4 Surprising Things About the Zombie Virus Behind Shingles

It’s possible that you haven’t heard much about shingles (also called zoster) or are fuzzy on what it is exactly. The painful, blistering rash strikes fear into the hearts of many in the over-50 crowd, but it’s important for everyone to understand what shingles is and how to protect yourself from it (hint: the vaccine is a must).

What is shingles?

In short, shingles is one of the two illnesses — the other being chickenpox — caused by the varicella-zoster virus, which is in the herpesvirus family.

“Shingles gives you a rash that is very, very painful, and people often need strong pain medications for it,” says Anna Wald, MD, a UW School of Medicine professor of medicine, epidemiology and laboratory medicine and pathology. “It’s one of the more disabling conditions among the elderly.”

Because the virus usually affects one group of nerves, only the skin served by those nerves breaks out. As a result, the rash usually forms a band on one side of the body or affects one side of the face. In people with weakened immune systems, however, the rash can spread across the body.

For younger folks, a shingles rash typically heals after a few weeks without lasting effects, but the risk of more serious complications increases with age.

“In some people, it causes long-term pain at the site that can last for months or years,” says Wald.

And though shingles is not technically curable, treatments exist to help you manage the discomfort and heal faster. Your doctor may give you antiviral drugs, and in some cases, add a short dose of steroids to reduce inflammation (which usually contributes to pain). You can also treat mild to moderate pain with over-the-counter pain relievers. More severe pain often requires prescription pain medications.

How is it related to chickenpox?

So, how exactly does a single virus cause shingles and chickenpox? Initially, even researchers had difficulty identifying the connection between the two infections because they are quite different.

Well, the first time you’re infected with the varicella-zoster virus, it shows up as chickenpox. Like other herpesviruses, once you’re infected with it, it lives inside of you for the rest of your life. Yikes. As you get older and your immune system stops working as well, the virus can reactivate and come back as shingles (anyone else getting serious zombie vibes?) This happens to about 1 in 3 adults. Once you hit your 80s, you have a 50% chance of getting shingles without a vaccine.

In 1995, they came out with a chickenpox vaccine, which, it turns out, also indirectly protects against shingles since it prevents the varicella-zoster virus from ever infecting you. So, if you got the chickenpox vaccine, you are unlikely to be at risk for shingles as you get older.

But if you have never had chickenpox or the chickenpox vaccine, you can catch chickenpox if you are exposed to someone who has shingles — the virus is still contagious. So, the rule of thumb: Don’t touch people’s blisters (duh) and get your vaccine. Also, it’s important to keep immunocompromised people (even if they are immunized or have had chickenpox) and infants away from anyone with shingles, since babies don’t get their first chickenpox vaccination until they’re 12 months old. Sometimes even close contact, not just touching, can result in passing the infection.

Who usually gets shingles?

If you have the varicella-zoster virus living in your body from previously having chickenpox, you’re more likely to get shingles as you get older and your immune system gets weaker.

“If you’re in your 80s, your chances of getting shingles are much higher than in your 50s,” says Wald. “And the probability that you’ll get chronic pain with it also increases as you get older.”

But age isn’t the only factor: Some younger folks also get shingles, especially those who are immunocompromised or those who have undergone a transplant or have another condition. And sometimes? You just get unlucky and get shingles, even if you’re younger; though again, it is more likely to be mild and short-lasting. Unfortunately, getting shingles once doesn’t make you immune to getting it again.

What’s the deal with the shingles vaccine?

Luckily, a shingles vaccine now exists called Shingrix, which is more than 90% effective in preventing shingles. Right now, the Centers for Disease Control and Prevention (CDC) recommends two doses of the shingles vaccine for adults 50 years and older (which is generally covered by insurance), regardless of whether you’ve already had shingles or the chickenpox vaccine. They also recommend the vaccine for adults aged 19 years and older who have weakened immune systems.

But why do you have to wait until 50? Shouldn’t we all just get the vaccine now?

“I’ve had people say that to me,” says Wald. “It’s a very unpleasant vaccine to get; I had a very sore arm and didn’t feel well for several days after getting that vaccine.”

But the main reason everyone hasn’t run right out to get this vaccine is that there just isn’t solid research yet on how long the vaccine lasts. Waiting until 50 targets the years when the risk of shingles starts to rise steeply.

What are some surprising things about the shingles virus?

Aside from its zombielike talent for coming back to life, here are more fascinating facts about shingles:

If you’ve never had chickenpox as a kid, you can still get it as an adult

If you haven’t had chickenpox, you can’t get shingles because the virus isn’t in your body. But you can catch chickenpox from someone with chickenpox or shingles if you’re not immune.

If you’re vaccinated against chickenpox, however, you’re mostly protected from catching chickenpox from someone with chickenpox or shingles — so make sure you’ve done that. (Confusing, we know.) However, the vaccine does not protect you 100%, so you still may want to reduce your exposure.

Or, if you actually had chickenpox, then you’re protected against catching it again. But the chickenpox virus now lies dormant in your body, and it can cause shingles if it reactivates. Creepy? Yes. Which is exactly why you need to get the shingles vaccine to reduce your risk of the virus reactivating and becoming shingles.

Quick tip: You should really try to avoid getting chickenpox as an adult by getting vaccinated, because the virus can be more serious than when you’re a kid and lead to pneumonia and hospitalization.

Shingles increases your risk for stroke

In the weeks to months after you’ve had shingles, you are at a temporarily increased risk of stroke. According to Wald, your risk is even higher if your shingles rash is on your face. The reason? The virus can actually infect and damage the blood vessels in the brain, which predisposes you to a stroke.

The shingles vaccine may help with dementia

On the plus side? Over the last few years, several studies have shown that if you’re vaccinated for shingles, your risk of dementia is about 15% to 25% lower, depending on the study. It’s not super clear why — it could be that the vaccine prevents shingles, and shingles contributes to dementia, or even that the vaccine just stimulates your immunity and slows down the dementia process.

“We don’t quite understand the mechanism of it yet,” says Wald. “But given that zoster can lead to stroke and other problems with the central nervous system, it might be a direct effect, so if you vaccinate, you’re actually reducing your risk of dementia.”

Shingles can affect your vision and hearing

Wald emphasizes that shingles is a serious disease that can cause many issues. For example, if it’s on your face, it can also affect your eyes and occasionally cause vision loss. And shingles near the ear can cause Ramsay Hunt syndrome, a neurological condition that can lead to hearing loss, facial weakness and balance issues. Deep breaths — these complications aren’t common but can be serious, especially for people who are immunocompromised.

Understanding shingles and its risks is important. Getting vaccinated can protect both your health and the health of people in your life who might be vulnerable.