Shingles is a painful skin rash caused by the reactivation of the chickenpox (varicella-zoster) virus in people who have previously had chickenpox. Shingles can occur at any age, but as people get older their chance of getting the disease increases, and complications also become more common. People with a weakened immune system are also at higher risk of shingles. Although rare, it is possible to have shingles more than once.
In England and Wales there are about 50,000 cases of shingles in people aged 70 or above every year, and it is estimated that about 50 of these cases result in death. Around one in four adults will experience shingles in their lifetime. In September 2013 the UK introduced a shingles vaccine, which is offered to people when they turn 70.
Shingles is an infection of a nerve and the skin surrounding it. Common symptoms include a tingling sensation, followed by localised pain and a rash which develops into clusters of painful, itchy, fluid-filled blisters. These blisters usually affect an area on one side of the body, often the chest, back or side. In most cases, the painful rash lasts 7 to 10 days and takes two to four weeks to fully heal.
Shingles infection can affect one side of the face. In 10-20% of shingles cases it can develop in the eye (ophthalmic shingles), which can cause severe pain. In about 4% of these cases shingles can lead to long-term effects such as decreased vision or even permanent blindness in that eye. If certain nerves in the head are infected, the person may experience hearing loss, dizziness, tinnitus, loss of taste, or Bell’s palsy (paralysis of the face). These symptoms are known as Ramsay Hunt syndrome, which may leave people with some degree of permanent hearing loss or facial paralysis.
Shingles can cause complications such as “postherpetic neuralgia” (PHN), a severe burning, throbbing or stabbing nerve pain which can last for several months or even years after the rash has gone. Current treatments for PHN are not very effective. It is very rare in people under the age of 50, but quite common in older people, affecting more than 1 in 10 of those who get shingles (14,000 people a year in the 70+ age group). Sometimes PHN leads to hospitalisation.
In this film, produced by the Shingles Support Society , Andy Ford describes the symptoms of shingles.
It is caused by the varicella-zoster (chickenpox) virus, which also causes chickenpox. When someone has chickenpox, the virus remains dormant in the nerve, from where it can be reactivated later in life as immunity to the chickenpox virus declines with time. Shingles is not passed on from person to person, and it is not possible to catch shingles from someone who has chickenpox. However, direct contact with shingles blisters can infect someone who has not had chickenpox, and they may develop chickenpox as a result.
Shingles cannot always be prevented, but the shingles vaccine reduces the chance of developing it. Since September 2013 this vaccine has been offered to all 70 year olds in the UK, with a catch-up programme for those aged 71-79. The main aim of the vaccine is to help prevent post-herpetic neuralgia (PHN); it prevents two thirds of cases of post-herpetic neuralgia (PHN) in older people. Before the vaccine was introduced shingles affected 50,000 people over the age of 70 each year in the UK. The vaccine programme is expected to prevent nearly 40% of these cases. For those who do still get shingles the illness may well be milder and last for a shorter time than usual.