Babies exposed to shingles

Shingles | Breastfeeding | CDC

An immunocompetent mother with shingles may be able to continue breastfeeding if she does not have skin lesions on her breast.

Shingles, also known as herpes zoster or zoster, is caused by the varicella zoster virus, the same virus that causes chickenpox (varicella). After a person recovers from chickenpox, the virus stays dormant (inactive) in the body and can reactivate years later, causing shingles. Anyone who has recovered from chickenpox may develop shingles, but the risk of shingles increases as you get older.

Shingles cannot be passed from one person to another and cannot be spread to an infant through breast milk. However, the varicella zoster virus can spread from a person who has active shingles and cause chickenpox in someone who has never had chickenpox or received the chickenpox vaccine. The virus is spread through direct contact with fluid from the rash blisters caused by shingles.

Should a mother with shingles continue to breastfeed?

Maybe. If a mother has active shingles infection, she can continue to breastfeed if she does not have skin lesions on her breast. If a lesion develops on or near the areola, where the infant’s mouth would touch the lesion while nursing, then the mother needs to express her milk on that side to maintain her milk supply and prevent mastitis. She can discard that milk until the infant can resume nursing directly at that breast. She may need access to a hospital-grade pump and additional lactation support to maintain her milk supply and reduce the possibility of developing a breast infection.

Before expressing breast milk, mothers should wash their hands well with soap and water and, if using a pump, follow recommendations for proper cleaning. Breastfeeding can continue on the unaffected breast during this time. All lesions should be covered with clean, dry bandages until they are healed to avoid direct contact with an infant. Mothers need to be vigilant about hand washing until all lesions are fully crusted over.

Immunocompromised mothers who develop an active shingles infection can seek consultation from a specialist on how or if to proceed with breastfeeding. If the infant comes into direct contact with the shingles lesions, consultation with a pediatric specialist is recommended and Varicella-Zoster Immune Globulin may be considered.

Should a mother on antivirals continue to breastfeed?

Yes. Women can take antiviral medications to treat shingles while breastfeeding. Review the LactMedexternal icon database for the most current information on medications and lactation when advising breastfeeding mothers on medication safety.

If a mother is on antivirals, does her infant also need treatment?

Most infants who develop chickenpox can tolerate the infection. However some may experience complications. Mothers should consult their child’s health care provider, even for infections that seem mild.

Is the varicella (chickenpox) vaccine safe to administer to lactating mothers?

Yes. The varicella vaccine should be administered to nursing mothers who lack evidence of immunity. Two doses of the chickenpox vaccine is more than 90% effective at preventing chickenpox. Excretion of the vaccine strain in human milk or of transmission to infants has not been found.

Shingles (for Parents) - Nemours KidsHealth

What Is Shingles?

Shingles, also called zoster or herpes zoster, is a skin rash caused by a viral infection of the nerves right below the skin.

What Causes Shingles?

The varicella zoster virus causes shingles and chickenpox. Anyone who has had chickenpox can later develop shingles — even children. That's because the virus stays dormant (resting) in the nervous system for the rest of a person's life.

In many people, the virus never comes back. But in others, it flares up and causes shingles. It's uncommon for someone to get shingles more than once.

People of all ages can get shingles, but most cases are in people over 50 years old.

What Are the Signs & Symptoms of Shingles?

Often the first shingles symptoms happen in the area where the rash will appear. A person may have tingling, itching, or pain in this area. When the rash shows up, the pain may be mild or severe.

The rash starts as groups of tiny pimples on one side of the body or the face. It's often in the shape of a band or belt. The pimples change to pus-filled blisters that break open and scab over in about 7–10 days. The scabs usually heal and fall off about 2–4 weeks after the rash starts.

Some kids with shingles also may have a fever and a headache, and might feel tired and achy. Rarely, a child has the pain of shingles without the rash. More severe symptoms can happen, but usually in people over age 50.

What Problems Can Happen?

Most cases of shingles heal on their own, with or without treatment, and won't lead to any other problems. In rare cases, shingles can lead to complications, including:

Ongoing pain (post-herpetic neuralgia): Damaged nerve fibers in the skin send confused messages to the brain, leading to pain. Pain can go on for a long time after the shingles rash is gone. This is the most common shingles complication.
Vision problems: Shingles near or in an eye can lead to vision loss.
Skin infections: A shingles rash can become infected with bacteria, leading to impetigo or cellulitis.
Nervous system problems: Shingles on the face can involve different nerves that connect to the brain. This can lead to nerve-related problems such as facial paralysis, hearing problems, and problems with balance. In very rare cases, shingles can lead to encephalitis (inflammation of the brain).

How Is Shingles Diagnosed?

Doctor usually can diagnose shingles by looking at the rash. Rarely, a doctor may send a small sample of infected skin to be checked in a laboratory.

If you think your child might have shingles, call your doctor. If your child might have shingles on the face, it's important to get a doctor's help right away to keep the infection from spreading to the eyes.

How Is Shingles Treated?

Not all kids who get shingles need treatment. If a doctor decides a treatment may help, it should start right away. Treatment usually includes an antiviral medicine and pain-control medicines.

Antiviral medicines like acyclovir (Zovirax) or valcylovir (Valtrex):

help heal the skin rash
stop the virus from multiplying
help control pain

Pain medicines (over-the-counter or prescription creams, sprays, or skin patches):

help control pain
ease inflammation (swelling and redness)

Medicines can't rid the body of the virus, but they can lower the chances of complications and help speed healing. Ask your doctor if treatment might help your child.

As the rash heals, keep the area clean. Wash it with water and a mild soap, and apply cool, wet compresses to the blisters several times a day to ease pain and itching. Oatmeal baths also can bring relief.

To prevent the virus from spreading to other people, keep the rash covered at all times.

Can Shingles Be Prevented?

It's not always possible to prevent shingles. But the chickenpox vaccine can make a case of shingles less serious. If your child hasn't had chickenpox, ask your doctor about getting the chickenpox vaccine.

There is a shingles vaccine, but it's mostly given to older adults. The older someone is, the more severe shingles can be. Kids are unlikely to be seriously affected by shingles.

What Else Should I Know?

Children whose shingles rash that can't be completely covered should not go to school or childcare until the blisters scab over and are dry.

Newborn babies, pregnant women, people with weakened immune systems, and anyone who is not immune to chickenpox should avoid close contact with anyone who has shingles until the rash is gone.

Reviewed by: Kate M. Cronan, MD

Date reviewed: September 2019

Herpes zoster (shingles) | Memorial Sloan Kettering Cancer Center

This information tells you about herpes zoster (shingles), including how it spreads and how it is treated.

What is herpes zoster?

Herpes zoster, also called herpes zoster, is an infectious disease caused by the varicella-zoster virus. This is the same virus that causes chickenpox. Herpes zoster occurs only in those individuals who have previously had chickenpox. When chickenpox passes, the varicella-zoster virus remains in the body as inactive. This means that you may not feel symptoms, but the virus is still present in the body. When the varicella-zoster virus becomes active again, it causes herpes zoster.

What are the symptoms of herpes zoster?

Persons with herpes zoster develop a rash similar to chickenpox. It can cause itching, burning and pain.

In localized herpes zoster, the rash usually appears as a wide streak on one side of the body. In disseminated (more widespread) herpes zoster, the rash covers a larger area of the body.

How is herpes zoster spread?

Herpes zoster can be spread by touching the blisters of an infected person. Disseminated herpes zoster can be spread through contact with liquid droplets from the nose and throat of an infected person. Droplets containing the virus are released into the air when an infected person coughs or sneezes. They are easy to inhale and become infected.

If you have had chickenpox before, your virus will not become active through contact with a person who has herpes zoster. However, if you haven't had chickenpox, you can get it after being in contact with someone who has herpes zoster.

Who is at risk of getting herpes zoster?

Herpes zoster usually develops in people with serious illness or a weak immune system.

How to treat herpes zoster?

Herpes zoster is treated with antiviral medicines, skin creams and, if necessary, pain medicines.

What precautions are taken in the hospital if I have herpes zoster?

Isolation measures are measures we take to prevent the spread of infection among patients. If you were diagnosed with chickenpox during your hospital stay or were at risk of contracting the disease:

You will be placed in a private room.
Keep the door to your room closed at all times.
A sign will be placed on your door telling all staff and visitors to wash their hands with soap or alcohol-based hand rub before entering and after leaving your room.
Isolation measures are different for localized and disseminated herpes zoster.
- For localized herpes zoster, all visitors and staff must wear a yellow gown and gloves while in your room. They are issued outside your room and can be disposed of in your room.
- For disseminated herpes zoster, visitors and staff should wear a yellow gown, gloves, and a respiratory mask while in your room.
  - If you follow these isolation measures, you are not allowed to walk around the ward.
For any type of herpes zoster, you are prohibited from walking around the ward and accessing the following areas of the hospital:
- food pantry in your department;
- recreation center at M15;
- children's recreation areas in M9;
- cafeteria;
- main lobby;
- any other common areas within the hospital.
You may have art therapy or massage sessions in your room.
When you leave your room for diagnostic tests, you must wear a yellow gown and gloves. If you have disseminated herpes zoster, you will also need to wear a mask.

You can stop following these precautions when all blisters have dried and crusted over.

What are the ways to prevent herpes zoster?

Zostavax ^® vaccine is used to prevent herpes zoster. This vaccine is recommended for people over 60 years of age, but is not suitable for people with weakened immune systems. Your doctor can provide more information about this vaccine.

Where can I get more information about herpes zoster?

If you have questions, ask your doctor or nurse. Also, for more information, you can visit the websites:

CDC

www.cdc.gov/shingles/hcp/clinical-overview.html

New York State Department of Health

www. health.ny.gov/diseases/communicable/shingles/fact_sheet.htm

Chickenpox - Symptoms, Adult Vaccination - Shingles Vaccine

07/22/2022

Chicken pox ( aka chickenpox ) is an acute infectious disease caused by the varicella zoster virus ( varicella zoster virus ). This is one of the herpesviruses, type 3.

After the primary infection, the virus remains in the body (in the ganglia of sensory nerves) as a latent infection, which, when reactivated, causes herpes zoster (shingles, or it is also called herpes zoster, which is logical, based on the name).

The virus is easily transmitted from people who have chickenpox to those who have never had the disease or have never been vaccinated. Chickenpox is less contagious than measles, but more contagious than mumps and rubella.

If one person has it, up to 90% of people close to that person who do not have immunity will also become infected. The virus is spread primarily through close contact with a person with chickenpox, either by airborne droplets or by contact with the contents of blisters on the skin. There is a lot, a lot of virus in them this time.

A person with chickenpox is considered contagious one to two days before the rash appears and until all the rashes (vesicles) have crusted over. Or within 5 days after the last rash appeared.

Manifestations of chicken pox

The classic symptom of chickenpox is a rash that turns into itchy, fluid-filled blisters that turn into scabs over time. Also, the patient is concerned about the temperature above 38.0 C for 2 to 5 days and non-specific symptoms - general weakness, fatigue.

In healthy children, chickenpox usually occurs in a mild form with an itchy rash, malaise, and a temperature up to 38.5-38.9C for 2-3 days. But infants, adolescents, adults, pregnant women, and immunocompromised people are at risk for more severe illness and have a higher rate of complications (bacterial skin infections, bleeding, pneumonia, encephalitis, sepsis). Some cases of severe chickenpox with serious complications may require hospitalization.

In the past, some parents have participated in "wind party" to deliberately expose their unvaccinated children to chickenpox in the hope that they will become infected. The leading medical communities in the United States and Europe strongly advise against hosting or participating in such events. Chickenpox can be serious and can lead to serious complications and death, even in healthy children. There is no way to tell in advance how severe your child's symptoms will be. So don't risk exposing your child to the disease.

The best way to prevent chickenpox is to get vaccinated

Everyone, including children, teenagers and adults, should get two doses of the vaccine 6 weeks apart if they have never had chickenpox or have never been vaccinated. For people living with HIV, the interval between vaccines should be at least 12 weeks.

Two doses of the varicella vaccine ( varilrix ) are more than 90% effective in preventing chickenpox. By getting vaccinated, you protect yourself and other members of your family and community. This protection is especially important for people who cannot get vaccinated, such as people with a weakened immune system (reducing the body's ability to fight germs and disease) or pregnant women.

As for herpes zoster, this is the reactivation of the virus, which occurs with a strong decrease in immunity. Usually, if a person has had an episode of herpes zoster, it is necessary to exclude HIV infection, but this is not the only disease against which immunity can fall. Varicella zoster virus may reactivate during chemotherapy for cancer or immunosuppressive therapy for rheumatoid diseases.

Often, in people over 50 years of age, due to the natural suppression of the immune system, characteristic rashes may appear, accompanied by an intense pain syndrome along the nerves where the virus multiplies. The diagnosis is usually established clinically but may require laboratory confirmation ( PCR fluid from vesicles ).