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Close Encounters of the Microbial Kind


Shingles (herpes zoster) is a condition that arises as a result of the reactivation of the varicella zoster virus (VZV) following a previous chickenpox infection. The re-activated virus then infects the region of the skin that is supplied by the nerve it’s been inhabiting resulting in a painful rash and itchy blisters. Pain during, and prior to, the rash is common, and other symptoms can include fever, headache, malaise or fatigue. The whole episode usually lasts 2–4 weeks. Complications of shingles can arise, and these are more likely in the elderly or in those who are immunocompromised. The most common is postherpetic neuralgia which affects 20–70% of shingles sufferers over the age of 50 years and can last for months or years. Up to 20% of cases affect the eye resulting in a condition known as “herpes zoster ophthalmicus” that can cause ulceration and permanent scarring of the cornea and glaucoma. Treatment of shingles is usually focussed on relieving the pain and itching that accompany the disease. However, anti-viral agents such as acyclovir can be given to sufferers in at-risk groups, including those over the age of 50 years, or those with significant symptoms. Anti-viral drugs are most effective if given within 72 h of the rash starting. Those with shingles can transmit VZV to others, and this can cause chickenpox in those without immunity to the virus. Effective vaccines against shingles are available and are administered to those over 50 years of age in many countries.

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Wilson, M., Wilson, P.J.K. (2021). Shingles. In: Close Encounters of the Microbial Kind. Springer, Cham.

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