Shingles is an infection involving nerves and their surrounding areas. It’s caused by the virus known as varicella-zoster (VZ). VZ is a different virus than herpes simplex, which is the virus that causes genital herpes, though the rashes may look similar. Usually shingles shows up as a painful rash on the skin over top of the affected nerve, often around the side of the ribcage.
The symptoms last for two to four weeks, but some people still have nerve pain after the rash disappears. This complication is more likely in people over age 50. Though shingles can be painful and unsightly, serious complications are rare. Around one-quarter of people will develop shingles during their lifetime, and it is most common in adults over age 50. Most people only have shingles once, though it can recur.
Who Is at Risk for Shingles?
People who have had chickenpox retain virus particles after the disease goes away. These virus particles inactively reside in nerve roots near the spinal cord. This is harmless and doesn’t cause symptoms. However, sometimes the virus reactivates and starts multiplying again, often years or decades after chickenpox. The characteristic rash, itching, and pain of shingles is the result.
The older the person, the greater the risk of developing shingles. It is also more common in people whose immune system is compromised, like people with HIV, people who must take corticosteroids, and people on chemotherapy. Physical and mental stress can increase the likelihood of shingles, but in many cases there’s no indication of why it occurs.
Increasing Rates of Shingles Have Been Reported Worldwide
Researchers in several places across the globe have noticed an increase in the rate of shingles over the past 20 years or so. It isn’t simply that there are more elderly people, because the rate has gone up, from 4.7 episodes per 1,000 person-years in 1997 to 5.7 episodes per 1,000 person-years in 2013.
As the demographic bulge comprised of the Baby Boomers reaches retirement age, an increase in shingles cases is to be expected simply due to there being more people at risk due to advanced age. But the increase appears to go beyond what can be accounted for by simple demographic shifts.
Shingles Rates Are Actually Decreasing in Young Children
In the youngest children, ages 0 to 9, the rate of shingles has actually decreased by 50% since 2004. The biggest increases in adult shingles rates have occurred in the 40 to 49 age group and the 60 to 69 age group, though rates for people over age 80 remain the highest of any age group.
The drop in rates of shingles in young children is believed to be due to increasingly widespread vaccination against chickenpox, while the increase in rates of shingles in adults is believed to be due to autoimmune diseases, an increase in the number of people who have had transplants (and must take drugs that compromise the immune system to prevent organ rejection) along with the natural increase in risk due to an aging immune system.
Chicken Pox Vaccines Are Not Believed to Be at Fault
One early theory on why shingles rates were increasing was a belief that widespread chickenpox vaccination reduced people’s natural immunity to VZ, but that theory has been debunked. For one thing, shingles rates in adults started going up before the chickenpox vaccine was introduced in many places. Moreover, once the chickenpox vaccine became widely used, the rate of shingles in adults did not increase any faster than it had before. Finally, in countries that don’t have routine chickenpox vaccination, similar increases in shingles rates have resulted.
A Shingles Vaccine Exists
In the US, a shingles vaccine is available to adults age 50 and older. However, the CDC recommends that people wait until age 60 if possible, because immunity wears off after several years. If you experience symptoms of shingles, including general malaise, tingling under the skin, or eruption of sores along the ribcage or the side of the face, taking antiviral medication as soon as possible can keep the severity of the outbreak to a minimum and help reduce the chances of complications from shingles. To learn more about shingles and the other herpes viruses and their treatments, we encourage you to look through our blog content.
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