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Shingles Disease Overview

 

The Virus

The Varicella Zoster Virus (VZV) is a herpes virus and member of the sub-family Alphaherpesviridae.¹ Humans (and some higher primates) are the only long term host of a pathogen of an infectious disease.¹ VZV is one virus that causes two diseases, chickenpox and shingles. Primary VZV infection results in chickenpox (varicella) usually affecting children and young adults. Once the clinical symptoms of varicella have resolved, the VZV remains dormant in the nervous system of the infected person (virus latency).² In some individuals, the VZV reactivates in later life, resulting in the clinical manifestation of shingles (herpes zoster). Therefore, a susceptible individual (chickenpox naive) can be infected with varicella (chickenpox) as it is the primary virus, but they cannot be infected with herpez zoster (shingles) - this condition only occurs when the VZV is reactivated in the body. Susceptible individuals (chickenpox naive) may also be infected and develop chickenpox by coming into contact with an individual with shingles, as the fluid filled vesicles associated with shingles contain VZV.³

References

1. Bernard Roizman, The family Herpesviridae – A brief introduction. Fields virology. 19961.
2. Koyuncu O et al. Cell Host Microbe. 2013 Apr; 13(4):379-3932.
3. Immunisation against infectious disease, Department of Health. Varicella – Ch. 281.
4. Plotkin, S.A et al. Vaccines. (6th ed.) Philadelphia: Saunders- Elsevier; 2013. p. 837-69.
5. Arvin A. Aging, Immunity, and the Varicella–Zoster Virus. N Engl J Med. 2005; 352(22): 2266-2267.
6. Immunisation against infectious disease, Department of Health. Shingles (herpes zoster) – Ch. 28a.
7. Gnann JW Jr, Whitley RJ. Clinical practice. Herpes zoster. N Engl J Med. 2002;347:340-6.
8. Meister W et al. Demography, symptomatology, and course of disease in ambulatory zoster patients. A physician-based survey in Germany. Intervirology 1998;41:272-7.
9. Dworkin RH, Schmader K. The epidemiology and natural history of herpes zoster and post herpetic neuralgia. Pain Research & Clinical Management. 2001;11:39-64.
10. Shaikh, S. Evaluation and Management of Herpes Zoster Ophthalmicus. American Family Physician. 2002;1.
11. Gauthier et al. Epidemiology and costs of herpes zoster and postherpetic neuralgia in the United Kingdom. Epidemiol infecti. 2009 137 38-472.
12. Johnson RW. Zoster associated pain: what is known, who is at risk and how can it be managed? Herpes 2007:14 (s2):30A-34A.
13. Dworkin RH et al. Recommendations for the Management of Herpes Zoster. Clinical Infectious Diseases. 2007;44:S1-26.
14. Johnson WJ and Dworkin RH Treatment of herpes zoster and post-herpetic neuralgia. BMJ 2003 326 748-750.
15. NHS Choices: http://www.nhs.uk/Conditions/Shingles/Pages/Treatment.aspx.
16. NHS Choices: http://www.nhs.uk/Conditions/postherpetic-neuralgia/Pages/Treatment.aspx.
17. Johnson RW. Zoster-associated pain: what is known, who is at risk and how can it be managed? Herpes 2001;14 Suppl 2:30-42.

Useful links

Shingles Aware
Shingles Aware is a website developed, funded and maintained by MSD.

PHE Shingles Programme

PHE Shingles Vaccine Coverage Rate data

Green Book

Supporting documentation

Prescribing Information | Summary of Product Characteristics | Patient Information Leaflet

GB-CIN-00055 | Date of Preparation: April 2019