How the Contagious Shingles Virus is Transmitted

By Victoria Clayton. Medically reviewed by Tom Iarocci, MD. May 7th 2016

It is one of the most commonly transmitted viruses.

Shingles is a peculiar and extremely painful, localized skin rash that’s tantamount to receiving a surprise attack from a long-forgotten enemy. Caused by the varicella zoster virus, the same virus that causes chicken pox, shingles may catch up to you years after transmission.

“When you get chicken pox or the immunization for chicken pox, you acquire the varicella zoster virus in your nervous system, and it stays there forever,” explains pediatrician Anne A. Gershon, MD, director of the division of Pediatric Infectious Diseases at Columbia University Medical Center in New York City.

Once you’ve had chicken pox, you may eventually come down with shingles. Trouble is, there’s plenty of misunderstanding about how this virus (which causes both chicken pox and shingles) is transmitted.

Note: If you haven’t had chicken pox as a child or have not been immunized against it, someone with a shingles rash can transmit the virus to you, but you’ll get chicken pox, not get shingles -- at least not in the short term.

In roughly one out of every three people in the U.S., shingles crops up literally decades after having chicken pox. 

How Is the Shingles Virus Transmitted?

The shingles virus and the chicken pox virus are one and the same – both are the varicella zoster virus. Shingles can’t be passed from one person to another, but the varicella zoster virus can, especially if you aren’t immune to it.

The varicella zoster virus is generally transmitted during childhood through the respiratory system. A child would inhale the virus from a sick person’s sneeze, for instance, or from chicken pox particles in the air. The virus would then infect the tonsils and lymph nodes, get picked up by the white blood cells and spread all over the body, thereby causing chicken pox.  

Shingles can erupt years later, possibly due to your aging immune system and to environmental factors. Its oozy, open lesions contain the active viruses. The sores break down and become moist and inflamed, explains Gershon. They are highly contagious.

When the virus aerosolizes or becomes airborne, it enters through the respiratory tract of someone who is susceptible.

“Varicella zoster is one of the most contagious viruses we know,” says Gershon. “It’s transmitted when someone with chicken pox or shingles scratches the lesions, and the virus gets in the air.” Shingles is not quite as infectious as chicken pox, she adds.

If you’ve had chicken pox or the immunization for chicken pox, you already have varicella zoster in your nervous system. (Even if you’re in the same room with someone with the rash, there’s no risk of further transmission.)

Do Vaccines Help Prevent Shingles?

Vaccines do help prevent shingles, and getting vaccinated is important not just to prevent shingles itself but because there may be a link between shingles and stroke or heart attack risk. The Centers for Disease Control and Prevention recommends all adults 50 and older get the shingles vaccine.

Getting inoculated with the chicken pox vaccine as part of your normal childhood vaccinations is vital for future health. “The immunization for chicken pox prevents severe chicken pox, which means you don’t run the risk of life-threatening complications like staph infections or encephalitis that occasionally crops up with chicken pox,” Gershon says.

Research from the Children’s Hospital of Philadelphia Vaccine Education Center also notes that the chicken pox vaccine weakens the zoster virus and may help reduce outbreaks of shingles in the future. 

Next Steps

  • Since shingles lesions do become inflamed and airborne, some experts recommend covering the rash and avoiding tight clothes or irritating adhesives.
  • Don’t try topical antibiotics unless your doctor recommends them. Most practitioners recommend simply keeping the area clean and dry.  
  • Ask your doctor about prescribing antivirals, which can accelerate healing. Also ask about Zostavax, the shingles vaccine approved for people over age 50. “It’s safe and hastens healing, but it’s only about 50-percent effective,” Gershon adds.

For Caregivers

  • If you’re looking after a loved one, steer clear of anyone who has not had chicken pox or been immunized against it if you possibly can. And parents should get their children vaccinated for chicken pox as soon as possible.
  • The Centers for Disease Control and Prevention warns, “More than 95 percent of adults have been exposed to varicella zoster, which means you pose no risk. Infants and young children who have not been immunized are the primary concern.”

Related Articles

Shingles and Chickenpox During Pregnancy

Shingles Complications and Health Risks

Shingles (Herpes Zoster) Symptoms and Treatments

Sources

Gershon A.A., MD, varicella zoster researcher and director of the Division of Pediatric Infectious Diseases at Columbia University Medical Center in New York City. http://www.columbia.edu/cu/pedsid/agershon.html. Interviewed May 2014.
Dworkin R.H., MD, et al. “Recommendations for the Management of Herpes Zoster.” Oxford Journal of Clinical Infectious Diseases; 44 (Supp. 1): page 1-26.   http://cid.oxfordjournals.org/content/44/Supplement_1/S1.long#sec-6. Accessed May 2014.
Children’s Hospital of Philadelphia. “A Look at Each Vaccine: Varicella (Chickenpox) Vaccine.” http://www.chop.edu/service/vaccine-education-center/a-look-at-each-vaccine/varicella-chickenpox-vaccine.html. Accessed June 2014.
Centers for Disease Control and Prevention. “CDC Recommends Shingles Vaccine.” http://www.cdc.gov/media/pressrel/2008/r080515.htm. Accessed May 2014.
Immunization Action Coalition. “Varicella Questions and Answers.” http://www.immunize.org/catg.d/p4202.pdf. Accessed May 2014.
Centers for Disease Control and Prevention. “Protect Yourself Against Shingles: Get Vaccinated.” http://www.cdc.gov/features/shingles/. Accessed May 2014. 

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