Shingles

Shingles (herpes zoster) is a viral disease that develops when the chickenpox virus, which becomes dormant in certain nerves after causing acute illness, is somehow reactivated. The distinguishing feature of shingles is a painful rash that develops along the pathway of a nerve in which the virus has lain dormant.

Among people who have had chickenpox, only a small proportion ever develop shingles. The disease is relatively uncommon before age ten, but its incidence increases steadily with each decade of life. Fewer than one percent of people who develop shingles will have a relapse.

Several factors, including stress, injury and weakening of the immune system, increase children's susceptibility to shingles.

Normally, shingles runs its course within a few weeks and causes no serious long-term complications. The symptoms are most severe in a child whose immune system is compromised.

WHEN SHOULD I SUSPECT THAT MY CHILD HAS SHINGLES?
Shingles is very uncommon in healthy children; rashes are much more likely to be due to allergic reactions or skin irritation than to reactivation of the chickenpox virus at this age. However, you should suspect shingles if the rash was preceded by a flulike illness and pain along the nerve pathway. Look also for the distinguishing features of a shingles outbreak—namely, painful, blisterlike lesions appearing in a clear-cut line, on only one side of the body.

WHAT HAPPENS DURING A SHINGLES OUTBREAK?
Flulike symptoms and pain often precede the outbreak by several days. The rash begins as red spots which quickly turn into blisters. Five to ten days later, the blisters fill with pus, dry up and scab over. Fever, pain and tenderness usually continue through this progression. Without treatment, new crops of blisters will appear for up to a week and the rash will persist for three to five weeks. The pain may last for months.

IS MEDICAL ATTENTION NECESSARY?
Yes. Medication can be given to reduce the severity of a shingles episode. A doctor also should perform a thorough workup to see if some underlying condition has made the child susceptible to shingles.

HOW CAN THE PEDIATRICIAN TELL IF MY CHILD HAS SHINGLES?
Because the shingles rash has unique characteristics, the doctor will be able to identify it by sight.

WHAT TREATMENTS ARE AVAILABLE?
Although there is no cure, the antiviral drug acyclovir, taken by mouth or injection, can shorten the outbreak and lessen its severity. Acetaminophen in appropriate doses for the child's age and weight may help reduce pain. Local applications of wet compresses or calamine lotion also can be helpful.

PREVENTING SHINGLES
Since a varicella vaccine has been developed and approved, its use in immunization schedules will reduce the incidence not only of chicken pox but shingles as well.

Excerpt from THE DISNEY ENCYCLOPEDIA OF BABY & CHILD CARE, © 1995 DSH Communications, Inc. This material is based on current medical research and, to the best of the editors' knowledge and understanding, is accurate and valid. However the reader should not use information contained in this material to alter a medically prescribed regimen or as a form of self-treatment, without seeking the advice of a licensed physician.