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Shingles: A Second Strike by the Chickenpox Virus

The virus that caused the illness many of us had as kids lurks for decades. It can strike anew with an itchy, painful rash, and fever.

If you're like many people, you had chickenpox as a kid. The itchy, blistering rash, fever, and headache are tough to forget.

And if you're like many people, you know someone who has had a second bout with the virus that causes chickenpox. That's right: The varicella zoster virus can get you twice. Its painful, long-delayed second strike is known as shingles.

Dormant virus

Once you've had chickenpox, the virus lies dormant in nerve roots. In some people, it may never surface. But in those whose immune systems are weakened by disease, stress, medication, or age, varicella zoster can rear its painful head.

The virus can reactivate and travel to the skin. The most commonly involved sites are the thoracic and lumbar areas. The result: pain, itching, and a blistering rash on one side in a very specific distribution. The pain can precede the rash by days to weeks. The pain is described as a "burning," "throbbing," or "stabbing" sensation. The rash usually lasts a week or two, but can linger a month or more. The lesions crust by seven to 10 days and are no longer considered infectious.

According to the CDC, the lifetime risk of developing shingles is about 30 percent.

An antiviral drug can treat shingles if used as soon as symptoms appear. Since the infection can spread, and treatment must begin immediately to be effective, people who suspect symptoms of shingles should call their health care provider right away. Blisters should not be scratched.

Possible complications

In some cases, shingles can lead to postherpetic neuralgia (PHN), a disorder of nerve fibers and skin that causes severe burning, stabbing pain for months or, for some people, even years. PHN pain can be so severe it becomes debilitating. According to the CDC, PHN is more likely to be seen in older people, and may occur in up to half (and possibly more) of untreated people aged 60 and older. 

In addition to PHN, the CDC reports that shingles may also result in serious eye complications. In very rare cases, people can also experience hearing problems, pneumonia, and brain inflammation (encephalitis). 

Vaccine

A shingles vaccine is available for people 50 and older, even if they haven't had chickenpox, but the vaccine is not approved for younger people. The vaccine is at least 50 percent effective; however, the effectiveness of the vaccine is reduced as age increases, reports the CDC.

The vaccine is covered under Medicare Part D. The amount of cost sharing (the amount you have to pay) may vary. Private insurance and Medicaid may or may not cover the vaccine. 

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