QUESTION

My neighbor says that she “caught” shingles from her sister. Could this be true? I didn’t think shingles was contagious.

ANSWER

Shingles itself is not contagious, but the virus that causes it is. Here’s what can happen… The varicella zoster virus that causes shingles is the same virus that causes chicken pox. Shingles–characterized by flulike symptoms, itching, tingling and a painful rash with blisters–is actually a reactivation of this virus in a person who has had chicken pox. The virus can remain dormant in the central nervous system for years…often for a lifetime. It’s unclear why it suddenly reactivates, but it is evident that people with weakened immune systems and the elderly are far more prone to a reactivation of this virus than younger, healthier adults. Someone with chicken pox can spread the varicella zoster virus to others through coughing, sneezing, kissing or via the fluid of open blisters. When spread, it can cause chicken pox in a person who has not previously had chicken pox or who has not had the chicken pox vaccine. (Some people may get chicken pox even if they’ve had the vaccine, but it will be mild.) If your neighbor never had chicken pox (99% of Americans over age 40 have had chicken pox, even if they don’t remember getting it), she may have become infected with the virus if she touched her sister’s open shingles blisters. However, she would have developed chicken pox, not shingles. Once a person’s shingles blisters crust over (roughly a week or 10 days), the virus cannot be spread. The shingles rash typically clears within two to four weeks. Treatment: Shingles is often treated effectively with an antiviral drug such as valacyclovir (Valtrex), which works best if treatment is begun within three days of the appearance of symptoms. Early treatment can often help prevent a very painful condition called postherpetic neuralgia (PHN), which can persist for months or years. For this reason, any person who thinks he/she has shingles should see a doctor as soon as possible. It’s especially important to contact one’s doctor if the rash occurs near the eye as the infection can cause permanent vision damage. Prevention: The Centers for Disease Control and Prevention recommends the shingles vaccine for most people over age 60–whether or not they’ve had chicken pox–since the risk for shingles increases with age. This vaccine is a stronger version of the chicken pox vaccine, and though it’s not 100% effective, it can help prevent a reactivation of the virus and cause milder symptoms in those who do get shingles. Caution: Pregnant women, anyone with a weakened immune system or with severe allergies to gelatin or neomycin antibiotics should not get the vaccine.