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Fluids & Electrolytes
MYTH: Shingles develops when an older adult is reinfected with the chicken pox virus.
FACT: Herpes zoster, commonly known as shingles, is caused by reactivation of dormant varicella-zoster (chicken pox) virus already present in the body from an earlier episode of chicken pox. After acute chicken pox resolves, the varicella-zoster virus remains dormant in nerve cells near the spine. Aging and other factors compromising immunity increase the risk that the virus will become active, causing shingles.
MYTH: Shingles isn't contagious.
FACT: Contact with a person infected with shingles doesn't produce shingles in someone else. But a person with shingles can transmit chicken pox to someone who has no immunity against it.
MYTH: The first sign of shingles is a rash of fluid-filled blisters.
FACT: The first sign of shingles is usually a burning pain or paresthesia in one location on one side of the body. This prodrome can last from 1 day to 3 weeks before the hallmark macular rash emerges; this then evolves into a vesicular rash characteristic of shingles. Shingles rash most commonly occurs on just one side of the body, typically along the chest or trunk or alongside the forehead or scalp.
MYTH: Discomfort from shingles is limited to the duration of the rash.
FACT: Severe pain that persists 30 days after rash onset or cutaneous healing is a serious complication of shingles known as postherpetic neuralgia.
MYTH: Antiviral drugs must be given before rash onset to be effective.
FACT: The earlier antiviral therapy is started (with drugs such as acyclovir, famciclovir, or valacyclovir), the greater the likelihood of thwarting an outbreak. But these drugs can lessen the severity and duration of an outbreak even after the rash appears, especially if given within the first 72 hours. Antiviral therapy also reduces pain.
Arvin A. Aging, immunity, and the varicella-zoster virus. The New England Journal of Medicine. 352(22):2266-2267, June 2, 2005.
Gnann JW Jr., Whitley R. Herpes zoster. The New England Journal of Medicine. 347(5):340-346, August 1, 2002.
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