dose of shingles (Herpes zoster) vaccine is funded for all adults aged 70 years of age under the National Immunisation Program. There is a catch-up program for people aged 71 to 79 years until 31 October 2023. To receive the funded vaccine, visit your local doctor or vaccination provider. Although the vaccine is provided at no cost, a consultation fee may apply.
Evidence suggests a reduced incidence of shingles among healthy recipients of zoster vaccine, although currently there is insufficient information to assess long term effects of the vaccine.
Adults aged 60 to 69 years can also receive a single dose of zoster vaccine unless they have previously received a dose, there is a contraindication or they are immunocompromised. Vaccine is not funded for this group.
Routine use of zoster vaccine in persons aged 50 to 59 years is not recommended. However, individuals who wish to protect themselves may consider receiving the vaccine. Vaccine is not funded for this age group.
People with underlying chronic illnesses such as arthritis, hypertension, chronic renal failure, diabetes and other similar conditions can safely receive zoster vaccine, so long as they do not have a weakened immune system. Please talk to your doctor to discuss further.
Zoster vaccination is not recommended for use in people under 50 years of age and is not registered in Australia for this age group.
Zostavax™ contains live attenuated varicella-zoster virus, containing 14 times more virus than childhood varicella vaccines. People with significantly weakened immune systems must not receive Zostavax™. People with weakened immunity should discuss vaccination for zoster with their doctor.
Zoster vaccination is contraindicated when there has been a serious reaction following a previous dose of any varicella containing vaccine.
If in doubt, seek advice from a specialist.
Other resources
Help and assistance
For further information, please contact your local doctor, community health centre or nearest public health unit or 13HEALTH (13 432584).
If you are in an emergency situation, call 000
Contact
- Get qualified health advice 24/7 for the cost of a local call. 13 HEALTH (13 43 25 84)