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Do You Still Believe These 6 Shingle Virus Myths?

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Only old people get shingles. You are in the clear once the rash is gone. The shingle vaccine just doesn't work. Do you still believe common myths surrounding the shingle virus?

Do You Still Believe These 6 Shingle Virus Myths?

If you have ever cared for a patient with shingles, you probably hope you never have the shingles experience- intense itching and pain. Unfortunately, according to the Center for Disease Control (CDC), 1 in 3 people in the United States will be diagnosed with shingles.  This is a surprising 1 million cases diagnosed each year. Shingles, also known as herpes zoster, is caused by the varicella zoster virus- the same virus that causes chickenpox. Those at greater risk for shingles include the following individuals:

  • With medical conditions that weaken the immune system
  • Receiving immunosuppressive medications
  • Over the age of 50
  • Recent illness or trauma
  • Under stress

Despite the high rate of occurrence, there are still common myths and misconceptions associated with shingles.  Do you still believe any of these myths?

Myth #1: 

It is all about the rash.

Fact:  The shingles rash is usually a group of small blisters that eventually dry and scab over in about a month. This itchy rash is one of the tell-tale characteristics of shingles but pain often causes the most discomfort.  The pain can be severe and may occur as early as 2 to 4 days before the rash. Unfortunately, the nerve pain caused by shingles can also continue long after the rash disappears.

Myth #2:  

Shingles only occur on one side of the back.

Fact:  It is true shingles often occur on one side of the body, is linear and follows a nerve pathway (dermatome).  However, shingles can occur anywhere on the body, including eyes and ears. Approximately 2% of cases are disseminated (shingles on both sides of the body) and occur along multiple dermatomes.

Myth #3:  

Only older adults get shingles.

Fact:  It is true that as you age, your risk of shingles increases and about 50% of shingle cases are in the over 60 age group.  However, shingles can occur in anyone at any age. Individuals with compromised immune systems, due to illness, medications, trauma or stress, are at greater risk.

MYTH #4:  

Shingles and Chickenpox are the same disease.

Fact:  Shingles is caused by varicella zoster- the same virus that causes chickenpox.  However, shingles and chickenpox are not the same illness.  Here are key differences:

  • Chickenpox is milder and usually affects children under 10 years of age
  • Once you have chickenpox, the varicella zoster virus lies dormant in the body.  People get shingles when varicella zoster is reactivated in the body.

Shingles is not spread from person to person. However, if someone has not had chickenpox (or the chickenpox vaccine) they can contract chickenpox from direct contact with fluid from shingle blisters.  

Myth #5:  

There is no treatment for shingles, you just have to suffer through it.

Fact:  It is possible to reduce the severity of shingles by starting antivirals (acyclovir, famciclovir and valacyclovir) within the first three days of an outbreak. The nerve pain associated with shingles can be treated at early onset and with persistent nerve pain after the outbreak has resolved.  Treatment to treat pain may include:

  • Topical capsaicin and numbing agents  (i.e. lidocaine)
  • Corticoid steroids
  • Oral analgesic and narcotics
  • Anticonvulsants
  • Tricyclic antidepressants

Myth #6:

There is nothing you can do to avoid the shingles.  

Fact:  Two vaccinations against shingles are currently available- Shingrix and Zostavax.  Zostavax has been used since 2006 and is a live vaccine. The newer Shingrix (a recombinant zoster vaccine) is recommended over Zostavax by the Center for Disease Control.  The CDC recommends healthy adults, 50 years or older, receive Shingrix in two doses, separated by 2 to 6 months. Shingrix has proven to be up to 90% effective in preventing shingles compared to Zostavax 65% effectiveness rate. Shingrix is available to individuals who have had shingles or have received Zostavax in the past.  Studies have shown 99% of individuals over the age of 50 have had chickenpox and Shingrix is recommended even if you don’t remember having chickenpox.

**Note:  Zostavax may still be given to individuals that prefer Zostavax, are allergic to Shingrix or prefer vaccination with only one injection.  

Prevention of Complications

The shingles vaccine is the only way to prevent shingles and the complications of shingles. The most common complication is a condition called postherpetic neuralgia (PHN). People with PHN have severe pain in the areas where they had the shingles rash, even after the rash clears up. The pain from PHN may be severe and debilitating, but it usually resolves in a few weeks or months. Some people can have pain from PHN for years and it can interfere with daily life. About 10 to 13% of people who get shingles will experience PHN, although it is rare among people under 40 years of age. Shingles may also lead to serious complications involving the eye such as vision loss. Although rare, shingles can also lead to pneumonia, hearing problems, blindness, brain inflammation (encephalitis), or death.

What are your thoughts on the shingles vaccine?  Has your geographical area experienced shortages of the vaccination?

For additional Information:

Center for Disease Control, Shingles Vaccine: What You Should Know

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Nurse with over 20 years with diverse nursing experience, including: community health, home care and hospice, nursing education, leadership and rehabilitation.

43 Likes, 5 Followers, 22 Articles, 23,489 Visitors, and 172 Posts.

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Shortage of Shingrix here in Mass, for at least a year. Frustrating.

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Shingrix is on back order here in MD for months now.

Edited by hello33

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Thanks for a great article.  I did believe that shingles confined itself to one dermatome.  Since I'm pushing (cough, cough) I will soon be asking to start the Shingrix series.

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Actually last year I learned that you can have shingles without rash. My SO was diagnosed with it and then put on valacyclovir.

 

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I'm still looking for information about re-infection. It was thought that having shingles (I did) "recharged" the body's immune response to the virus making a second bout very unlikely. (Decreasing the value of getting the vaccine.)

Has anyone seen any good info on this subject?

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22 hours ago, Jedrnurse said:

I'm still looking for information about re-infection. It was thought that having shingles (I did) "recharged" the body's immune response to the virus making a second bout very unlikely. (Decreasing the value of getting the vaccine.)

Has anyone seen any good info on this subject?

Not actual information, but I have seen shingles reappear twice in two different people. It's not likely to have it twice, or more often than that, but it does happen. These patients were immunocompromised though. Usually, people with healthy immune systems (or immunity to shingles) don't get it again after having it once. 

I skimmed the article below, but it is not current (from 2012).

https://academic.oup.com/jid/article/206/2/190/2192549

From what I gleaned from the article, I think that vaccination and reinfection both boost the body's immunity to the varicella zoster virus (VZV), which makes a second infection unlikely in immunocompetent people. In terms of getting the vaccine, the short-term benefit of reinfection from VZV seems to negate getting the vaccine to ward of recurrent VZV in healthy people.

The benefit of vaccination looks to be more realistic for long term protection against recurrent VZV in immunocompromised individuals, but, as the paper said, this needs to be studied.

 

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1 hour ago, JollyBug92 said:

Not actual information, but I have seen shingles reappear twice in two different people. It's not likely to have it twice, or more often than that, but it does happen. These patients were immunocompromised though. Usually, people with healthy immune systems (or immunity to shingles) don't get it again after having it once. 

I skimmed the article below, but it is not current (from 2012).

https://academic.oup.com/jid/article/206/2/190/2192549

From what I gleaned from the article, I think that vaccination and reinfection both boost the body's immunity to the varicella zoster virus (VZV), which makes a second infection unlikely in immunocompetent people. In terms of getting the vaccine, the short-term benefit of reinfection from VZV seems to negate getting the vaccine to ward of recurrent VZV in healthy people.

The benefit of vaccination looks to be more realistic for long term protection against recurrent VZV in immunocompromised individuals, but, as the paper said, this needs to be studied.

 

Thanks for pointing this out!

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