I am 51-year-old female nurse, diagnosed with shingles a few weeks ago. I am puzzled about how this could have happened because I thought I was in excellent health. I work out, don't smoke and take vitamins. However, I wasn't getting much sleep and just started perimenopause. I work in a nursing home but was told I couldn't get the virus from patients, that it is a virus dormant in me from when I had chickenpox as a child.

Cathy

Shingles (also known as herpes zoster) and chickenpox are both caused by the varicella-zoster virus (VZV). The majority of people in developed countries such as the United States will become infected with this virus at some time, usually during childhood. This infection results in chickenpox, a self-limited, typically harmless illness that causes a characteristic rash of vesicles (blisters).

After the patient recovers from the illness, VZV remains dormant in the body, usually forever. Later in life, about 15 percent of people will develop an episode of shingles. Shingles is a localized rash of vesicles that look like those of chickenpox. However, with shingles, the rash typically remains in one area, on a single side of the body. This is because the virus remains dormant in the nerves, and it reactivates in the region of distribution of a single nerve. Occasionally, shingles can spread to other areas of the body, but that typically occurs only in people with defective immune systems.

Shingles can occur at any age, to any person. However, it is more likely to occur in two settings. The first is older age. The highest rate of infection occurs in those older than 60. In these people, the risk is between five and 10 cases per 1,000 people per year. Patients who have compromised immune systems, either by malignancies such as lymphoma, by AIDS or from congenital problems, are also at higher risk of shingles.

However, as I said above, previously healthy people frequently develop the infection. Sometimes it can be related to transient changes in the immune system due to lack of sleep, stress or other factors. But more often than not, there is no good explanation for why it occurred. Experts do not recommend testing for immunodeficiency in a person who develops a first episode of shingles. Because shingles occurs twice in only about 4 percent of the population, some physicians will evaluate a patient for an immune disorder if the patient, especially a young one, develops shingles for the second time.