Is shingles contagious?

Shingles itself is not a very contagious disease. However, being in contact with someone who has the rash may cause small children to develop chickenpox. Pregnant women, adults who have never had chickenpox, and persons with impaired immune systems should be careful because direct contact with anyone suffering from shingles could cause them a serous infection. If you have shingles, it is crucial to avoid sharing towels and clothes, or even a bed, with your partner or other members of your household.

Triggers for the condition

It has been proven that shingles can affect both adults and children who have already had chickenpox, but is much more common in older people. Reactivation of the virus is most common in elderly people whose immune system is weakened, and who have not been vaccinated. There are various possible causes of immunosupression:

• conditions that affect the immune system, including HIV infection
• periods of increased stress
• excess alcohol intake
• long term courses of steroids
• chemotherapy or radiotherapy - cancer treatments
• medications used after organ transplants - the meds called immunosuppressants

Shingles and stress - hypothesis

The very important question whether stress can increase our susceptibility to viral infections like Herpes and Shingles. Several researches have found that stress really plays an important role. The researches have been conducted on astronauts during and after space flight because there were evidence of frequent reactivation of chickenpox. The researches have shown that 30% of astronauts saliva during and after the flight showed such activation while less than 1% did before the flight suggesting that the stress and anxiety of space flight increased risk for shingles. These results indicate that VZV can reactivate sub-clinically in healthy individuals after non-surgical stress.

Diagnosis of shingles

The diagnosis is usually not possible until the skin lesions develop, but once they develop, diagnosis is easy because the pattern and location of the blisters and the type of cell damage displayed are very characteristic of the disease. So, in most cases a common physical examination would be enough.

Although tests are rarely necessary, they may include the following:

• Viral culture of skin lesion
• Microscopic examination using a Tzanck preparation - staining a smear obtained from a blister. Cells infected with the herpes virus will appear very large and contain many dark cell centers or nuclei.
• Complete blood count (CBC) may show an elevated white blood cell count (WBC), a nonspecific sign of infection
• Rise in antibody to the virus 

Possible complications

Complications are very rare but possible, especially in people who have a weakened immune system. If shingles affects the area near the eye, an ophthalmologist should be consulted because the surface of the eye can be scarred, which can damage vision.

When shingles affect the ear it is causing earache, dizziness, deafness and paralysis in the face. This is called Ramsay Hunt syndrome. It is possible, though really rare, for the virus to infect the brain causing an inflammation called encephalitis. Symptoms can include high fever and confusion.

Very important thing to know is that having shingles can be really serious during pregnancy because it can lead to pneumonia or even miscarriage.