The very same virus that causes chickenpox is the virus that causes herpes zoster, or shingles. This virus is known as varicella zoster virus (VZV). Chickenpox, while uncomfortable and very contagious, is usually a benign illness of childhood that is characterized by a rash with small blisters. When the VZV is reactivated, commonly after the sixth decade of life, herpes zoster presents itself as a rash that is accompanied by severe pain.(1)

Primary infection with this menacing virus is most likely to take place by way of the respiratory tract. After the virus begins to develop, it results in the usual blisters. But what causes this virus to be reactivated and display itself later in life as herpes zoster remains unknown. It simply remains latent until some stimulus reactivates it. Most who are diagnosed with herpes zoster have no history of recent exposure to individuals with VZV infection. Herpes zoster, more commonly known as shingles, can occur at any age, but seems to occur with the greatest frequency in the sixth to eighth decade of life. It has also been suggested that approximately 2 percent of patients who suffer from herpes zoster will suffer a second episode of the infection. The prevalence of herpes zoster in HIV-infected individuals appears higher than in other age-matched immunocompetent persons.(2, 3)

The onset of this disease is accompanied by pain that is often severe and may continue throughout the progression of the disease. Blistering that crusts over in one to two weeks follows the initial signs of itching, burning, and tingling.(4) The total duration of the disease is generally between 7-10 days; however, it may take as long as two to four weeks for the skin to return to normal.

Approximately 45 percent of patients over 50 who develop shingles will experience pain persisting for more than six weeks after the rash clears up. This is known as postherpetic neuralgia, and is intense, burning, and unrelenting. It is almost never seen in children who develop zoster, and is a rarity among adults less than 50 years old. Sometimes nerves in the facial area are affected and the individual can lose the sense of taste on part of their tongue. This syndrome is known as Ramsay-Hunt syndrome.

People who are immunocompromised are at risk for zoster. In fact, individuals with Hodgkin's disease and non- Hodgkin's lymphoma are at greatest risk for the development of shingles. Another population at much greater risk of developing shingles are individuals who have received a bone marrow transplant.(1)