Can Shingles Kill You?

What are the symptoms of shingles?

The primary symptom of shingles is burning, tingling pain that can be intense (only about 4% of people with shingles do not report pain), or itching in a band-like distribution on one side of the body.¹

Within a few days to two weeks, a rash of fluid-filled blisters appears, similar to chicken pox blisters, but clustered. Typically the cluster is where the pain was, but in some cases, the shingles rash can develop around the eye.

In rare cases, shingles can involve any part of the body.

Very mild shingles can sometimes go unnoticed, consisting only of mild pain and few or no blisters. However, other people might experience fatigue, fever, headache, and other systemic symptoms.

In some cases, the shingles pain can linger for weeks or months after the rash has disappeared.

What causes shingles?

Shingles, or herpes zoster, are caused by the varicella-zoster virus. This is the same virus that causes chicken pox. After you have had chickenpox, the virus remains dormant in your nervous system. In most cases, it stays there quietly for the rest of your life.

However, sometimes it can flare up and cause shingles.

Most people in the US are vaccinated against chicken pox as children. The vaccine is extremely effective. However, as it is a live attenuated vaccine, there is a tiny risk of getting shingles due to being vaccinated. This risk is much lower than from actual infection.²

Who gets shingles?

Anyone who has had chickenpox or been vaccinated against it can get shingles. As chickenpox can be very mild, many people have it without knowing. Because of this, the two-dose Shingrix vaccine is recommended for all US adults age 50. The risk of shingles increases with age, and it is rare to get it before 50. Risk increases substantially by the age of 60.

Other risk factors for shingles are:

• A compromised immune system as a result of a medical condition or the use of immunosuppressive medications

• Stress

• Having recently had a bone marrow or organ transplant

However, shingles can sometimes happen in young, healthy people for no apparent reason.

Pediatric shingles can occur in the children of mothers who have chickenpox late in pregnancy. Because of this, the chicken pox vaccine is not recommended if you are pregnant. These children can be born with chicken pox or develop it within a few days. As they were infected so young, they can sometimes get shingles in childhood.

Most people who get shingles only have it once.

Can you die from shingles?

While it can be extremely painful and interfere with daily activities, shingles is typically not considered serious. Most people make a full recovery, and, as mentioned, it's rare to get it more than once.

However, shingles can sometimes result in significant complications. These are more common if you have shingles lesions on your face.

Shingles in or near the eye can result in painful eye infections and even temporary or permanent vision loss. Shingles in or near the ear can cause hearing or balance problems that can be long-lasting or permanent.

Other known complications include:

• Zoster paresis: Weakness in muscles related to the affected nerves, which is long-lasting in about half of cases

• Neuralgia PHN: Pain that persists for at least three months after the rash appears

• VZV meningoencephalitis: This can present as meningitis or meningoencephalitis, which can be fatal

• VZV vasculopathy: An infection of the cerebral arteries which can produce both ischemic and hemorrhagic stroke, including in children. This risk is much higher if you have shingles lesions around your eye. This presents with headaches, mental status changes, and focal neurological deficits.

• VZV and giant cell arteritis: This affects the temporal arteries and causes inflammation.

So, yes, you can die from shingles, but this is extremely rare. The vast majority of people recover fine.

How are shingles treated?

Your doctor may prescribe you an antiviral medicine such as acyclovir, valacyclovir, or famciclovir. These can shorten the length and severity of the illness and reduce your risk of complications. They work best if started right after the rash appears.

Other than that, treatment focuses on making you more comfortable and includes:

• Over-the-counter or prescription pain medication

• Applying a wet compress to the rash

• Calamine lotion applied to the rash

• A colloidal oatmeal bath — a lukewarm bath containing ground oatmeal, which can relieve itching

• Wearing loose-fitting, natural-fiber clothing

• Reducing stress

• Trying to distract yourself from the pain by doing activities you enjoy

For the vast majority of people, shingles go away and do not come back. You should talk to your doctor if you experience systemic infection symptoms, especially a headache.

Are shingles contagious?

Yes and no. You cannot give another person shingles. However, if you have shingles, you could infect somebody who has not already had chickenpox. Shingles is part of the virus' reproductive strategy to infect unexposed children.

If you have shingles, stay away from anyone who has not either had chicken pox or been vaccinated, including very young children. You should also stay away from people with weakened immune systems.

Keep your rash covered when around others, avoid touching or scratching it, and wash your hands frequently.

How to prevent shingles

The best way to avoid shingles is to get vaccinated. The Shingrix vaccine, which is two doses, is recommended for all adults at the age of 50, whether or not you have had chickenpox, been vaccinated, or previously had shingles (while repeat bouts of shingles are rare, they are not unknown). The Shingrix vaccine is over 90% effective.³

As the vaccine is particularly reactogenic (likely to cause an adverse reaction), it's best to schedule your dose when you can take a day off work the next day. Some people experience side effects that interfere with normal activity, but these are short-lived, and getting shingles is much worse.

Vaccinating children against chickenpox is part of the strategy to prevent shingles; however, the incidence of shingles has increased due to an aging population.

The lowdown

In extremely rare cases, shingles can kill you if it gets into the brain and causes meningitis or affects your blood vessels and greatly increases your risk of a stroke.

These complications are more common in people over 65 or who have a compromised immune system. However, while highly unpleasant, the disease is not serious for the vast majority of people who catch shingles.

Everyone aged 50 or older should get the two-dose Shingrix vaccine to reduce their risk of getting shingles, especially as they get older and have a higher risk of complications.