Summary about Disease
Varicella Zoster Virus (VZV) causes two distinct diseases: varicella (chickenpox) and herpes zoster (shingles). Chickenpox is the primary infection, typically occurring in childhood, characterized by a widespread, itchy, blister-like rash. After chickenpox resolves, VZV remains dormant in nerve cells. Years later, the virus can reactivate, causing shingles, a painful rash that typically appears as a stripe on one side of the body.
Symptoms
Chickenpox:
Itchy, blister-like rash all over the body
Fever
Fatigue
Loss of appetite
Headache
Shingles:
Pain, burning, numbness, or tingling on one side of the body.
Rash that appears as a single stripe or band on one side of the body.
Fluid-filled blisters that break open and crust over
Itching
Fever
Headache
Sensitivity to touch
Postherpetic Neuralgia (PHN): nerve pain that persists after the shingles rash has healed.
Causes
Both chickenpox and shingles are caused by the varicella-zoster virus (VZV). Chickenpox results from initial infection with VZV. Shingles results from the reactivation of latent VZV in nerve cells. The reactivation can occur due to weakened immunity, stress, age, or other factors.
Medicine Used
Chickenpox:
Antiviral medications (acyclovir, valacyclovir, famciclovir) may be prescribed, especially for adults or those at risk of complications.
Calamine lotion to relieve itching.
Acetaminophen to reduce fever.
Shingles:
Antiviral medications (acyclovir, valacyclovir, famciclovir) to reduce the severity and duration of the outbreak.
Pain relievers (over-the-counter or prescription) to manage pain.
Corticosteroids to reduce inflammation.
Capsaicin cream or lidocaine patches for pain relief.
Antidepressants or anticonvulsants for postherpetic neuralgia (PHN).
Is Communicable
Yes. Chickenpox is highly contagious. Shingles is contagious, but only to those who have never had chickenpox or have not been vaccinated against it. Exposure to the fluid from shingles blisters can cause chickenpox in these individuals. Once the blisters have crusted over, shingles is no longer contagious.
Precautions
Chickenpox:
Vaccination is the best prevention.
Avoid contact with infected individuals.
If infected, stay home until all blisters have crusted over.
Practice good hygiene, including frequent handwashing.
Shingles:
Shingles vaccine (Shingrix) for adults aged 50 and older.
Avoid contact with pregnant women who have never had chickenpox or the vaccine, premature or low birth weight infants, and people with weakened immune systems.
Cover the rash.
Wash hands frequently.
How long does an outbreak last?
Chickenpox: The rash typically lasts for 5-10 days.
Shingles: The outbreak usually lasts 2-4 weeks. Pain from postherpetic neuralgia (PHN) can last for months or even years after the rash has healed.
How is it diagnosed?
Chickenpox: Typically diagnosed based on the characteristic rash.
Shingles: Usually diagnosed based on the characteristic rash pattern and pain. A viral culture or PCR test of blister fluid can confirm the diagnosis, especially in atypical cases.
Timeline of Symptoms
Chickenpox:
Incubation period: 10-21 days.
Initial symptoms: Fever, fatigue, headache.
Rash: Starts as small, itchy red spots that develop into blisters, then crust over.
Shingles:
Prodrome: Pain, burning, tingling, or numbness in the affected area several days before the rash appears.
Rash: Redness and small blisters appear in a band or stripe on one side of the body.
Blisters break open and crust over within 7-10 days.
Rash typically heals within 2-4 weeks.
Postherpetic Neuralgia (PHN): Pain persists for months or years in some individuals.
Important Considerations
Complications: Chickenpox and shingles can lead to complications, especially in certain populations (e.g., pregnant women, newborns, immunocompromised individuals, and older adults).
Vaccination: Vaccination against chickenpox is highly effective in preventing the disease. The Shingrix vaccine is highly effective in preventing shingles and PHN.
Early Treatment: Early treatment with antiviral medications can reduce the severity and duration of both chickenpox and shingles.
Postherpetic Neuralgia (PHN): This can be a debilitating complication of shingles. Early treatment of shingles can reduce the risk of developing PHN.
Ophthalmic Zoster: Shingles involving the eye (ophthalmic zoster) can cause serious complications, including vision loss, and requires prompt ophthalmologic evaluation and treatment.