Shingles is an infectious disease caused by the varicella-zoster virus (VZV) – the same one that causes chickenpox. After recovering from chickenpox, the virus remains dormant in nerve ganglia and can reactivate after years, causing shingles.
How infection occurs? Shingles is usually not a "new infection", but a reactivation in a person who once had chickenpox.
Who is the source of the pathogen? Human. The virus can spread from a person sick with shingles to a person who has not had chickenpox / has not been vaccinated – then that person will develop chickenpox (not shingles).
Incubation period: for chickenpox after contact with a person with shingles/chickenpox is usually 10–21 days (average 14–16 days). For shingles, one does not speak of typical "incubation" after exposure, because it is a reactivation after years of latency.
Who is most at risk: risk increases with age (especially after 50 years of age) and with reduced immunity. It is estimated that about 1 in 3 people will develop shingles in their lifetime.
2. Symptoms of shingles
Most often it starts with pain, burning, tingling, or itching in one place on the skin. After 1–a few days, a blistering, painful rash appears, usually on one side of the body (along the nerve). Fever, headache, chills, weakness may also occur.
Possible complications:
post-herpetic neuralgia (PHN) – chronic nerve pain persisting for months or even years; this is the most common complication.
ocular complications (when lesions concern the eye area) with a risk of vision deterioration,
bacterial superinfections of skin lesions, scars, and rarely neurological or pulmonary complications.
Urgent medical consultation is particularly important when:
rash or pain concerns the eye/face area,
neurological symptoms appear (e.g., facial paresis, severe dizziness),
a pregnant person, a person with significantly reduced immunity is sick, or lesions are extensive / with high fever.
3. Where does shingles occur?
VZV occurs all over the world, so shingles is a global disease – it is not "exotic". For travelers, the most important thing is that the risk depends more on age and immunity than on the destination. Particularly important for people 50+ and with chronic diseases or before/after immunosuppressive treatment.
4. How to protect yourself against shingles?
A. General prevention
Avoid contact with skin lesions of a sick person; do not touch blisters.
If you are sick: cover the rash, take care of hand hygiene, do not use shared towels/clothes.
Protect vulnerable people (pregnant women without immunity, newborns, people with reduced immunity) – because VZV can be "transferred" from shingles and cause chickenpox in them.
B. Vaccination (most important)
Vaccine against shingles: Shingrix – recombinant, adjuvanted vaccine (it is not a "live" vaccine).
For whom recommended:
routinely for adults ≥50 years old,
also for adults from risk groups / with reduced immunity (in many recommendations from 18 years of age).
Vaccination schedule:
2 doses intramuscularly
standard: 0 and 2 months, with flexibility to administer the 2nd dose between 2 and 6 months
in people who need a shorter schedule (e.g., before immunosuppression): an interval of 1–2 months is possible.
Booster doses: as of today, the need for booster doses after the primary cycle has not been established.
Duration of protection: observational studies have shown maintenance of high protection up to 10 years after vaccination.
Additional notes:
vaccination can be considered even after having had shingles (individual decision in qualification).
5. Summary
Shingles can be very painful and can leave behind long-lasting neuralgia and (less often) dangerous complications, especially when it affects the eye or ear area. It is particularly worth considering vaccination in people over 50 years of age and in people with reduced immunity / chronic diseases. If you want to have a full cycle completed before an important date (e.g., travel), it is best to start at least 2 months earlier (to make it in time with 2 doses), and comfortably – with greater advance within the 2–6 month window.