What is herpes zoster?
Herpes zoster, also known colloquially as shingles, is a viral disease triggered by the varicella-zoster virus (VZV). This virus causes another disease in addition to herpes zoster. The well-known chickenpox. It is the first infection caused by the virus. The means that when a person first gets infected with the viruses, he develops the disease chickenpox. However, after this childhood disease has cleared, the viruses remain dormant in the spinal ganglia. The viruses can remain inactive for a lifetime or break out again as herpes zoster. This can even be the case years to decades after chickenpox. The awakening viruses then spread along the nerve tracts and cause inflammation of the affected nerve tissue. The respective skin areas form the characteristic rashes of herpes zoster.
How contagious is herpes zoster?
It is important to know that herpes zoster can only be contracted by people who have had chickenpox before. The causative pathogens are the same. This is also important to know when talking about about the risk of infection. You cannot be susceptible to herpes zoster if you have never had chickenpox and have not been vaccinated against the pathogen.
How is herpes zoster transmitted?
Herpes Zoster cannot be passed on by an aerogenic droplet infection , which means that you do not become infected by coughing or sneezing at an infected person. VZV is transmitted through direct contact with the fluid of the vesicles. This usually happens via the smear infection. If a healthy person touches the blisters and their fluid or objects that have previously been contaminated by the infected person , they become infected.
How long is herpes zoster contagious?
From the appearance of the typical skin blisters until they have completely healed or crusted over, you are considered contagious. This usually takes about five to seven days. People with chickenpox, on the other hand, are already contagious one to two days before the rash develops. However, it takes just as long as with herpes zoster, namely until the blisters have completely healed and crusted over.
What are the symptoms of herpes zoster?
The symptoms vary greatly from case to case, so it is not possible to name any uniform symptoms. However, it can be said that the symptoms of herpes zoster follow a specific pattern.
During the early phase of the disease, there are not yet any exact symptoms. Those affected mostly complain of fatigue, aching limbs, mild fever and headache. These symptoms are also familiar from a normal flu infection. Over time, however, sensations such as skin tingling, occur in certain areas of the skin. After about three days, this tingling changes to pain and the characteristic skin rash forms.
The pain is felt before, during and often after the rash. The viruses attack the nerve pathways, which is why this is called neuropathic pain. These usually occur in a high intensity of pain. They can also cause stinging and burning . Many sufferers are left with post-herpetic neuralgia .
The characteristic feature of herpes zoster is clearly the skin rash. It usually starts with vague redness on the affected areas of the skin. Small skin nodules form, which develop into small itchy skin blisters within a few hours. At the beginning, these are still filled with a clear liquid, but become cloudy as the disease progresses. This phase lasts for about five days . Then the blisters slowly start to burst open and after two to ten days they dry out. Crusts form, which, when they fall off , make the whole rash disappear.
How is herpes zoster diagnosed?
Patients with suspected herpes zoster either go to a dermatologist or to their family doctor. If the eye area or ear area is affected , it is advisable to visit either the ophthalmologist or the ear, nose and throat specialist . Herpes zoster can be diagnosed by a doctor for the most part without problems. On the basis of the medical history and the physical examination, there is hardly any doubt. To rule out other diseases with symptoms similar to , herpes zoster can also be reliably detected in the following two ways:
- Direct detection: The VZV can be directly detected with the help of a wound swab by a PCR test. A cell culture can also provide direct detection.
- Indirect detection: The blood of the affected person is tested for specific VZV antibodies. If the brain is affected, an examination of the cerebrospinal fluid is necessary.
How is herpes zoster treated?
The painful symptoms and the unpleasant itching can be relieved by medication. For example, paracetamol or ibuprofen can be taken to relieve the pain. If the need arises, the doctor can also prescribe stronger medication to relieve the pain . Depending on the stage of the rash, the itching can be reduced with tinctures and ointments. Some medications or preparations can also ensure that the blisters dry out more quickly. In addition to all the symptomatic treatment measures, patients also receive causal treatment. Those affected are given antiviral drugs that fight the VZV in the body.
What complications can arise from herpes zoster?
As a rule, herpes zoster runs its course without complications. However, in some, rare cases, the following complications can occur:
- In a secondary bacterial infection, patients also become infected with bacteria in the already damaged skin area.
- Sensory disturbances and signs of paralysis occur in the affected skin region.
- Brain inflammations as well as meningitis develop when herpes zoster affects the central nervous system.
- In generalised herpes zoster, the entire body, including the internal organs, is infected with the virus.
People with an immune deficiency
are particularly susceptible to such complications. These include patients with cancer or AIDS. The
generalised herpes zoster are also particularly feared here.
How can herpes zoster be prevented?
People, who have never been infected with VZV in their lives, can have vaccinated against this pathogen. This not only protects against the childhood disease chickenpox, but also against a subsequent herpes zoster infection.