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Jingles disease. Shingles: Understanding Symptoms, Causes, and Effective Treatments

by alexxlab

What are the key symptoms of shingles. How is shingles diagnosed and treated. What causes shingles to develop. Who is at risk for developing shingles. How can shingles be prevented. What are the potential complications of shingles. How long does shingles typically last.

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What is Shingles and How Does it Develop?

Shingles, also known as herpes zoster, is a viral infection caused by the reactivation of the varicella-zoster virus (VZV) – the same virus responsible for chickenpox. After a person recovers from chickenpox, the virus can lie dormant in nerve tissues for years before potentially reactivating as shingles.

The Centers for Disease Control and Prevention (CDC) estimates that approximately 1 in 3 people in the United States will develop shingles during their lifetime. While shingles can occur at any age in individuals who have previously had chickenpox, it is most common in people over 50 years old.

How does shingles spread?

Shingles itself is not contagious, but the varicella-zoster virus can be transmitted from a person with active shingles to someone who has never had chickenpox or been vaccinated against it. In such cases, the exposed person would develop chickenpox, not shingles.

Recognizing the Symptoms of Shingles

Shingles typically affects a single sensory nerve ganglion and the skin area it supplies, usually on one side of the body. Common locations include the waist, chest, abdomen, or back, but symptoms can also appear on the face, eyes, mouth, and ears.

What are the most common symptoms of shingles?

  • A constant dull, burning, or gnawing pain, or sharp, stabbing pain that comes and goes
  • A skin rash resembling chickenpox, but limited to specific areas
  • Fluid-filled blisters that develop as part of the rash
  • Fever, fatigue, and chills
  • Headache and upset stomach

The progression of shingles symptoms typically follows this pattern:

  1. Pain, tingling, numbness, and itching in a specific area of skin
  2. After 1-2 weeks, a rash appears with red blotches and itchy, fluid-filled blisters
  3. Blisters may merge, forming a solid red band resembling a severe burn

Can shingles affect internal organs?

While less common, shingles can affect internal organs without causing a visible rash. Research has shown evidence of shingles in the digestive system, potentially leading to gastrointestinal dysfunction, and in brain arteries, which may increase the risk of stroke and dementia.

Diagnosing and Treating Shingles

Early diagnosis and treatment of shingles are crucial for managing symptoms and reducing the risk of complications. Healthcare providers typically diagnose shingles based on the characteristic rash and symptoms, but may also perform tests to confirm the presence of the varicella-zoster virus.

What treatments are available for shingles?

Treatment for shingles often includes a combination of antiviral medications and pain management strategies:

  • Antiviral drugs: Acyclovir, valacyclovir, or famciclovir to reduce the severity and duration of the outbreak
  • Pain relievers: Over-the-counter or prescription medications to manage pain
  • Topical treatments: Calamine lotion or capsaicin cream to soothe the skin
  • Cool compresses: To reduce inflammation and provide relief

In some cases, corticosteroids may be prescribed to reduce inflammation and pain, particularly for older adults or those with severe symptoms.

Preventing Shingles: Vaccination and Risk Reduction

The most effective way to prevent shingles is through vaccination. Two vaccines are currently available for shingles prevention:

  • Shingrix: A recombinant zoster vaccine recommended for adults 50 years and older
  • Zostavax: A live zoster vaccine, now largely replaced by Shingrix due to its higher efficacy

Who should get the shingles vaccine?

The CDC recommends Shingrix vaccination for adults 50 years and older, including those who:

  • Have previously had shingles
  • Have received the Zostavax vaccine in the past
  • Are unsure if they have had chickenpox

Individuals with weakened immune systems should consult their healthcare provider before receiving the vaccine.

Complications Associated with Shingles

While many people recover from shingles without long-term effects, some may experience complications, especially if left untreated or if treatment is delayed.

What are the potential complications of shingles?

  • Postherpetic neuralgia (PHN): Persistent pain lasting months or years after the rash has healed
  • Vision problems: If shingles affects the eye (herpes zoster ophthalmicus)
  • Hearing and balance issues: When shingles impacts the ear (Ramsay Hunt syndrome)
  • Skin infections: Bacterial infections of the shingles rash
  • Neurological complications: In rare cases, encephalitis or meningitis

Prompt treatment can significantly reduce the risk of these complications, emphasizing the importance of early medical intervention.

Living with Shingles: Managing Symptoms and Recovery

Coping with shingles can be challenging, but there are several strategies to manage symptoms and promote recovery:

  • Rest and reduce stress to support the immune system
  • Wear loose-fitting, natural fiber clothing to minimize skin irritation
  • Apply cool, wet compresses to soothe the rash
  • Take lukewarm baths with colloidal oatmeal to relieve itching
  • Eat a balanced diet rich in vitamins and minerals to support healing

How long does shingles typically last?

The duration of a shingles outbreak can vary, but most cases follow this general timeline:

  1. Prodromal stage (before the rash appears): 1-5 days
  2. Active stage (rash and blisters): 7-10 days
  3. Healing stage: 2-4 weeks for most people, though some may experience longer recovery periods

It’s important to note that some individuals may experience postherpetic neuralgia, which can persist for months or even years after the rash has healed.

Shingles in Special Populations: Considerations and Risks

While shingles can affect anyone who has had chickenpox, certain groups may be at higher risk or require special considerations:

How does shingles affect pregnant women?

Pregnant women who develop shingles generally do not experience increased complications, and the risk to the fetus is low. However, antiviral treatment should be discussed with a healthcare provider to ensure safety during pregnancy.

What are the concerns for immunocompromised individuals?

People with weakened immune systems, such as those undergoing chemotherapy or living with HIV, are at higher risk of developing shingles and may experience more severe symptoms. They may also be more prone to complications and require careful monitoring and treatment.

How does age impact shingles risk and severity?

The risk of developing shingles increases with age, particularly after 50. Older adults are also more likely to experience severe symptoms and complications, such as postherpetic neuralgia. This underscores the importance of vaccination for older populations.

Emerging Research and Future Directions in Shingles Management

Ongoing research continues to expand our understanding of shingles and improve treatment options:

  • Development of new antiviral medications with improved efficacy and fewer side effects
  • Investigation of novel pain management techniques for postherpetic neuralgia
  • Exploration of the potential link between shingles and increased risk of stroke and heart attack
  • Research into the long-term effectiveness of the Shingrix vaccine and potential need for booster doses

What promising treatments are on the horizon for shingles?

Researchers are exploring several innovative approaches to shingles treatment and prevention:

  • Gene therapy to target the dormant varicella-zoster virus
  • Immunomodulatory therapies to enhance the body’s natural defenses against viral reactivation
  • Nanotechnology-based drug delivery systems for more effective antiviral treatment
  • Development of therapeutic vaccines to treat active shingles infections

These advancements hold promise for improving outcomes and quality of life for individuals affected by shingles.

The Impact of Shingles on Quality of Life and Mental Health

Beyond its physical symptoms, shingles can significantly impact a person’s quality of life and mental well-being:

How does shingles affect daily life and productivity?

The pain and discomfort associated with shingles can interfere with sleep, work, and daily activities. Many individuals report decreased productivity and may need to take time off work during the acute phase of the illness.

What are the psychological effects of shingles?

Living with shingles, particularly when complications like postherpetic neuralgia occur, can lead to:

  • Anxiety and depression
  • Social isolation due to pain or embarrassment about the rash
  • Chronic fatigue and irritability
  • Decreased overall quality of life

Support groups and counseling can be beneficial for individuals struggling with the emotional impact of shingles.

Understanding shingles, its symptoms, and available treatments is crucial for early intervention and improved outcomes. By recognizing the signs of shingles and seeking prompt medical attention, individuals can minimize the risk of complications and speed up their recovery. Vaccination remains the most effective preventive measure, especially for older adults and those at higher risk. As research continues to advance, we can look forward to more effective treatments and management strategies for this challenging condition.

Shingles: Symptoms, treatment, and causes

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Shingles is a viral infection that results from the varicella-zoster virus (VZV), the same virus that causes chickenpox. It typically affects a single sensory nerve ganglion and the skin surface that the nerve supplies.

Anyone who has had chickenpox can later develop shingles.

In fact, according to the Centers for Disease Control and Prevention (CDC), an estimated 1 in 3 people in the United States develop shingles during their lifetime.

People can develop shingles if they had chickenpox in the past. This virus can lie dormant for years, and then reactivate as shingles. A person who has not had chickenpox before can get chickenpox through exposure to someone with shingles.

Shingles is most common after the age of 50, but it can appear at any age if a person has previously had chickenpox.

In this article, learn more about shingles, including symptoms, complications, and treatments.

Shingles usually affects one side of the body. This is most often the waist, chest, abdomen, or back. Symptoms can also appear on the face and in the eyes, mouth, ears. The virus can also affect some internal organs.

Shingles typically affects a single sensory nerve ganglion near the spinal cord, called a dorsal root ganglion. This is why the symptoms occur in specific areas of the body, rather than all over it. The pain results from nerve involvement, rather than the rash itself.

Symptoms can vary in nature, depending on where on the body they appear.

Some people have pain but no rash. Others may have a rash with pain that is accompanied by other symptoms, such as fever, chills, or headache.

Most common symptoms

Some of the most common symptoms of shingles include:

  • a constant dull, burning, or gnawing pain, or a sharp, stabbing pain that comes and goes
  • a skin rash that resembles a chickenpox rash but only affects certain areas
  • fluid-filled blisters that develop as part of the rash

Symptoms on the body

A blistering skin rash may appear in one or more distinct bands with sensory nerves of the skin, called dermatomes.

Common locations for this include:

  • the chest
  • the abdomen
  • the back
  • around the waist

It usually occurs only on one side of the body.

The location of the symptoms will depend on which dermatome distribution the virus affects.

Facial symptoms

If the rash affects the face, symptoms usually appear on one side only — usually around one eye and the forehead.

They can include:

  • pain over the affected dermatome
  • a rash
  • muscle weakness
  • headache

Eye symptoms

If the virus affects an ophthalmic nerve, it means that a person has herpes zoster ophthalmicus (HZO).

This can cause pain, redness, and swelling in and around the eye, as well as temporary or permanent loss of vision.

Ear symptoms

Shingles can also occur in or around the ear, leading to problems with balance and hearing, as well as muscle weakness on the affected side of the face.

These changes can be long-term or even permanent.

A person who develops symptoms in or around the ears and eyes should seek immediate medical attention to reduce the risk of complications.

Mouth symptoms

If shingles affects the mouth, a person may experience:

  • facial tenderness
  • pain in the mouth
  • toothache
  • lesions in hard and soft palate tissues

The pain and discomfort of these symptoms can make it difficult to eat or drink.

Internal shingles

Shingles can also affect the internal organs. There will not be a rash, but other problems can arise.

For example, researchers have found evidence of shingles in the digestive system, which can lead to gastrointestinal dysfunction, and in the arteries in the brain, which may increase the risk of stroke and dementia.

Other symptoms

There may also be other symptoms, including:

  • fever
  • fatigue
  • chills
  • headache
  • upset stomach

Symptom progression

Symptoms typically progress as follows:

  • Pain, tingling, numbness, and itching start to affect a specific part of the skin.
  • After up to 2 weeks, a rash appears.
  • Red blotches and itchy, fluid-filled blisters develop and continue to do so for 3–5 days.
  • The blisters may merge, forming a solid red band that looks similar to a severe burn. The gentlest touch may be painful.
  • Inflammation may affect the soft tissue under and around the rash.
  • After 7–10 days, the blisters gradually dry up and form scabs or crusts. As the blisters disappear, they may leave minor scarring.

Shingles usually lasts around 2–4 weeks. It is contagious until the blisters dry up and crust over.

Most people will only have an episode of shingles once, but it can recur in some people.

When to see a doctor

Getting treatment shortly after the onset of symptoms can help decrease the duration and severity of infection.

This is especially important for people over 60 and those who have a weakened immune system, as this could increase the risk of developing serious complications.

If the rash continues spreading to other parts of the body or other symptoms occur, such as high fever, it is best to consult with a doctor.

Additionally, those who develop a rash near the eye should seek immediate medical attention, as this can be a sign of HZO. The condition can cause scarring, vision loss, and permanent eye damage if left untreated.

A doctor may prescribe antiviral drugs to stop the virus from multiplying.

Antiviral treatment can help with:

  • reducing the severity and duration of symptoms
  • preventing complications from developing
  • lowering the risk of the rash coming back

In addition to antiviral drugs, there are several other ways to help manage symptoms, including:

  • using pain relief medication
  • reducing stress as much as possible
  • eating regular, nutritious meals
  • getting some gentle exercise
  • wearing loose fitting clothes for comfort
  • doing relaxing activities that will reduce stress and take a person’s mind off the pain, such as watching television, reading books, socializing, listening to music, or engaging in hobbies

To relieve itching, the CDC recommends:

  • applying calamine lotion
  • taking a lukewarm, oatmeal bath
  • placing a cool, damp washcloth on the blisters

Calamine lotion is available for purchase online.

Learn more home remedies for itching here.

Most people will recover with home treatment, but a person should seek medical help if other symptoms appear, such as a fever. Around 1–4% of people will need to spend time in the hospital due to complications.

Shingles results from VZV, the same virus that causes chickenpox. After a person recovers from chickenpox, the virus remains dormant in the sensory ganglia of their cranial nerve or the dorsal root ganglia within the peripheral nervous system.

VZV belongs to a group of viruses called herpes viruses. This is why shingles also has the name “herpes zoster.”

All herpes viruses can hide in the nervous system, where they can remain indefinitely in a latent state.

Under the right conditions, the herpes zoster virus can reactivate, similarly to waking up from hibernation, and travel down nerve fibers to cause a new active infection.

What triggers this is not usually clear, but it may happen when something weakens the immune system, prompting the virus to reactivate.

It is not possible to directly transmit shingles to another person. However, a person who has never had chickenpox can contract the virus by coming into direct contact with the fluid in the blisters of a person who currently has shingles.

If this happens, and the person has not received a vaccination against chickenpox, they would develop chickenpox first, not shingles.

Shingles does not spread through coughing or sneezing. Only direct contact with fluid from the blisters can spread the virus. Therefore, covering the blisters reduces the risk of contagion.

It is important to note that the virus is only active from when the blisters first appear to when they dry up and crust over. Transmission is not possible before the blisters develop or after the crusts form. If a person does not develop blisters, the virus cannot spread in the traditional sense.

Taking the following precautions can help prevent the transmission of the virus:

  • covering the rash
  • washing the hands often
  • avoiding touching or scratching the rash

It is also important for someone with shingles to avoid contact with:

  • infants who are preterm or have a low birth weight
  • pregnant people who have never had chickenpox or the vaccine for it
  • those with a weakened immune system

Doctors usually diagnose shingles through a physical exam by evaluating the appearance of the rash and blisters on the body.

In some cases, they may collect a tissue sample from the fluid of the blisters and send it to a lab to check if the virus is present.

They may also conduct a blood test to look for antibodies, which can determine whether a person has ever been exposed to the virus.

Vaccination can offer protection from both chickenpox and shingles.

For children: Chickenpox vaccine

Experts recommend routine immunization with the varicella vaccine (chickenpox vaccine) during childhood.

With two doses of the vaccine, there is at least a 90% chance of preventing chickenpox. Preventing chickenpox will also prevent shingles.

Children should receive the first dose at 12–15 months. The second dose is at 4–6 years.

Tests have shown the vaccine to be safe, though some children may experience:

  • pain at the injection site
  • a fever and a mild rash
  • temporary joint pain and stiffness

Since vaccination started in children, the number of shingles cases has dropped.

Are vaccines safe or not? Learn more here.

Also, click here to learn more about the brands of childhood chickenpox vaccines.

For older adults: Shingles vaccine

A different vaccine, the herpes zoster vaccine, is available for people aged 50 and older who have had chickenpox and therefore carry VZV. Experts also recommend this vaccine for those who have not had chickenpox or shingles.

In the U.S., 99.5% of people born before 1980 already have this virus in their system. The herpes zoster vaccine can help prevent shingles in people who already have the virus.

The options available are Zostavax and a newer vaccine called Shingrix.

After two doses of Shingrix, a person will have more than 90% protection against shingles, falling to just above 85% after 4 years, according to the CDC.

Who should not have the vaccine?

People who should not have the shingles vaccine without first discussing it with their doctor include those who:

  • have an allergy to any component of the shingles vaccine
  • have a weakened immune system
  • are or might be pregnant

Although anyone who has had chickenpox can develop shingles, some people may be at a higher risk.

Possible risk factors and triggers include:

  • older age
  • certain cancers or cancer treatment options
  • HIV
  • treatments that suppress the immune system
  • stress or trauma

Complications

Rarely, complications can arise — especially in people with an impaired immune system.

Possible complications of shingles include:

  • postherpetic neuralgia (PHN)
  • inflammation of the brain or spinal cord, increasing the risk of stroke, encephalitis, and meningitis
  • eye and vision problems
  • weakness
  • problems with balance and hearing
  • damage to blood vessels, which could lead to stroke
  • pneumonia

According to the CDC, around 10–18% of people who have shingles will develop PHN, a long-term complication in which the pain of a shingles rash lasts long beyond the rash itself.

It is more likely to occur if a person develops shingles after the age of 40, and the risk continues to increase with age.

In people with weak immune systems

People with a weakened immune system will have a higher risk of developing shingles and of experiencing severe symptoms and complications.

This includes people who:

  • have cancer, especially leukemia or lymphoma
  • have HIV
  • have undergone an organ transplant
  • are taking medications to suppress the immune system, including chemotherapy drugs

These people should seek medical attention as soon as possible if they have concerns about shingles-related symptoms.

What other precautions should a person take if they have a weak immune system? Find out here.

Anyone who has had chickenpox can develop shingles.

Most people make a full recovery from shingles within 3–5 weeks, but some experience severe complications. Those most at risk are people with a weakened immune system.

Getting the varicella vaccination during childhood can prevent both chickenpox and shingles. For those who did not have the vaccination in childhood, vaccines against shingles are available.

People aged 50 and older should talk to their doctor about the shingles vaccination.

Shingles: Symptoms, treatment, and causes

We include products we think are useful for our readers. If you buy through links on this page, we may earn a small commission Here’s our process.

Medical News Today only shows you brands and products that we stand behind.

Our team thoroughly researches and evaluates the recommendations we make on our site. To establish that the product manufacturers addressed safety and efficacy standards, we:

  • Evaluate ingredients and composition: Do they have the potential to cause harm?
  • Fact-check all health claims: Do they align with the current body of scientific evidence?
  • Assess the brand: Does it operate with integrity and adhere to industry best practices?

We do the research so you can find trusted products for your health and wellness.

Read more about our vetting process.

Was this helpful?

Shingles is a viral infection that results from the varicella-zoster virus (VZV), the same virus that causes chickenpox. It typically affects a single sensory nerve ganglion and the skin surface that the nerve supplies.

Anyone who has had chickenpox can later develop shingles.

In fact, according to the Centers for Disease Control and Prevention (CDC), an estimated 1 in 3 people in the United States develop shingles during their lifetime.

People can develop shingles if they had chickenpox in the past. This virus can lie dormant for years, and then reactivate as shingles. A person who has not had chickenpox before can get chickenpox through exposure to someone with shingles.

Shingles is most common after the age of 50, but it can appear at any age if a person has previously had chickenpox.

In this article, learn more about shingles, including symptoms, complications, and treatments.

Shingles usually affects one side of the body. This is most often the waist, chest, abdomen, or back. Symptoms can also appear on the face and in the eyes, mouth, ears. The virus can also affect some internal organs.

Shingles typically affects a single sensory nerve ganglion near the spinal cord, called a dorsal root ganglion. This is why the symptoms occur in specific areas of the body, rather than all over it. The pain results from nerve involvement, rather than the rash itself.

Symptoms can vary in nature, depending on where on the body they appear.

Some people have pain but no rash. Others may have a rash with pain that is accompanied by other symptoms, such as fever, chills, or headache.

Most common symptoms

Some of the most common symptoms of shingles include:

  • a constant dull, burning, or gnawing pain, or a sharp, stabbing pain that comes and goes
  • a skin rash that resembles a chickenpox rash but only affects certain areas
  • fluid-filled blisters that develop as part of the rash

Symptoms on the body

A blistering skin rash may appear in one or more distinct bands with sensory nerves of the skin, called dermatomes.

Common locations for this include:

  • the chest
  • the abdomen
  • the back
  • around the waist

It usually occurs only on one side of the body.

The location of the symptoms will depend on which dermatome distribution the virus affects.

Facial symptoms

If the rash affects the face, symptoms usually appear on one side only — usually around one eye and the forehead.

They can include:

  • pain over the affected dermatome
  • a rash
  • muscle weakness
  • headache

Eye symptoms

If the virus affects an ophthalmic nerve, it means that a person has herpes zoster ophthalmicus (HZO).

This can cause pain, redness, and swelling in and around the eye, as well as temporary or permanent loss of vision.

Ear symptoms

Shingles can also occur in or around the ear, leading to problems with balance and hearing, as well as muscle weakness on the affected side of the face.

These changes can be long-term or even permanent.

A person who develops symptoms in or around the ears and eyes should seek immediate medical attention to reduce the risk of complications.

Mouth symptoms

If shingles affects the mouth, a person may experience:

  • facial tenderness
  • pain in the mouth
  • toothache
  • lesions in hard and soft palate tissues

The pain and discomfort of these symptoms can make it difficult to eat or drink.

Internal shingles

Shingles can also affect the internal organs. There will not be a rash, but other problems can arise.

For example, researchers have found evidence of shingles in the digestive system, which can lead to gastrointestinal dysfunction, and in the arteries in the brain, which may increase the risk of stroke and dementia.

Other symptoms

There may also be other symptoms, including:

  • fever
  • fatigue
  • chills
  • headache
  • upset stomach

Symptom progression

Symptoms typically progress as follows:

  • Pain, tingling, numbness, and itching start to affect a specific part of the skin.
  • After up to 2 weeks, a rash appears.
  • Red blotches and itchy, fluid-filled blisters develop and continue to do so for 3–5 days.
  • The blisters may merge, forming a solid red band that looks similar to a severe burn. The gentlest touch may be painful.
  • Inflammation may affect the soft tissue under and around the rash.
  • After 7–10 days, the blisters gradually dry up and form scabs or crusts. As the blisters disappear, they may leave minor scarring.

Shingles usually lasts around 2–4 weeks. It is contagious until the blisters dry up and crust over.

Most people will only have an episode of shingles once, but it can recur in some people.

When to see a doctor

Getting treatment shortly after the onset of symptoms can help decrease the duration and severity of infection.

This is especially important for people over 60 and those who have a weakened immune system, as this could increase the risk of developing serious complications.

If the rash continues spreading to other parts of the body or other symptoms occur, such as high fever, it is best to consult with a doctor.

Additionally, those who develop a rash near the eye should seek immediate medical attention, as this can be a sign of HZO. The condition can cause scarring, vision loss, and permanent eye damage if left untreated.

A doctor may prescribe antiviral drugs to stop the virus from multiplying.

Antiviral treatment can help with:

  • reducing the severity and duration of symptoms
  • preventing complications from developing
  • lowering the risk of the rash coming back

In addition to antiviral drugs, there are several other ways to help manage symptoms, including:

  • using pain relief medication
  • reducing stress as much as possible
  • eating regular, nutritious meals
  • getting some gentle exercise
  • wearing loose fitting clothes for comfort
  • doing relaxing activities that will reduce stress and take a person’s mind off the pain, such as watching television, reading books, socializing, listening to music, or engaging in hobbies

To relieve itching, the CDC recommends:

  • applying calamine lotion
  • taking a lukewarm, oatmeal bath
  • placing a cool, damp washcloth on the blisters

Calamine lotion is available for purchase online.

Learn more home remedies for itching here.

Most people will recover with home treatment, but a person should seek medical help if other symptoms appear, such as a fever. Around 1–4% of people will need to spend time in the hospital due to complications.

Shingles results from VZV, the same virus that causes chickenpox. After a person recovers from chickenpox, the virus remains dormant in the sensory ganglia of their cranial nerve or the dorsal root ganglia within the peripheral nervous system.

VZV belongs to a group of viruses called herpes viruses. This is why shingles also has the name “herpes zoster.”

All herpes viruses can hide in the nervous system, where they can remain indefinitely in a latent state.

Under the right conditions, the herpes zoster virus can reactivate, similarly to waking up from hibernation, and travel down nerve fibers to cause a new active infection.

What triggers this is not usually clear, but it may happen when something weakens the immune system, prompting the virus to reactivate.

It is not possible to directly transmit shingles to another person. However, a person who has never had chickenpox can contract the virus by coming into direct contact with the fluid in the blisters of a person who currently has shingles.

If this happens, and the person has not received a vaccination against chickenpox, they would develop chickenpox first, not shingles.

Shingles does not spread through coughing or sneezing. Only direct contact with fluid from the blisters can spread the virus. Therefore, covering the blisters reduces the risk of contagion.

It is important to note that the virus is only active from when the blisters first appear to when they dry up and crust over. Transmission is not possible before the blisters develop or after the crusts form. If a person does not develop blisters, the virus cannot spread in the traditional sense.

Taking the following precautions can help prevent the transmission of the virus:

  • covering the rash
  • washing the hands often
  • avoiding touching or scratching the rash

It is also important for someone with shingles to avoid contact with:

  • infants who are preterm or have a low birth weight
  • pregnant people who have never had chickenpox or the vaccine for it
  • those with a weakened immune system

Doctors usually diagnose shingles through a physical exam by evaluating the appearance of the rash and blisters on the body.

In some cases, they may collect a tissue sample from the fluid of the blisters and send it to a lab to check if the virus is present.

They may also conduct a blood test to look for antibodies, which can determine whether a person has ever been exposed to the virus.

Vaccination can offer protection from both chickenpox and shingles.

For children: Chickenpox vaccine

Experts recommend routine immunization with the varicella vaccine (chickenpox vaccine) during childhood.

With two doses of the vaccine, there is at least a 90% chance of preventing chickenpox. Preventing chickenpox will also prevent shingles.

Children should receive the first dose at 12–15 months. The second dose is at 4–6 years.

Tests have shown the vaccine to be safe, though some children may experience:

  • pain at the injection site
  • a fever and a mild rash
  • temporary joint pain and stiffness

Since vaccination started in children, the number of shingles cases has dropped.

Are vaccines safe or not? Learn more here.

Also, click here to learn more about the brands of childhood chickenpox vaccines.

For older adults: Shingles vaccine

A different vaccine, the herpes zoster vaccine, is available for people aged 50 and older who have had chickenpox and therefore carry VZV. Experts also recommend this vaccine for those who have not had chickenpox or shingles.

In the U.S., 99.5% of people born before 1980 already have this virus in their system. The herpes zoster vaccine can help prevent shingles in people who already have the virus.

The options available are Zostavax and a newer vaccine called Shingrix.

After two doses of Shingrix, a person will have more than 90% protection against shingles, falling to just above 85% after 4 years, according to the CDC.

Who should not have the vaccine?

People who should not have the shingles vaccine without first discussing it with their doctor include those who:

  • have an allergy to any component of the shingles vaccine
  • have a weakened immune system
  • are or might be pregnant

Although anyone who has had chickenpox can develop shingles, some people may be at a higher risk.

Possible risk factors and triggers include:

  • older age
  • certain cancers or cancer treatment options
  • HIV
  • treatments that suppress the immune system
  • stress or trauma

Complications

Rarely, complications can arise — especially in people with an impaired immune system.

Possible complications of shingles include:

  • postherpetic neuralgia (PHN)
  • inflammation of the brain or spinal cord, increasing the risk of stroke, encephalitis, and meningitis
  • eye and vision problems
  • weakness
  • problems with balance and hearing
  • damage to blood vessels, which could lead to stroke
  • pneumonia

According to the CDC, around 10–18% of people who have shingles will develop PHN, a long-term complication in which the pain of a shingles rash lasts long beyond the rash itself.

It is more likely to occur if a person develops shingles after the age of 40, and the risk continues to increase with age.

In people with weak immune systems

People with a weakened immune system will have a higher risk of developing shingles and of experiencing severe symptoms and complications.

This includes people who:

  • have cancer, especially leukemia or lymphoma
  • have HIV
  • have undergone an organ transplant
  • are taking medications to suppress the immune system, including chemotherapy drugs

These people should seek medical attention as soon as possible if they have concerns about shingles-related symptoms.

What other precautions should a person take if they have a weak immune system? Find out here.

Anyone who has had chickenpox can develop shingles.

Most people make a full recovery from shingles within 3–5 weeks, but some experience severe complications. Those most at risk are people with a weakened immune system.

Getting the varicella vaccination during childhood can prevent both chickenpox and shingles. For those who did not have the vaccination in childhood, vaccines against shingles are available.

People aged 50 and older should talk to their doctor about the shingles vaccination.

The Moscow transport jingle will be determined on the Active Citizen portal

Moscow

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A single melody-jingle will be introduced in the salons and carriages of Moscow public transport – it should become a hallmark of the capital’s carriers. Muscovites themselves will choose from five options using the Active Citizen electronic voting platform. Over eight years of operation, this digital service has become a key instrument of civil society in Moscow, an important channel of communication between citizens and authorities. And definitely the most convenient way to get the opinion of Muscovites.

Photo: gazeta-borisovskie-prudi.ru

Almost 22,000 people have already taken part in choosing the best tune for Moscow transport on the evening of June 22, and the survey is just beginning. The popularity of the topic is not surprising: it is a musical phrase that every public transport passenger in Moscow will hear every day, and more than once. This means that this music will someday be inserted into films to create the atmosphere of Moscow in the 2020s. It is for her that we and our children will be nostalgic decades later.

Ten years ago, there was simply no reliable way to not only choose the best option “expertly”, but also to enlist popular support. Now in Moscow such a tool – incredible for the very recent past – exists in the form of the Active Citizen portal. Created immediately after the introduction of the federal and Moscow State Services portals with their clear personalization of accounts, this mechanism has become over the years one of the main communication bridges between citizens and the city government system in the capital. And this is a key mechanism for the formation of a mature, constructive civil society in the metropolis.

After the end of the voting, the winning melody will be recorded in autoinformers of all types of public transport in Moscow. It will precede important information messages, and this, according to transport workers, will help people better navigate the flow of audio information. However, the jingles of subways, trains, trams, buses and electric buses will differ in sound. In addition, it is these sounds that will greet customers of the Deptrans call center and will be included in the official applications of Moscow transport.

How it works

In April of this year, after the selection of the melody was announced, more than 150 songs were submitted to the selection committee. Under the terms of the competition, jingles should reflect Moscow transport as a cultural phenomenon, refer to cinema, literature, and be associated with warm childhood memories. But at the same time, it was necessary to emphasize the speed and innovativeness of transport. An expert jury worked on the initial screening, which formed a short list of the five best options.

Other similar public discussions on the Active Citizen platform work in a similar way. To the attention of the townspeople – and the number of those who voted can reach many hundreds of thousands of people – the options selected at the stage of preliminary examination are offered. This is how, with the initial abundance of offers, you can objectively choose the best.

As a recent example, in June, through Active Citizen, Muscovites chose a name for a landscaped square in the Presnensky District: it received the actual name of the square of the Donetsk People’s Republic. Earlier this year, more than 200,000 people took part in voting on the so-called parklets – summer verandas for cafes and restaurants equipped in parking spaces. 61% of those who voted supported this idea, suggesting more than 7,000 new places for installing parklets, including at Patriarch’s and Chistye Prudy. And every year, before the season of Christmas trees, Muscovites on the portal approve the layout of Christmas tree disposal points.

Active Citizen is often used to select the names of transport facilities and other toponyms. So, at the end of last year, a voting was launched on the portal, during which Muscovites chose names for 28 streets, boulevards and metro stations on promising lines. It was the Active Citizen users who approved the name “Ploshad treh vokzalov” (Three Station Square) for the MCD station (before the reconstruction it was called “Kalanchevskaya”), and the name of the Big Circle Line was fixed in this form. More than 235 thousand people took part in this vote, it became one of the most popular.

Moscow transport uses the Active Citizen service especially intensively – in some cases, ground transport routes are discussed with the help of this portal. And when the activities of street musicians in the subway were streamlined in the capital (the project “Music in the Metro”), it was the townspeople who became the people’s artistic council, choosing the best performers.

All this, of course, could be done in the traditional way – focusing on expert assessments and conducting sociological research. But the first of these methods does not guarantee taking into account the opinion of the townspeople, and the second one is not efficient enough. Only such a digital tool for direct interaction between citizens and authorities, such as Active Citizen, allows working in this area at a new qualitative level, involving millions of people in city management.

6 million active citizens

The Active Citizen project started exactly eight years ago, in 2014. The meaning of this service from the very beginning was to provide the possibility of direct electronic voting of Muscovites on various issues. To do this, the most transparent technologies were chosen with the possibility of accurate verification of users and a filter by place of residence up to a specific house. This strategy made it possible to create an accurate and operational tool for finding out people’s preferences.

Currently, Active Citizen has more than 6 million users – this figure, the creators of the service proudly note, is comparable to the population of New Zealand. Over the past year, the number of Muscovites registered in this system has increased by more than 800,000 people. Over the years of work on Active Citizen, 5,399 votes have taken place, in which almost 190 million votes have been cast. It is estimated that in the traditional way (appeals to the “paper” and electronic receptions of the government of Moscow), such a number of votes would have to be collected for 72 years.

More than 3,400 decisions made on the portal were taken for execution and implemented. This means that 30 to 40 decisions passed through Active Citizen are implemented every month; by decision per day! At the same time, we are talking only about those issues that are within the competence of the capital’s executive power and comply with the current regulatory framework. As a result of discussions and voting in Active Citizen, laws of the city of Moscow were adopted (this was the case, for example, with a ban on the sale of alcoholic energy drinks), as well as resolutions of the Moscow government and departmental decisions.

Many of the development programs that Muscovites have come to love in recent years are closely linked to the work of Active Citizen. This is, for example, “Million Trees” – it is on the portal that residents of a particular area decide where landscaping will take place and which tree species from those proposed by dendrologists will be used. Over the nine seasons of the program, more than 11,000 Moscow courtyards were planted with greenery, and more than 1.1 million trees and shrubs were planted. No less active were voting on the My Street project (Muscovites approved the projects of 48 streets), and now My District.

At Active Citizen, Muscovites improved and approved the standard of the Moscow polyclinic, which our city is now rightfully proud of. There are also temporary discussions on the portal, but important for people – for example, school graduates choose through the portal artists who will perform at the city graduation ball in Gorky Park.

Over the years, the functionality of the service has been improved and its reliability has increased. Thus, in 2016, auditors from PricewaterhouseCoopers (PwC) confirmed that there were no elements suspicious in terms of voting integrity on the portal. And in 2017, AG switched to blockchain technology, being the first of the Moscow city portals and services to master a new level of transparency.

The popularity of the platform is also facilitated by the fact that it is very easy to take part in voting. To do this, it is enough to log in to the ag.mos.ru portal using a verified account of the city mos.ru or Gosuslug. An accurate indication of the place of residence will make it possible to take part in polls and voting for a particular area. And really active citizens, who often take part in voting, receive bonus points that can be redeemed in the bonus store.

Given that Active Citizen has been developing subsidiary projects in recent years, such as the Electronic House apartment building management system, Million Prize incentive programs, the popularity of the platform will only grow. And this means that this service has won its place in urban life firmly and for a long time.

The modern metropolis is such a complex matter in the spatial and social sense that it is impossible to manage it with the old methods, simply by ensuring impeccable discipline in city services and departments. It is necessary not only to take into account the opinion of the inhabitants of the city, but to do it constantly, almost in real time. The fact that this has become possible thanks to Active Citizen and other metropolitan digital services is the main reason for the managerial flexibility due to which Moscow is better than most other megacities in the world in navigating such turbulence zones as the recent coronavirus pandemic. This means that, armed with modern tools of civil society, we will overcome other difficulties on the way to building the city of the future.

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Authors:

Government of the Russian Federation
Moscow
Donetsk People’s Republic
New Zealand

Published in the Moskovsky Komsomolets newspaper No. 28810 dated June 24, 2022

Newspaper headline:
Choose, so with music

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