Shingles (Herpes zoster)

What is shingles?

Shingles, also known as herpes zoster, is a viral infection that causes a painful rash. It is caused by the varicella-zoster virus (VZV), the same virus that causes chickenpox. After a person recovers from chickenpox, the virus remains inactive in the body. Shingles occurs when the virus reactivates later in life, often when the immune system is weakened.

How is shingles transmitted?

Shingles is a reactivation of the varicella-zoster virus that is already dormant in your own body, so you do not catch shingles from someone else who has shingles. However, if you have never had chickenpox before and are not vaccinated with the chickenpox vaccine, you can catch chickenpox from someone with shingles. 

The virus is spread by direct contact with fluid from the blister or breathing in infectious particles from the blisters. Shingles can happen many decades after getting chickenpox infection. 

What are the symptoms of shingles? 

Common symptoms of shingles include:

• Pain, itching, tingling or numbness in one area of skin before the rash appears

• Rash, typically on one side of the body, often as a single stripe of blisters. It can also appear on the face, sometimes near the eye. If it occurs in or near the eye, seek medical attention immediately, as it may lead to blindness in the affected eye(s)

• Fever

• Headache

• Chills

• Fatigue

Shingles infection can lead to complications, specifically postherpetic neuralgia (PHN).  This is persistent nerve pain that may continue for months or years after the rash heals.

What are the risk factors?

 Risk factors for shingles include:

• Weakened immune system (e.g.  cancer, chemotherapy or other medications that suppress the immune system, high stress)

• Elderly aged 60 years or above

How is shingles treated?

Patients are given antiviral medications such as acyclovir, valacyclovir, or famciclovir to treat the infection. These medications can help to reduce the severity and duration of the illness and reduce the risk of complications.

Other symptomatic treatments include pain relievers such as ibuprofen or acetaminophen, calamine lotion or cool compresses to help soothe the skin and relieve itching and keeping the rash clean and dry to prevent secondary bacterial infections.

How to prevent shingles?

Vaccination is an effective preventive measure for shingles. Shingles vaccine is recommended under the National Adult Immunisation Schedule (NAIS). Shingles vaccine does not prevent chickenpox.

For adults who have never had chickenpox infection, blood tests can confirm if they have never had infection.  In that case, chickenpox vaccine is recommended instead of shingles vaccine.

Other preventive measures:

• Practise good personal hygiene at all times.

• Wash your hands regularly with soap, especially before handling food or eating, after going to the toilet, or when hands are dirty.

• Avoid touching your face, including eyes, nose and mouth with unwashed hands.

• Avoid sharing of food/drinks or eating utensils.

• Keep the rash/blisters covered and avoid touching them to prevent them from spreading to others.

Please refer to Health advice for travellers for the full list of precautions to take when travelling.