Shingles

About shingles

Shingles, also known as herpes zoster, is caused by the varicella zoster virus, which is also responsible for chickenpox.

Anyone who has had chickenpox can develop shingles. It occurs because of a reactivation of the chickenpox virus, which remains in the nerve cells of the body after an attack of chickenpox.

About one in 3 people will get shingles in their lifetime. Shingles usually affects older people and the risk of complications increases with age, particularly for those over 65, Aboriginal and Torres Strait Islander people aged 50 and over, and some people with weakened immune systems.

Shingles can lead to serious illness that can last for months, including post-herpetic neuralgia (PHN) and other complications, including pneumonia, hearing problems, blindness or swelling of the brain.

Symptoms of shingles

Shingles is a skin rash characterised by pain and blistering that usually appears on one side of the face or body. Tiredness, headache, photophobia, and tender and painful skin may occur 2 to 3 days before the skin turns red and breaks out in tiny fluid-filled blisters.

Shingles can affect any part of the body. Classically, the rash caused by shingles often takes the shape of a belt from the midline on one side of the body. The chest and lumbar region are most commonly affected. The rash forms its characteristic pattern because the virus works down the nerves that branch out from the spinal cord.

The rash usually lasts about 10 to 15 days. During that time, a scaly crust might appear. Once the attack is over, the skin usually returns to normal, but there can be some scarring or a secondary bacterial infection in severe cases.

How shingles spreads to a person who has not had chickenpox disease or vaccinations

Shingles can spread when a person comes into contact with fluid contained in the rash blisters. The virus can spread by direct contact with the lesions or by touching any dressings, sheets or clothes soiled with discharge from the spots. This can cause chickenpox in people who have never had chickenpox disease or vaccination.

Shingles, chickenpox and pregnancy

An attack of shingles during pregnancy will not harm the unborn baby. The mother is already carrying the varicella zoster virus before developing shingles and there is no increase in the risk of passing it on to the foetus if shingles develops.

However, an attack of chickenpox during pregnancy can be serious and requires urgent medical attention.

Post-herpetic neuralgia (PHN)

Sometimes the pain doesn’t go away once the shingles rash has cleared. This persistent pain in the region for longer than 3 months is called post-herpetic neuralgia (PHN).

The risk of PHN increases with advancing age. It is reduced by prior vaccination, but not by antiviral medications.

Pain-relieving medication or tablets specific for nerve pain may be needed to help manage symptoms.

Treatment for shingles

Anti-viral medications can help ease the pain and shorten an attack of shingles. The medication works best if administered within 3 days, and ideally within 24 hours, of the onset of a rash. Analgesic medication may also ease PHN but consult your doctor first.

If you think you have shingles, seek urgent medical attention.

Shingles and chickenpox vaccination

The National Immunisation Program (NIP) provides a free shingles vaccine, Shingrix® (2 dose course) to:

• people aged 65 and older
• Aboriginal and Torres Strait Islander people aged 50 and older
• eligible people 18 and older who are considered at increased risk of herpes zoster due to an underlying condition and/or immunomodulatory/immunosuppressive treatments.

Two doses are required for maximum protection.

Check with your immunisation provider if you can get a free Shingrix® vaccine.

While the NIP vaccines are free, your vaccination provider may charge a consultation fee for the visit.

Vaccination is still recommended for people who have had shingles infection in the past. It is recommended to wait at least a year after recovery.

The NIP provides a free chickenpox vaccine:

• to children aged 18 months (as a combined vaccine with measles, mumps and rubella)
• as catch-up for all children up to 20
• for refugees and humanitarian entrants aged 20 and over.

People aged 14 and older require 2 doses of the chickenpox vaccine, one to 2 months apart.

Australian Immunisation Register

The Australian Immunisation Register records the vaccines given for all people living in Australia. This means that if you see another health service anywhere in Australia, then your vaccine history can be checked on the register.

Your doctor or immunisation provider will record your vaccines to the register on your behalf.

Check your immunisation records on the Australian Immunisation Register.

Where to get help

• Your GP (doctor) or immunisation provider
• Nurse-on-Call Tel. 1300 60 60 24 – for expert health information and advice (24 hours, 7 days)
• National Immunisation Information Line Tel. 1800 671 811
• SAEFVIC Tel. 1300 882 924 (option 1)