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 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.

In an older person or someone on chemotherapy, for instance, the virus can reactivate and travel to the skin. The result: pain, itching, a blistering rash on one side of the face or chest, headache, and fever. The rash usually lasts a week or two but can linger a month or more.

“You want to be aware of shingles because 20 percent of people will get it at some time,” warns Susan J. Rehm, M.D., an infectious disease expert in Cleveland.

An antiviral drug can treat shingles. “The sooner we see you, the better,” Dr. Rehm says. “If you suspect symptoms of shingles, call your doctor right away and don’t scratch the blisters. The infection can spread.”

Possible complications

In some cases, shingles can lead to pneumonia or postherpetic neuralgia, a disorder of nerve fibers and skin that causes severe burning, stabbing pain for months.

A shingles vaccine is available for people 60 and older, even if they didn't have chickenpox. The vaccine is not approved for younger people. The vaccine is at least 50 percent effective. “According to data, the effectiveness of the vaccine is reduced as age increases,” Dr. Rehm says.

The vaccine can cost about $150 a dose. It’s covered under Medicare Part D—if you do some legwork. Your doctor writes a prescription for the vaccine. After your pharmacist fills the prescription, you take the vaccine to your doctor to be injected.