Question:
A co-worker of mine who thought she had painful poison ivy called in sick today, because her doctor diagnosed shingles. I heard there is a new shingles vaccine. I am 35 years old and not pregnant. Should I be concerned that I will catch shingles from her, and should I get the shingles vaccine?
Answer:
There are a lot of pieces to this problem. Shingles, also called herpes zoster, is a nerve and skin infection caused by the same virus that causes chickenpox. Shingles is a re-activation of the chickenpox virus that remained in the nerve root from a person’s initial chickenpox infection years ago.
The virus activation and infection is restricted to that single nerve root, which supplies only one side of the body. That accounts for the pattern of the rash, which always follows the nerve around that side of the body, stopping at the body’s midline. The nerve involvement explains the pain associated with shingles.
The skin rash begins as red patches along the nerve path and soon becomes blisters. They heal in 2-8 weeks without treatment. However, treatment with oral anti-viral medication (acyclovir, famvir, or valtrix) shortens the attack and reduces the symptoms.
Shingles is only contagious through direct skin-to-person contact with someone who has never had chickenpox. Small children and infants, as well as patients with decreased resistance (cancer patients, patients with AIDS, patients on chemotherapy, etc.), are at greater risk to catch chickenpox from someone with shingles. It is advisable to cover the area where the shingles are evident if out in public to avoid skin contact with another individual.
Bottom line, shingles is not very contagious; and unless you are susceptible, have never had chickenpox or had direct contact with the co-worker’s skin lesions, you have no significant risk. There is a vaccine available for shingles that is recommended for patients over 60 who have not had shingles. The reason for the age recommendation is that the severity of shingles seems to increase with age. The vaccine has limited protection in some patients, but would hopefully decrease the severity of the shingles in those patients.
Younger patients have less severe cases of shingles and respond well to the oral shingles medication. The earlier a person makes the correct diagnosis and begins treatment, the less severe the shingles should be. With your young age of 35, I would not recommend that you get the shingles vaccine.