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The question

I'm a healthy thirtysomething man and recently had shingles. I thought it was something that elderly people get – but so many people my age are sharing their awful experiences. What's the deal with shingles?

The answer

Shingles are caused by the varicella zoster virus, the same bug behind chicken pox. After an episode of chicken pox clears up, the virus remains dormant in the body but can come back later as shingles.

Shingles cause a painful and itchy rash that can affect any part of the body, but often appear as a single strip of blisters on one side of the body or face. In the initial stages of shingles, there may not be a rash but there can be pain, numbness or tingling in the affected area. Often when the rash isn't present, shingles can be mistaken for other conditions such as muscle strain or a kidney or lung infection.

Even if it's not there at first, a red blistering rash can develop after the onset of pain and be accompanied by fever, chills, general aches and fatigue.

A person with shingles is contagious and can pass the virus on to anyone who is not immune to chicken pox (i.e. anyone who hasn't had it before), which can be especially dangerous for those with weak immune systems, newborns and pregnant women.

While shingles isn't life-threatening in healthy individuals, it can be very painful and lead to long-term symptoms such as chronic pain and vision problems (if the outbreak is near the eyes). Early detection and quick treatment can minimize the chances of long-term effects.

The reason shingles occur is not entirely clear, but in the majority of cases it's the result of a weakened immune system from conditions such as chronic disease, cancer, HIV or overwhelming stress. Some medications can suppress the immune system and thus be a contributing factor to contracting shingles. For this reason, it is important that younger people who've had shingles see their doctor to investigate why their immune system was weakened in the first place and to rule out serious illnesses.

Historically, shingles has mainly affected people over 60, but there does seem to be an increase in younger, healthy individuals getting the disease.

There is some thought that this is due in part to the introduction of the chicken pox vaccine. The vaccine has been very effective at reducing the number of chicken pox cases and by extension, is expected to limit shingles cases in the future.

However, for those who had chicken pox before the rollout of the vaccine (young adults in their 20s and 30s specifically), they are being exposed to the virus less. The result is that their immune response to the virus decreases over time, which results in more cases of shingles later in life.

There is currently a shingles vaccine (Zostavax) that is approved for people over 60 to help prevent this disease because it can cause significant illness and pain in older individuals. The vaccine is not available to younger adults because they tend to recover faster from shingles, although there is discussion to introduce it to this age group in the future.

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