Chickenpox and shingles: speed of diagnosis critical, says April International UK

Most people have had chickenpox – usually when they are children, and sometimes they are deliberately exposed to it, the main reason being because it is thought to be preferable to have chickenpox early on in life so children can build up an immunity to the infection. It is thought to be less painful when you go through the infection at a young age, and with little or no damage to health. For example, men who are exposed to chickenpox later on in life can suffer from reduced fertility. However, after you have had chickenpox, the varicella zoster virus remains in nerve cells in your spinal cord for life.

Normally, the virus lies dormant and doesn't cause any problems. But if your immune system, which normally protects your body against infection, is weakened, the virus can become active again. If this happens, it causes shingles. Shingles can be very painful and dangerous, particular if the rash occurs near an eye.

Shingles can affect you at any age - one in four people are affected by it at some point in their life - but it's more common in the elderly. Shingles isn't infectious in the same way as chickenpox, where the virus can be passed on to other people by coughs and sneezes. However, the virus can be passed on by direct contact with fluid from shingles blisters, until they dry up and crust over. This can cause chickenpox in people who aren't already immune to it. People with shingles should avoid contact with people who have a lowered immunity, babies or pregnant women.

The first sign of shingles is usually excessively sensitive, tingling or burning skin where the shingles rash subsequently appears. The area is often painful. At the same time, you may experience fever, headache and enlarged lymph nodes. A rash develops a few days later, which usually appears as a band, following the route of a nerve supply to the skin. At first, the rash consists of small red spots and reddened skin in the same area. The spots then turn into small blisters, which dry up after a few days and gradually form scabs. Once the scabs have fallen off, a small pock-mark may be left.

A common complication of shingles is pain in the area of the rash that persists after the rash has disappeared, called post-herpetic neuralgia. People with intractable post-herpetic pain often become depressed. Post-herpetic neuralgia is more likely to occur the older you are.
Often the symptoms of shingles are mild and no medical treatment is needed. However, if you recognise the symptoms of shingles developing early on, go and see your GP as soon as possible. Early treatment can make the symptoms less severe, and reduce your risk of complications.
Urgent medical treatment is required if the following symptoms of shingles develop:
• high fever
• confusion
• loss of memory
• exhaustion
• severe headache
• any symptoms affecting the eye area

The shingles virus can be treated with antiviral medication. Painkillers can relieve the pain, while calamine lotion should help to reduce the itching.
Shingles that affects the eyes requires antiviral therapy and urgent referral to an ophthalmologist as the eyesight can be permanently damaged if the infection is not recognized and treated very quickly..
If someone with a weakened immune system is exposed to shingles they are usually referred to hospital for possible intravenous antiviral therapy, as they're at very high risk of complications from chickenpox. They may be offered an injection of immunoglobulin or antiviral antibodies.

This doesn't prevent the disease, but may reduce the length and severity of the infection, and the risk of complications. The sooner immunoglobulin is given, the more effective it is likely to be. It must be given within 96 hours to have a significant effect.
The treatment of post-herpetic neuralgia can involve painkillers, capsaicin cream and, if necessary, specific antidepressants.
Pregnant women who have never had chickenpox, people with a weakened immune system or newborn babies who are exposed to the chickenpox or shingles virus can be given an injection of antibodies that may stop chickenpox developing. The sooner this is given after exposure to the virus, the more likely it is to work.

Commenting on the infection, Debbie Purser, CEO at April International UK said: “Both chickenpox and shingles are inextricably linked, and so those lucky enough to build up a strong immunity at an early age will hopefully avoid a repetition of the infection later in life. However, as the virus stays within the body, everyone can suffer from Shingles, should their immune system be weakened later on in life through, for example, prolonged periods of stress. Look out for any of the symptoms and see your GP straightaway, if you are worried. April International UK’s policyholders are covered for all aspects of Shingles treatment and our 24 hour helpline may be an important element in helping to identify Shingles near to an eye, for example. Our priority is to look after the health of our policyholders and to avoid the infection from getting any worse. A critical part of this is speed of response and our helpline can respond rapidly, wherever you are in the world.