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Shingles: What It Is and How to Prevent It

Prevention & Screenings

People who have had chickenpox as children may give little thought to the condition after the virus clears up and the itchy red bumps disappear. Unfortunately, the virus that causes chickenpox, called the varicella-zoster virus, can rear its ugly head later in life in the form of shingles, a painful blistery rash often accompanied by a slew of other symptoms such as stomach pain, fever, chills, headache, joint pain and more.

As with most health issues, education is key to prevention and early diagnosis. Here's what you need to know about shingles and how to avoid it.

How do you get it and who's at risk? Once chickenpox clears up, the varicella-zoster virus lies dormant in the nervous system. In many cases, it remains that way. However, in some individuals, the virus reactivates and finds its way through nerve pathways and to the skin, where it causes shingles, also known as herpes zoster. Scientists aren't quite clear why the virus reactivates, but research suggests that it has something to do with a vulnerable immune system.

Anyone who has had chickenpox can potentially develop shingles, but especially individuals who contracted the virus before age one. Those most at risk for shingles also include people older than 50 and those with weakened immune systems, whether it be due to disease or certain medications such as immunosuppressive drugs. Individuals who are on a chemotherapy regimen may also be susceptible to shingles. Most people only have one outbreak of shingles, but in rare cases it can recur.

Early studies indicate that children who received a single dose of the varicella vaccine to protect against chickenpox have a reduced risk of developing shingles later in life. However, because the vaccine was introduced in 1995, research continues on its effects as the vaccinated children age and on whether it's helpful to have a booster dose of the vaccine.

What are some of the symptoms of shingles? Typically, the painful, tingling or burning rash of shingles will only affect a small portion of the body. Feelings of pain, itching or tingling are often precursors to the rash, which eventually becomes red and itchy and develops fluid-filled blisters that rupture and crust over. Additionally, people with shingles tend to have fever, chills, aches and fatigue. In cases when the virus affects a facial nerve, the person may experience difficulty moving the face or have a drooping eyelid or loss of taste, vision or hearing. The rash forms blisters that usually scab over in a week to 10 days, but it takes two to four weeks to clear up, and the pain may linger longer.

Individuals who believe they may have shingles should visit their doctor for prompt diagnosis and treatment. Health care providers are usually able to diagnose shingles simply by examining the rash.

How can shingles be treated or prevented? Shingles is treated with antiviral medications, such as acyclovir, famciclovir or valacyclovir. These medications may alleviate discomfort as well as shorten the virus's lifespan. Additionally, a health care provider may determine that corticosteroids, antihistamines, pain medications or capsaicin ointments are necessary.

To soothe rashes, individuals may try applying a cold compress or calamine lotion to the affected area, as well as taking a starch or oatmeal bath.

Shingles itself is not contagious, but the virus that causes shingles can be spread to someone who has never had chickenpox and can cause chickenpox. The same virus could then cause shingles later in life. The virus is spread through direct contact with fluid from the rash blisters, so it's important to keep the blisters covered. Once the rash develops scabs, the virus is no longer contagious.

The best way to prevent shingles is to get vaccinated. The shingles vaccine is recommended for most people over age 60 to reduce their risk of shingles and the pain associated with the disease.

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C. diff is the name of a common, easily transmittable infection caused by the bacterium Clostridioides difficile. The infection causes your colon (bowel) wall to become inflamed, resulting in severe, watery diarrhea. Left untreated, it can cause a serious complication called toxic megacolon.

C. diff affects about 250,000 people in the United States every year. Some people get it only once in their lifetime, but if you have a C. diff infection, there is up to a 1 in 4 chance you might relapse (the same infection returns) or get it again within eight weeks. People at the highest risk for a C. diff infection are those who take or have recently taken antibiotics, especially if they have a weak immune system.

The bacteria live in feces (poop), and in soil and water. They spread easily and can live for a long time on hard and soft surfaces, like linens and clothing. If someone who has C. diff on their hands touches a door handle and you touch it after, the bacteria transfer to your hand. They then can enter your gastrointestinal system if you touch your mouth or handle food before washing your hands.

Protect yourself and others from getting a C. diff infection in a healthcare setting

hand washing in a hospital

If you are a patient in a hospital, skilled nursing facility or rehabilitation center, you are at higher risk of getting a C. diff infection — not just because you likely have a weak immune system from the condition that put you in the facility but also because of the number of people you may encounter while you’re there.

Here are some steps you can take to lower the risk of getting C. diff in a healthcare facility:

  1. Make sure all healthcare workers and visitors wash their hands before they touch you and your things. If you don’t see them wash their hands, ask them to do so.
  2. Wash your hands well with soap and water every time you use the bathroom. If you use a bedside commode, ask to be transported to a sink to wash your hands or use a waterless hand sanitizer.
  3. Wash your hands before eating or drinking. If you can’t get to a sink, ask the staff or a friend to supply you with a waterless hand sanitizer to use while you are in bed or sitting in your chair.
  4. Allow cleaning staff access to your environment. Clear everything off the bedside table or nightstand, and remove clothing or linens from the bedside rails so they can be wiped down.

Patients with a diagnosed C. diff infection should not share a room with someone who does not have the infection. If you do share a room and your roommate contracts C. diff, ask to be moved.

Stop the spread of C. diff at home

household cleaning supplies

C. diff doesn’t just affect people in healthcare facilities. It can happen at home, too.

Here are steps you can take to reduce the risk of spreading C. diff at home:

  1. If your home has a second bathroom, reserve one for the person with the C. diff infection to limit exposure to others.
  2. If your home has only one bathroom, make sure the toilet seat, flusher, faucets, light switches and doorknob are cleaned with a bleach-based cleaner after each use.
  3. If the infected person is immobile, keep waterless hand sanitizer within reach.
  4. Clean common home surfaces (door knobs, light switches, fridge handles, etc.).
  5. Wash clothing (especially underwear), towels and linens separately and in the hottest water possible.
  6. Wear disposable gloves while handling clothing and linens, especially if the person is incontinent (loses control of their bowels). Wash your hands after removing the gloves.
  7. Shower with soap to remove C. diff that may be on the skin.

This educational resource was created with support from Seres Therapeutics and Nestle Health Science.