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Shingles and chickenpox (Varicella-zoster virus) - Highlights

Description

An in-depth report on the causes, diagnosis, treatment, and prevention of shingles and chickenpox.

Alternative Names

Chicken pox; Herpes zoster; Postherpatic neuralgia

Highlights:

Chickenpox Vaccine Recommendations

The CDC recommends the following chickenpox (varicella) vaccination schedules for:

  • Children ages 12 months - 12 years. All healthy children should receive their first chickenpox shot at age 12 - 15 months and a second shot at age 4 - 6 years (preferably before entering pre-kindergarten, kindergarten, or first grade).
  • Adolescents and Adults ages 13 years and older. All healthy teenagers and adults who have never had chickenpox or the vaccine should receive 2 doses of the varicella vaccine, given 4 - 8 weeks apart.

Shingles Vaccine Recommendations

The CDC recommends the shingles (varicella-zoster) vaccine (Zostavax) for all adults age 60 years and older who have healthy immune systems. Zostavax is not approved for people younger than age 60.

Home Remedies for Chickenpox Relief

Chickenpox is uncomfortable and unpleasant, but most cases are relatively mild and resolve within 7 - 10 days. In otherwise healthy people who have a low risk for complications, home remedies can help provide relief from itching and fever.

  • Oatmeal baths can help relieve itching.
  • Calamine lotion can help dry out blisters and soothe skin.
  • Acetaminophen (Tylenol) can help reduce fever.
  • Antihistamines may relieve severe itching and aid sleep.

Most important, donâ ' t scratch! Scratching the blisters can cause scarring and lead to a secondary infection.

Resources

References

Advisory Committee on Immunization Practices. Recommended adult immunization schedule: United States, 2009. Ann Intern Med. 2009 Jan 6;150(1):40-4.

American Academy of Pediatrics Committee on Infectious Diseases. Prevention of varicella: recommendations for use of varicella vaccines in children, including a recommendation for a routine 2-dose varicella immunization schedule. Pediatrics. 2007 Jul;120(1):221-31.

American Academy of Pediatrics Committee on Infectious Diseases. Recommended immunization schedules for children and adolescents -- United States, 2007. Pediatrics. 2007 Jan;119(1):207-8.

Centers for Disease Control and Prevention (CDC). A new product (VariZIG) for postexposure prophylaxis of varicella available under an investigational new drug application expanded access protocol. MMWR Morb Mortal Wkly Rep. 2006 Mar 3;55(8):209-10.

Centers for Disease Control and Prevention (CDC); Advisory Committee on Immunization Practices (ACIP). Update: recommendations from the Advisory Committee on Immunization Practices (ACIP) regarding administration of combination MMRV vaccine. MMWR Morb Mortal Wkly Rep. 2008 Mar 14;57(10):258-60.

Chaves SS, Gargiullo P, Zhang JX, Civen R, Guris D, Mascola L, et al. Loss of vaccine-induced immunity to varicella over time. N Engl J Med. 2007 Mar 15;356(11):1121-9.

Davis MM, Marin M, Cowan AE, Guris D, Clark SJ. Physician attitudes regarding breakthrough varicella disease and a potential second dose of varicella vaccine. Pediatrics. 2007 Feb;119(2):258-64.

Harpaz R, Ortega-Sanchez IR, Seward JF; Advisory Committee on Immunization Practices (ACIP) Centers for Disease Control and Prevention (CDC). Prevention of herpes zoster: recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Recomm Rep. 2008 Jun 6;57(RR-5):1-30.

Kimberlin DW, and Whitley RJ. Varicella-zoster vaccine for the prevention of herpes zoster. N Engl J Med. 2007 Mar 29;356(13):1338-43.

Marin M, GĂĽris D, Chaves SS, Schmid S, Seward JF; Advisory Committee on Immunization Practices, Centers for Disease Control and Prevention (CDC). Prevention of varicella: recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Recomm Rep. 2007 Jun 22;56(RR-4):1-40.

Marin M, Meissner HC, Seward JF. Varicella prevention in the United States: a review of successes and challenges. Pediatrics. 2008 Sep;122(3):e744-51.

Myers MG, Seward JF, LaRussa PS. Varicella-zoster virus. In: Kliegman RM, Behrman RE, Jenson HB, Stanton BF, eds. Kliegman: Nelson Textbook of Pediatrics. 18th ed. Saunders; 2007:chap 250.

Quan D, Hammack BN, Kittelson J, Gilden DH. Improvement of postherpetic neuralgia after treatment with intravenous acyclovir followed by oral valacyclovir. Arch Neurol. 2006 Jul;63(7):940-2.

Sampathkumar P, Drage LA, Martin DP. Herpes zoster (shingles) and postherpetic neuralgia. Mayo Clin Proc. 2009 Mar;84(3):274-80.

Strangfeld A, Listing J, Herzer P, Liebhaber A, Rockwitz K, Richter C, et al. Risk of herpes zoster in patients with rheumatoid arthritis treated with anti-TNF-alpha agents. JAMA. 2009 Feb 18;301(7):737-44.

Tyring SK. Management of herpes zoster and postherpetic neuralgia. J Am Acad Dermatol. 2007 Dec;57(6 Suppl):S136-42.

Urman CO and Gottlieb AB. New viral vaccines for dermatologic disease. J Am Acad Dermatol. 2008 Mar;58(3):361-70.

Whitley RJ, Gnann JW Jr. Herpes zoster in the age of focused immunosuppressive therapy. JAMA. 2009 Feb 18;301(7):774-5.

Woolery WA. Herpes zoster virus vaccine. Geriatrics. 2008 Oct;63(10):6-9.

  • Reviewed last on: 5/21/2009
  • Harvey Simon, MD, Editor-in-Chief, Associate Professor of Medicine, Harvard Medical School; Physician, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
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