Comments on: Wait! Is It Chickenpox, Shingles, Zoster, or What??

by: The Doc

Sun, 11 Apr 2010 20:45:30 +0000

Ranjith,
You’re right: Varicella and zoster are the same virus; there is no antigenic difference between the two. Once you have had chickenpox (varicella), you are susceptible to shingles (zoster) because the virus retreats to your central nervous system when the chickenpox clears. Your immune system then keeps it sequestered there. When some immune insult (a cold, stress, sleep deprivation, or merely getting older) weakens your immune system, the virus is allowed to temporarily “escape.” It travels down a nerve root and causes a localized infection. However, since your immune system “remembers” the virus, it quickly manages to catch up with the infection before it can spread all over your body. Furthermore, since you already have antibodies and white cells that can rapidly react to the reawakened virus, the immune response can be fairly vigorous; this is what causes the marked inflammation and pain that often accompany shingles.
I hope that helps.
Doc

by: Ranjith

Thu, 08 Apr 2010 01:48:43 +0000

Varicella and Zoster are the same virus..Why is immunity lacking to Zoster virus when Varicella can never recur?..Is there any antigenic difference between Varicella and Zoster virus?

by: The Doc

Sat, 03 Apr 2010 14:16:46 +0000

Did you have chickenpox (a whole-body rash), or did you have shingles (rash limited to a small area on one side of the body)? Post-herpetic pain is common with shingles, and its treatment is fairly straightforward. However, if you had generalized varicella (chickenpox), it’s possible that you have developed a radiculitis, which is an inflammation of the nerve root(s) that lead to your arm. Do you have any problems with your immune system, such as diabetes, long-term prednisone therapy, etc? A compromised immune system can increase your chances of developing radiculitis. And, since you’re apparently an adult, it’s a bit late for you to be getting chickenpox, which makes me wonder about immune deficiency.
Your doctor is the best one to sort this out and recommend appropriate therapy (i.e., corticosteroids, gabapentin, etc.)
Good luck…sounds like you’re pretty uncomfortable.

by: shalet

Wed, 31 Mar 2010 12:06:13 +0000

I have a pain in my right arm after i had a bout of chicken pox, I had pox and a week later was down with high fever and pain in my right arm.The doctor suspected respiratory infection and gave me antibiotics for it, I still have pain in my arms and I have constant pain while doing routine tasks and working(at the computer). I have more pain in right hand and sometimes in left hand as well. When i try to massage or squeeze the area it hurts.
The doctor i am seeing prescribed paracetamol. and it doesnt work.
Please give me an answer.
thanks doc

by: I.N.

Wed, 24 Mar 2010 03:04:21 +0000

Varicella is a viral infection that causes a dermatological eruption. The rash first appears in face and abdomen, and then it will move towards the entire surface of the body, including the head and genital organs, and even inside the mouth, ear, vagina. The rash elements are at first small vesicles of 5 to 10 millimeters that are red and appear over two or more days in waves.

by: Sharon

Tue, 02 Mar 2010 01:54:32 +0000

Hi there, great blog…well done!!

My mother is just over 60 years old. She has this horrid pain from over 1.5 weeks of shingles. She has completed using her anti-viral medicine and her pain killers. The little rash on her back has disappeared but she has excruciating pain all over her body.

She has had severe arthritis in her knees for the past 2 years with both knees having cartilages removed. She is on anti-arthritis medication.

After reading up a bit on this topic, is it correct that anti-arthritis medicine actually increases the incidence of shingles? Will my mum be ok.. I love her so much I am afraid.. because she has been putting up with pain for the past 2 years of arthritis, now shingles…. I am worried…?

How do I get my healthy mum back?

Pls help…

by: The Doc

Sun, 06 Dec 2009 23:33:37 +0000

Hello, Rose.
First, if you’ve had chickenpox and your immune system is intact, you have at least partial immunity to the virus. Therefore, it’s exceedingly unlikely that you’re catching it from someone else. I assume that your current eruption of pox is following all the rules for someone who is immunocompetent — that is, they are popping up in a belt-like area (called a dermatome) on one side of your body only. If they’re erupting all over the place, something is awry with your immune system and your doc should be chasing that down.
Although most cases of shingles resolve in a week or two, it isn’t unusual for a single episode of shingles to last several weeks, and it isn’t unheard of for someone to get recurrent episodes. Once again, though, frequent recurrences are more likely to occur in a person whose immune system is weakened for some reason (stress, diabetes, certain medications like prednisone, etc.). As you probably know, the vaccine is recommended for people over the age of 60; it is made from a live virus, so a small percentage of people who get the vaccine will develop a mild case of shingles following the injection. As far as I know, having an active case of shingles doesn’t prevent you from getting vaccinated, but most of the time we recommend that the vaccine be withheld until the episode subsides and the symptoms resolve.
Given your age and history, I’d see the physician who prescribed the acyclovir and Zithromax to:
1. Make sure you have shingles
2. Ensure that you don’t have any obvious immune problems (diabetes, etc.)
3. See if you can get vaccinated a bit earlier than the recommended age of 60, since you seem to have a tendency to get shingles.
Hope that all helps. Good luck!! (By the way, I got shingles as a teenager, believe it or not, and I still remember it very clearly)

by: Rose

Thu, 03 Dec 2009 23:11:56 +0000

I had chicken pox as a child, in my teens (babysitting), in my thirties and in my late forties exact same symptoms was told it is now shingles. In the past 5 yrs I’ve had it 3 times. I feel awful and get 1-5 pox (very itchy). Now at age 54, I got it again 3 weeks ago and had 2 pox but was so tired and weak missed 4 days of work. I was prescribed acyclovir and z pak for the bronchitis. I finished them 2 weeks ago. I was feeling a little stronger but keep getting new pox every couple of days. Today I feel sick and tired again. Why do I keep getting this? I’ve heard it can be stress related. I just started a new job 1 week before I became ill. Can I be getting it from a person that has no symptoms. I’d like to get the vaccine but I can’t until I am pox free right? Help I can’t stand this.

by: The Doc

Wed, 14 Jan 2009 23:23:00 +0000

Hi, John.
Anyone who has had chickenpox or been vaccinated for chickenpox can get shingles later in life.

If your wife is certain that she had chickenpox as a child, there is no risk associated with being around her father. To be certain, her doctor could run a serology to make sure she is immune.

Chickenpox is spread by respiratory droplets. VZV is an enveloped virus (subject to drying), so it won’t survive indefinitely on environmental surfaces. It is conceivable that a person with chickenpox could leave respiratory droplets on the chair, and someone who is not immune could visit the chair, pick up secretions from the infected individual, and inadvertently inoculate their own mucus membranes, but I suspect the threat is more theoretical than real.
I just wrote an article on chickenpox and pregnancy for Suite101. If you’d like to visit, here’s the link:
http://pregnancychildbirth.suite101.com/article.cfm/pregnancy_and_chickenpox

by: John Garvey

Wed, 14 Jan 2009 15:18:23 +0000

Hi Doc,

If a child is vaccinated against chicken pox, does that mean that the child may develop shingles later in life? (Due to the exposure to the chicken pox virus in the vaccine).

Also, my wife (who had chicken pox as a child) is 6 weeks pregnant and her father has in the last week contracted shingles. Should we avoid contact (ie. play it very safe) or not worry about normal social contact at all? When it is said that chicken pox is very contagious does that mean we can catch it off a chair if a person who has shingles sits in it?? I know this may seem a little paranoid but I obviously want to be reassured of the risks involved. As they say, ‘Better safe than sorry’