Herpes-zoster (Shingles)

Page last updated: 08 November 2016

Herpes-zoster (Shingles) is a painful blistering rash caused by reactivation of the varicella zoster virus – the same virus that causes chickenpox. The shingles rash occurs when the dormant chickenpox virus is reactivated in the nerve tissue, causing inflammation of the nerves. Sometimes pain in the affected region can be severe and prolonged. When it lasts more than 3 months it is called post herpetic neuralgia (PHN). Other less common complications may include scarring, skin infections, loss of vision or hearing, pneumonia, or neurological complications.

Causes

Once you have had chickenpox, the virus can stay in your nervous system for many years. For reasons that are not fully understood, the virus may become active again and give you shingles. Shingles can spread through direct contact with an uncovered rash. 1 in 3 people will develop shingles in their lifetime. As a person gets older, the risk of getting shingles and PHN increases.

Symptoms

Initial symptoms of shingles can include headache, fever, flu like symptoms and malaise (general feeling of uneasiness). A stinging or burning sensation may appear on the affected area before the appearance of the skin rash (normally within 1-2 days of the initial symptoms).

The rash is commonly on the trunk or body but can also appear on the face or other parts of the body and can be quite painful, causing a tingling or burning sensation. It creates a stripe or belt like pattern on the affected area and is usually limited to one side of the body. The rash forms small blisters which fill with a liquid and burst before the skin crust over and heals.

Although most people recover within a few weeks, some go on to develop chronic nerve pain called post herpectic neuralgia. This may be severe and can sometimes go on for months.

Prevention

Shingles is a vaccine preventable disease. Immunisation against shingles is achieved by a dose of the Zostavax® vaccine which can be given to adults 50 years and over.

National Shingles Vaccination Program

The shingles vaccine is provided free for people aged 70 years under the National Immunisation Program. There is also a five year catch-up program for people aged 71 – 79 years until 31 October 2021. To receive the immunisation visit your local doctor or vaccination provider. It is important to note that although the vaccine is provided at no cost, a consultation fee may apply.

Routine vaccination of persons aged 70–79 years is expected to obtain the greatest benefits against shingles and its complications. Further information is provided in the online version of The Australian Immunisation Handbook 10th edition.

People who are not eligible to receive the free vaccine are able to purchase the vaccine on the private market.

Vaccinations don’t stop at childhood. Ask your general practitioner or vaccination provider about other vaccines you may be eligible for.

A range of resources, including posters and factsheets on the National Shingles Vaccination Program are available on the Immunise Australia Publications & Resources website.