Ok. I need some information.

renerian, BSN, RN · Jul 2, 2003

Okay herpes can be dormant. It hangs out of nerve fibers particularly along the spine. Different body stressors can reactivate, so to speak, the herpes illness. If it comes back as shingles, yes it is very painful. It can pop up at anytime once you have had the infection. Does that help.

renerian

nowplayingEDRN · Jul 2, 2003

shingles is chronic...can return at anytime after the first outbreak....very painful as it follows nerve tracks. Hope this helped.

glow_worm · Jul 2, 2003

Renerian is correct. Viruses cannot be cured, and they lie dormant in your body for life. Most people do not have a second visible manifestation of the varicella virus (chicken pox), but when they do, it's called "shingles" (herpes zoster). It is the exact same virus that causes chicken pox. Most of the time it lies dormant in nerve bundles throughout the body, but when activated by anything that can suppress the immune system (stress, illness, trauma, surgery, etc), it reappears. It can reoccur at any time in a person's life, and multiple times. It will not look exactly the same as chicken pox, for it appears along dermatomes (tracts along the body connected to a reactivated nerve bundle). See:

http://www.nevdgp.org.au/herpes_on_net/vzv/dermatomes.htm

Also, people who have never had chicken pox can acquire the varicella virus from a person with active herpes zoster! Anyone who has had chicken pox is immune, and cannot contract another person's herpes zoster. In other words, an active outbreak is a reactivation of that person's own virus.

The same can be said for herpes I and II, once called "oral" and "genital" herpes. Many times people have these virsuses, but they do not manifest themselves until the immune system is suppressed. There is no cure for any of the herpes virsuses. When a person takes zovirax/ondansetron or some other anti-viral, it targets viral particles that are free & outside the nerve bundles -- there is always a small amount of the virus that hides out in the nerves, untouched by medication, ready for future reactivation.

beckymcrn · Jul 2, 2003

Thank you for the info.

Next question

When is it contagious? Before it breaks out, when is is in active phase? Or all throughout?

glow_worm · Jul 3, 2003

I used to work for the "herpes hotline" with ASHA (under the CDC umbrella). Most of our callers focused on herpes simplex I/II. The info below is for these. There is probably specific info on the net regarding Herpes Zoster, but maybe some of this info would apply:

We would tell people that you can assume contagion during prodrome, or when that tingling/itchy feeling comes (2-3 days before a breakout). However, there are not always prodromal symptoms, so one can assume that they were contagious a few days before a breakout. The blisters, redness, sores, etc.. are highly contagious. As the immune system fights off the new occurrance, there are fewer and fewer viral particles. However, we would tell people that it is contagious until completely healed.

This is from a drug company. The info seems to correspond with that for herpes simplex:

Who is Most Susceptible to Herpes Zoster?

Although chickenpox nearly always occurs in children (over 75% of the cases occur in children under the age of 10), shingles occurs most often in adults over the age of 50. Some clinicians believe that the virus reactivates as immunity declines with either advanced aging or HIV infection/AIDS; however, it is not really known what specifically triggers reactivation of the virus.

Is Herpes Zoster Contagious?

VZV can be transmitted from a person with either chickenpox or herpes zoster to someone who has never had chickenpox, although chickenpox is much more contagious than herpes zoster. If transmission occurs, the previously uninfected person will develop chickenpox, not herpes zoster. (You can't "catch" herpes zoster - remember, it's a recurrence of a dormant VZV infection, not a new infection.)

What are the Signs and Symptoms of Herpes Zoster?

The symptoms of herpes zoster generally occur in two phases:

* Prodrome - During the prodrome, a person will experience pain, usually in a "dermatome" (an area of skin containing the nerves harboring the reactivated virus). Dermatomes follow a horizontal band-like pattern from front to back. The affected area may itch, feel numb, or be sensitive to touch. Some patients also experience flu-like symptoms such as fever or muscle aches. The prodrome stage usually lasts for a few days before a rash erupts.

* Active shingles - A rash will erupt in the area where the pain or itching was felt; it soon develops into small blisters that fill with pus, then break and form a crust within 7 to 10 days.

Some may experience a third phase:

* Postherpetic neuralgia - In some, the pain lasts longer than a month after the onset of shingles, especially in people over 50 years of age. The pain may extend beyond the area originally affected, and some areas may have no feeling at all. Postherpetic neuralgia is not completely understood, but some think it may be due to skin and nerve scarring as the result of repeated inflammation. There are various ways to treat it that may provide pain relief.

beckymcrn · Jul 3, 2003

Thank you for your help.

I just need to know if a nurse with shingles can transmit to an imunocompromised pt ie patients on chmo therapy???

That is really what is worring me

Danamegg · Jul 3, 2003

Beckymcrn, I cannot assist you with your question regarding transmission of shingles. Our MD told us that shingles cannot be transmitted between persons. My mum, who lives next door to us had shingles during April this year and my husband had it in June. Co-incidence? :confused:

Karis · Jul 14, 2003

I had the chickenpox when I was very young and I barely remember it. I have had one episode of the shingles. It started out with my back itching very badly for approximately a week. I woke up one day with what I thought was two small pimples that were a little sore. The next morning, there were quite a few pustules that really hurt just to have my shirt touch my back. My doctor gave me pain meds and also antivirals. Antivirals can help to lessen the course of the outbreak as well as help to prevent postherpetic neuralgia. I took the pain meds for about 2 days and the antivirals for about a week. I was not allowed to work until each and every pustule had scabbed over. Although you cannot give someone the shingles, you can pass along the chickenpox to anyone who has never had it. Luckily, I do not suffer any lingering effects of neuralgia. I would not take any chances with someone who is immunosuppressed.

glow_worm · Jul 14, 2003

You can transmit the varicella virus to an immunocompromised pt ONLY if they have not had prior exposure to the virus (which is a minority of the population in this country). They would then get chicken pox, not shingles. *AND* you would need an active outbreak to transmit the virus, meaning that you would need to demonstrate herpes zoster or chicken pox! If a patient is demonstrating herpes zoster, this means that it is a reactivation of their OWN virus.

It is called "herpes zoster" or "shingles" when it it the 2nd occurrance of varicella virus (the exact same virus).

It is a fairly common experience for the elderly or immunocompromised pt in the ICU to demonstrate "shingles".