Search this site Search all sites Search. Go to whole of WA Government Search. Open search bar Open navigation Submit search. Health conditions. Facebook Youtube Twitter. Home Health conditions Shingles. Shingles Shingles is a viral infection characterised by a painful rash on the skin. The infection is caused by the varicella zoster virus, the same virus that causes chickenpox. You can only get shingles if you have had chickenpox. How do you get it? If the virus becomes active again, it typically presents as shingles.
It is rare to have more than one outbreak of shingles. Can you spread shingles? It is not possible to catch shingles from someone experiencing a shingles outbreak. Unlike chickenpox, the virus is not airborne and cannot be spread by coughing and sneezing.
Detection of varicella-zoster virus from a skin or lesion swab by nucleic acid testing from a skin or lesion swab. Detection of varicella-zoster virus antigen from a skin or lesion swab by direct fluorescent antibody from a skin or lesion swab. A vesicular skin rash with a dermatomal distribution that may be associated with pain in skin areas supplied by sensory nerves of the dorsal root ganglia. Note: Laboratory confirmation should be strongly encouraged for vaccinated cases.
If positive, samples should be referred for identification as a vaccine or wild type strain. More than 80 per cent of nonimmune household contacts of a case of chickenpox will become infected. Nonimmune people exposed to shingles cases will develop chickenpox not zoster if they become infected. In Australia, the varicella vaccine is recommended for nonimmune, healthy individuals from 12 months to 14 years of age.
It should be administered at 18 months of age. It provides protection against infection in 70—90 per cent of individuals. Live attenuated varicella vaccine VV is currently available as a monovalent vaccine. Two quadrivalent combination vaccines containing live attenuated measles, mumps, rubella and varicella viruses MMRV are also registered in Australia.
MMRV is given at 18 months of age. Vaccination is contraindicated in immunosuppressed people and pregnant women. For further details, see the current edition of the Australian immunisation handbook National Health and Medical Research Council. Immunosuppressed people, pregnant women close to term and newborns should be protected from exposure. If exposure has occurred in these persons, varicella zoster immunoglobulin VZIG is effective in modifying or preventing the disease if given within 96 hours of exposure.
In the nonhospitalised patient with a normal immune system and uncomplicated varicella, aciclovir is not recommended because it provides only marginal benefits. In immunocompromised patients and in normal patients with severe disease or with complications of varicella such as pneumonitis, hepatitis or encephalitis aciclovir may be used. Consult the current version of Therapeutic guidelines: antibiotic.
Aspirin should never be given to children under 16 years of age with varicella, because of a strong association with the development of Reye syndrome.
Some antiviral medications famciclovir, valaciclovir or aciclovir have been effective in treating varicella zoster infections in patients with a rash less than 72 hours old. They give pain relief, accelerated healing and may be of benefit in reducing the incidence of postherpetic neuralgia. More intensive treatment is warranted in high-risk patients. Consultation with an infectious diseases physician is advised. Adequate analgesia should not be forgotten.
Significant contact is defined as face-to-face contact for at least 5 minutes, being in the same room for greater than 1 hour or household contact. Vaccination may be used to prevent or attenuate illness if given to susceptible contacts within 5 days preferably 72 hours of first exposure. High-risk susceptible contacts where vaccination is not indicated, such as neonates, pregnancy and immunosuppressed persons, should be offered VZIG within 96 hours of exposure.
If vaccination is not contraindicated, it should follow at least 5 months later. See the current edition of the Australian immunisation handbook , National Health and Medical Research Council, for further details and supply.
Otherwise, children should not be excluded. Any nonimmune person admitted to hospital who has a known exposure to varicella should be isolated for days 10—21 after exposure or up to 28 days if given VZIG, to reduce the risk of spread to immunosuppressed patients.
Children with chickenpox are excluded for at least 5 days after the rash appears. A few remaining scabs are not a reason for continued exclusion. Children with shingles which occurs only rarely can attend school if the lesions can be covered adequately; however, exclusion from swimming and contact sports should be advised for seven days after the rash appears.
Parents of children with immunosuppressive diseases should be advised of cases of chickenpox in the school because they may wish to voluntarily exclude their own child. Immunosuppressed people, in particular those with haematological malignancies, are at high risk of more severe infection. VZIG should be offered to these patients if exposed. Susceptible household contacts of these patients should be vaccinated.
Varicella infection during the first trimester of pregnancy confers a small risk of miscarriage. Maternal infection before 20 weeks rarely may result in the fetal varicella zoster syndrome, with the highest risk 2 per cent occurring at 13—20 weeks. Clinical manifestations include growth retardation, cutaneous scarring, limb hypoplasia and cortical atrophy of the brain. Shingles or herpes zoster is a condition caused by the chickenpox varicella-zoster virus.
Shingles can only occur in people who have previously had chickenpox. When a person recovers from chickenpox, the virus does not completely disappear from the body but stays dormant in the nerves of the spine.
However, as a person gets older, it is possible for the virus to reappear in the form of shingles. Shingles is uncommon before the age of 12 years with most cases occurring in people over the age of 40 years.
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