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Is Shingles Contagious?
Q: I have a two-year-old in my nursery who was diagnosed with shingles. What do I tell the other parents? And is it contagious? Everyone thinks it's the plague.
A: This is NOT the plague, although people like to stay away as if it is. The same virus that causes chickenpox causes shingles (also known as zoster). In fact, for a person to get shingles, they usually have had chickenpox before. After a case of chickenpox, the virus tends to hang around in the body along certain nerve roots. Then for some unknown reason, it comes to life moving along the nerve causing the raised, bubbly, reddened rash that you can see. Shingles tends to be in a specific distribution as it follows the path a nerve does. It most often appears on the trunk, on one side of the body, and usually is not painful (unlike in adults).
Shingles can occur with any child at any age, but is more common after ten years of age. It is spread by direct contact with the rash, which differs from the respiratory spread of chickenpox. This rash tends to crust over and dry up over a week's time, if not sooner, just like chickenpox. Complications are rare, although sometimes the rash can become superinfected with bacteria germs. We do get a bit more concerned when it is on the face, particularly about the eye.
As long as all the kids in the nursery have normal immune systems that can fight exposure to infections well, I would not be overly alarmed. Zoster is contagious only to those people who have not had chickenpox or the chickenpox vaccine. The course of this disease is usually mild and the prognosis good. However, if some children in the nursery cannot fight infection normally, I would have them call their doctors immediately to tell them about the exposure.
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Henry Bernstein, M.D., is currently the associate chief of the Division of General Pediatrics and director of Primary Care at Children's Hospital, Boston. He also has an academic appointment at Harvard Medical School.
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