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Shingles (Zoster)

Florida Health

Disease Control

Shingles is caused by the herpes zoster virus. If an individual had chicken pox as a child the virus is already present—the virus stays inactive in the body. Shingles causes an extremely painful rash on one side of the body or face in the form of blisters. The blisters usually scab over in 7–10 days and clear up in 2 to 4 weeks.

1 to 5 days before the rash develops people usually have tingling, itching and pain in the area where the rash will develop. In most cases, the rash forms in a single stripe around the right or left side of the body. In some cases, the rash forms on the face. Shingles can affect the eye and cause vision loss.

  • Transmission and Symptoms
  • Treatment
  • Vaccination

Transmission

Shingles cannot be spread from one person to another. However, the virus that causes shingles, the varicella zoster virus, can be spread from a person with active shingles to another person who has never had chickenpox. In such cases, the person exposed to the virus might develop chickenpox, but they would not develop shingles.

The virus is spread through direct contact with fluid from the rash blisters caused by shingles. A person with active shingles can only spread the virus when the rash is in the blister-phase. Shingles is not contagious before the blisters appear. Once the rash has developed crusts/scabs, the person is no longer contagious.

Shingles is less contagious than chickenpox and the risk of a person with shingles spreading the virus is low if the rash is covered.

If you have shingles:

  • Keep the rash covered.
  • Avoid touching or scratching the rash.
  • Wash your hands often to prevent the spread of the virus.

Until your rash has developed crusts, avoid contact with:

  • pregnant women who have never had chickenpox or the chickenpox vaccine
  • premature or low birth weight infants
  • people with weakened immune systems, such as people with human immunodeficiency virus (HIV) infection

1 to 5 days before the rash develops people usually have tingling, itching and pain in the area where the rash will develop. In most cases, the rash forms in a single stripe around the right or left side of the body. In some cases, the rash forms on the face. Shingles can affect the eye and cause vision loss.

Other Symptoms

  • Upset stomach
  • Headache
  • Fever and chills

Several antiviral medicines are available to treat shingles. To be effective, these medications must be started as soon as possible after the rash appears. If shingles in suspected contact your health care provider immediately. Pain medication can be used to control the pain. Colloidal oatmeal baths, wet compresses, and calamine lotion can help relieve some of the itching.

The CDC recommends people > 50 receive two doses of Shingrix shingles vaccine. Zostavax was discontinued by its manufacturer Merck in the United States as of July 2020. The latest expiration date of remaining Zostavax doses was November 2020. Shingrix is administered as a 2-dose series by the intramuscular route. The second dose should be given 2 to 6 months after the first dose. The Advisory Committee on Immunization Practices (ACIP) recommends that people who previously received Zostavax receive 2 doses of Shingrix. The first dose of Shingrix may be given at least 2 months after Zostavax.