Vaccine
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Shingles (HCP)

Herpes zoster (shingles) is caused by reactivation of varicella‑zoster virus (VZV), the virus that causes chickenpox.
After primary infection, VZV remains latent in dorsal root/cranial nerve ganglia and can later reactivate—more likely with immune senescence or immunosuppression—producing a painful dermatomal rash.

The rash is typically a unilateral stripe of vesicles in one or more dermatomes; facial/ophthalmic involvement requires urgent evaluation.
Shingles itself is not transmitted person‑to‑person; however, fluid from shingles vesicles can transmit VZV to a susceptible person (causing chickenpox, not shingles). Vaccination is highly effective at preventing shingles and its complications. Early antivirals reduce severity and duration.

Risk Factors

• History of chickenpox (anyone previously infected is at risk)
• Age >50 years
• Immunocompromise (HIV/AIDS, cancer, transplant, steroids/chemotherapy)
• Stress and chronic conditions (e.g., diabetes, CKD, chronic lung disease)

Symptoms

• Pain, itching, tingling or numbness days–weeks before rash
• Painful unilateral vesicular rash in a dermatomal band; vesicles crust in a few days
• Burning/throbbing/stabbing pain; ± fever, headache, chills, fatigue
• Urgent care if rash near the eye due to vision risk

Transmission

Shingles cannot be directly "caught." VZV from vesicle fluid can infect a non‑immune person and cause chickenpox. Risk falls once lesions crust.
Keep rash covered; avoid touching; frequent handwashing
Avoid contact with susceptible pregnant women, newborns, and immunocompromised persons

Diagnosis

Clinical—unilateral dermatomal vesicular eruption. If uncertain/complicated, test vesicle material for VZV (PCR).

Treatment

• Antivirals (acyclovir, valacyclovir, famciclovir) ideally within 72 hours of rash onset
• Pain control: NSAIDs/acetaminophen; consider neuropathic agents or stronger analgesics as needed
• Skin care: calamine, cool compresses; keep lesions clean/dry to prevent bacterial superinfection

Complications

• Postherpetic neuralgia (PHN): persistent neuropathic pain months–years
• Bacterial superinfection, scarring; ophthalmic zoster → vision loss
• Rare: pneumonia, encephalitis, stroke—especially in immunocompromised

Prevention

WHO recommends recombinant zoster vaccine in a two‑dose schedule (≥2‑month interval) for adults ≥50 years and those with chronic conditions in settings where herpes zoster is a significant public‑health issue. The vaccine reduces risk of shingles and PHN and is indicated even after a prior episode.

In Egypt, the Egyptian Drug Authority approved Shingrix on 11 Sep 2023; public launch occurred 26 Apr 2024 (GSK event). Varicella vaccination in childhood lowers lifetime shingles risk versus natural infection.

References:CDC – Shingles |WHO – Herpes Zoster |EDA – Shingrix PI (2023)

Shingrix