Shingles

Question 1

For shingles, state:

• Causative agents
• How it is spread and who is most at risk

Answer 1

Causative agents:
• Reactivation of the latent Varicella-Zoster Virus

How it is spread and who is most at risk:
• Can be spread by direct contact with skin rash of those infected. This causes chickenpox in people who are not immune
• More common in people who are immunosuppressed

Question 2

For shingles, state:

- General signs and symptoms (5)

Answer 2

• Painful chickenpox like rash on a small area of the skin
• Usually on one side of the body
• Pain, paraesthesia and dysesthesia
• Vesicle distribution follows dermatome regions
• Post-herpetic neuralgia: pain and tingling associated with the rash may persist for weeks or months after rash has cleared

Question 3

For shingles, state:

- Oral signs and symptoms (5)

Answer 3

• Oral lesions (vesicles) rupture early
• Usually seen as small ulcers resembling apthuous ulceration
• Confined to distribution of a nerve
• Facial or oral lesions in areas supplied by the trigeminal ganglion
• May involve the eye

Question 4

For shingles, state:

• Prevention (3)
• Treatment (3)

Answer 4

Prevention:
• Avoid contact with those who have not had chicken pox
• Avoid those who are immunosuppressed
• Wash hands thoroughly

Treatment:
• Antivirals (Acyclovir) within 72 hours
• Doctor can advise ways to minimise discomfort associated with symptoms e.g. topical creams, pain medications
• Lesions resolve in 2-3weeks