Varicella-Zoster Virus (VZV) Samples

Bay Biosciences provides high quality, clinical grade, cryogenically preserved sera (serum) and matched K3-EDTA plasma specimens from shingles-varicella-zoster virus (VZV) positive patients.

The sera (serum) and K3-EDTA plasma specimens are processed from shingles-varicella-zoster virus (VZV) positive patient’s peripheral whole-blood using customized collection and processing protocols.

Shingles Varicella-Zoster Virus (VZV) Overview

Shingles is a viral infection that causes a painful rash. The shingles rashes can occur anywhere on the body. It typically looks like a single stripe of blisters that wraps around the left side or the right side of the torso. Shingles is caused by the varicella-zoster virus, the same virus that causes chickenpox.

It typically affects a single sensory nerve ganglion and the skin surface that the nerve supplies.

After someone had chickenpox, the virus stays in the body for the rest of your life. Years later, the virus may reactivate as shingles.

Shingles is not a life-threatening condition, but it can be very painful. Vaccines can help lower the risk of shingles. Early treatment may shorten a shingles infection and lessen the chance of complications.

The most common complication is postherpetic neuralgia. This is a painful condition that causes shingles pain for a long time after the blisters have cleared.

According to the Centers for Disease Control and Prevention (CDC), an estimated 1 in 3 people in the United States develop shingles during their lifetime.

Individuals can develop shingles if they had chickenpox in the past. This virus can lie dormant for years, and then reactivate as shingles. A person who has not had chickenpox before can get chickenpox through exposure to someone with shingles.

Shingles is most common after the age of 50, but it can appear at any age if a person has previously had chickenpox.

Anyone who has had varicella (chickenpox) may subsequently develop herpes zoster. Zoster can occur in childhood but is much more common in adults, especially older people. People with various kinds of cancer have a 40% increased risk of developing zoster. People who have had zoster rarely get it again; the chance of getting a second episode is about 1%.

Herpes zoster often affects people with weak immunity.

Signs and Symptoms of Shingles Varicella-Zoster Virus (VZV)

Shingles usually affects one side of the body. This is most often the waist, chest, abdomen, or back. Symptoms can also appear on the face and in the eyes, mouth, ears. The virus can also affect some internal organs.

Varicella-zoster virus (VZV) or shingles, typically affects a single sensory nerve ganglion near the spinal cord, called a dorsal root ganglion. This is why the symptoms occur in specific areas of the body, rather than all over it. The pain results from nerve involvement, rather than the rash itself.

Symptoms can vary in nature, depending on where on the body they appear.

Some patients have pain but no rash. Others may have a rash with pain that is accompanied by other symptoms, such as fever, chills, or headache.

Most Common Symptoms

Some of the most common symptoms of shingles include:

A constant dull, burning, or gnawing pain, or a sharp, stabbing pain that comes and goes. tingling
Fluid-filled blisters that develop as part of the rash
Itching
A skin rash that resembles a chickenpox rash but only affects certain areas
Sensitivity to touch

Symptoms On The Body

A blistering skin rash may appear in one or more distinct bands with sensory nerves of the skin, called dermatomes.

Common locations for this include the following:

Abdomen
Around the waits
Back
Chest

It usually occurs only on one side of the body.

The location of the symptoms will depend on which dermatome distribution the virus affects.

Facial Symptoms

If the rash affects the face, symptoms usually appear on one side only, usually around one eye and the forehead.

They can include the following:

A rash
Headache
Muscle weakeness
Pain over the affected dermatome

Eye Symptoms

If the virus affects an ophthalmic nerve, it means that a person has herpes zoster ophthalmicus (HZO).

This can cause pain, redness, and swelling in and around the eye, as well as temporary or permanent loss of vision.

Ear Symptoms

Shingles can also occur in or around the ear, leading to problems with balance and hearing, as well as muscle weakness on the affected side of the face.

These changes can be long-term or even permanent.

A patient, who develops symptoms in or around the ears and eyes should seek immediate medical attention to reduce the risk of complications.

Mouth symptoms

If shingles affects the mouth, a person may experience:

Facial tenderness
Lesions in hard and soft palate tissues
Pain in the mouth
Toothache

The pain and discomfort of these symptoms can make it difficult to eat or drink.

Internal Shingles

Shingles can also affect the internal organs. There will not be a rash, but other problems can arise.

For example, researchers have found evidence of shingles in the digestive system, which can lead to gastrointestinal dysfunction, and in the arteries in the brain, which may increase the risk of stroke and dementia.

Other Symptoms

There may also be other symptoms, including the following:

Chills
Fever
Fatigue
Headache
Upset stomach

Symptom Progression

Symptoms typically progress as follows:

Pain, tingling, numbness, and itching start to affect a specific part of the skin.
After up to 2 weeks, a rash appears.
Red blotches and itchy, fluid-filled blisters develop and continue to do so for 3–5 days.
The blisters may merge, forming a solid red band that looks similar to a severe burn. The gentlest touch may be painful.
Inflammation may affect the soft tissue under and around the rash.
After 7–10 days, the blisters gradually dry up and form scabs or crusts. As the blisters disappear, they may leave minor scarring.

Shingles usually lasts around 2–4 weeks. It is contagious until the blisters dry up and crust over. Most patients will only have an episode of shingles once, but it can recur in some patients.

Managing Shingles Varicella-Zoster Virus (VZV)

In addition to seeking medical treatment, people can take other steps to alleviate their symptoms and reduce discomfort. These include:

Applying calamine lotion to the skin
Getting enough sleep and rest
Reducing stress through a healthy lifestyle, meditation, and deep breathing exercises
Using a wet compress on the itchy and inflamed skin and blisters
Taking an oatmeal bath
Wearing loose-fitting clothing made of natural fibers, such as cotton

Patients should avoid scratching the rash and blisters as much as they can. Breaking the skin or bursting the blisters can cause infection and further complications.

Shingles vs. Other Conditions

The symptoms of shingles can sometimes resemble those of other conditions, such as the following:

Chickenpox
Cellulitis
Folliculitis
Herpes simplex virus
Irritant contact dermatitis
Insect bites
Impetigo
Mucosal candidiasis, or oral thrush

In most cases, a doctor can make a diagnosis according to a person’s medical history, a physical exam, and symptoms. However, they may take a sample of skin, mucus, or blood for testing to confirm the diagnosis.

Is Shingles Varicella-Zoster Virus (VZV) Contagious?

According to the National Health Service, shingles is not contagious. But the varicella-zoster virus that causes it can be spread to another person who hasn’t had chickenpox , and they could develop chickenpox.

The varicella-zoster virus is spread when someone comes into contact with an oozing blister. It’s not contagious if the blisters are covered or have formed scabs.

To prevent the varicella-zoster virus from spreading if you have shingles, be sure to keep the rash clean and covered. Do not touch the blisters, and make sure to wash your hands often.

Avoid being around at-risk people, such as people who are pregnant or have weak immune systems.

Causes of Shingles Varicella-Zoster Virus (VZV)

Shingles results from VZV, the same virus that causes chickenpox. After a patient recovers from chickenpox, the virus remains dormant in the sensory ganglia of their cranial nerve or the dorsal root ganglia within the peripheral nervous system.

VZV belongs to a group of viruses called herpes viruses. This is why shingles also has the name “herpes zoster.”

All herpes viruses can hide in the nervous system, where they can remain indefinitely in a latent state.

Under the right conditions, the herpes zoster virus can reactivate, similarly to waking up from hibernation, and travel down nerve fibers to cause a new active infection.

What triggers this is not usually clear, but it may happen when something weakens the immune system, prompting the virus to reactivate.

The reason for shingles is unclear. It may be due to lowered immunity to infections as people get older. Shingles is more common in older adults and in people who have weakened immune systems.

Varicella-zoster is part of a group of viruses called herpes viruses. This is the same group that includes the viruses that cause cold sores and genital herpes.

As a result, shingles is also known as herpes zoster. But the virus that causes chickenpox and shingles isn’t the same virus that causes cold sores or genital herpes, which is a sexually transmitted infection.

Diagnosis of Shingles Varicella-Zoster Virus (VZV)

Health care providers usually diagnose shingles based on the history of pain on one side of the body, along with the telltale rash and blisters. Doctors usually diagnose shingles through a physical exam by evaluating the appearance of the rash and blisters on the body.

In some cases, they may collect a tissue sample from the fluid of the blisters and send it to a lab to check if the virus is present.

They may also conduct a blood test to look for antibodies, which can determine whether a person has ever been exposed to the virus.

Treatment of Shingles Varicella-Zoster Virus (VZV)

There’s no cure for shingles. Early treatment with prescription antiviral drugs may speed healing and lower your risk of complications. These drugs include:

Acyclovir (Zovirax)
Famciclovir
Valacyclovir (Valtrex)

Shingles can cause severe pain, so your doctor provider also may prescribe:

Anticonvulsants, such as gabapentin (Neurontin, Gralise, Horizant)
Capsaicin topical patch (Qutenza)
An injection including corticosteroids and local anesthetics
Tricyclic antidepressants, such as amitriptyline
Numbing agents, such as lidocaine, in the form of a cream, gel, spray or skin patch

Shingles generally lasts between 2 and 6 weeks. Most people get shingles only once. But it’s possible to get it two or more times.

A doctor may prescribe antiviral drugs to stop the virus from multiplying.

Antiviral treatment can help with the following:

Lowering the risk of the rash coming back
Preventing complications from developing
Reducing the severity and duration of symptoms

In addition to antiviral drugs, there are several other ways to help manage symptoms, including the following:

Doing relaxing activities that will reduce stress and take a person’s mind off the pain, such as watching television, reading books, socializing, listening to music, or engaging in hobbies
Eating regular, nutritious meals
Getting some gentle exercise
Reducing stress as much as possible
Using pain relief medication
Wearing loose fitting clothes for comfort

Itch Relief

To relieve itching, the CDC recommends:

Applying calamine lotion
Placing a cool, damp washcloth on the blisters
Taking a lukewarm, oatmeal bath

Most patients will recover with home treatment, but a person should seek medical help if other symptoms appear, such as a fever. Around 1–4% of patients will need to spend time in the hospital due to complications.

Home Remedies For Shingles Varicella-Zoster Virus (VZV)

Home treatment can help ease your shingles symptoms. According to the NIA, these remedies include:

Applying wet cold compresses to the rash to reduce pain and itching
Taking cool baths or showers to clean and soothe the skin
Applying calamine lotion or making a paste with water and baking soda or cornstarch to reduce itching
Eating foods with vitamin A, vitamin B12, vitamin C and vitamin E
Taking L-lysine supplements to strengthen the immune system

Shingles Varicella-Zoster Virus (VZV) Vaccine

One vaccine called Shingrix is currently approved by the Food and Drug Administration (FDA) to prevent shingles. The CDC recommends adults over 50 years old receive two doses of Shingrix separated by 2 to 6 months. The vaccine is over 90-percent effective.

While side effects such as allergic reactions are possible from the vaccine, they are rare. And the CDC has no documented cases of the varicella-zoster virus being transmitted from people who were vaccinated.

For Children: Chickenpox Vaccine

Experts recommend routine immunization with the varicella vaccine (chickenpox vaccine) during childhood.

With two doses of the vaccine, there is at least a 90% chance of preventing chickenpox. Preventing chickenpox will also prevent shingles.

Children should receive the first dose at 12–15 months. The second dose is at 4–6 years.

Tests have shown the vaccine to be safe, though some children may experience:

A fever and a mild rash
Pain at the injection site
Temporary joint pain and stiffness

Since vaccination started in children, the number of shingles cases has dropped.

Risk Factors of Shingles Varicella-Zoster Virus (VZV)

Anyone who has ever had chickenpox can develop shingles. Most adults in the United States had chickenpox when they were children. That was before the availability of the routine childhood vaccination that now protects against chickenpox.

Factors that may increase your risk of developing shingles include:

Age: The risk of developing shingles increases with age. Shingles typically occurs in people older than 50. And people over the age of 60 are more likely to experience more-severe complications.
Cancer treatments: Radiation therapy or chemotherapy can lower your resistance to diseases and may trigger shingles.
Some diseases: Diseases that weaken the immune system, such as HIV/AIDS and cancer, can increase the risk of shingles.
Certain medications: Drugs that prevent rejection of transplanted organs can increase your risk of shingles. Long-term use of steroids, such as prednisone, may also increase the risk of developing shingles.

Complications of Shingles Varicella-Zoster Virus (VZV)

Shingles complications can include the following:

Damage to blood vessels, which could lead to stroke
Eye and vision problems
Inflammation of the brain or spinal cord, increasing the risk of stroke, encephalitis, and meningitis
Neurological problems: Shingles may cause inflammation of the brain (encephalitis), facial paralysis, or problems with hearing or balance.
Postherpetic neuralgia: For some people, shingles pain continues long after the blisters have cleared. This condition is known as postherpetic neuralgia. It occurs when damaged nerve fibers send confused and exaggerated messages of pain from your skin to your brain.
Problems with balance and hearing
Pneumonia
Weakness

According to the CDC, around 10–18% of patients, who have shingles will develop PHN, a long-term complication in which the pain of a shingles rash lasts long beyond the rash itself.

It is more likely to occur if a person develops shingles after the age of 40, and the risk continues to increase with age.

In Patients with Weak Immune System

Individuals with a weakened immune system will have a higher risk of developing shingles and of experiencing severe symptoms and complications.

This includes individuals who have the following:

Are taking medications to suppress the immune system, including chemotherapy drugs
Cancer, especially leukemia or lymphoma
HIV
Have undergone an organ transplant

These people should seek medical attention as soon as possible if they have concerns about shingles-related symptoms.

Other Complications

Complications from shingles are more likely to occur in older people or people with weakened immune systems. The following are possible shingles complications:

Postherpetic Neuralgia

Following shingles, some patients continue to experience nerve pain and intense itching in the area where the rash was. This is known as postherpetic neuralgia (PHN). It is the most common complication of shingles and develops in around 10–13 percent of patients who have had shingles.

PHN can persist for months or even years after the other symptoms of shingles have cleared. PHN can be severe, and the pain can be constant or intermittent. In some people, very light touch or changes in temperature can trigger the pain.

PHN can interfere with daily life and can cause anxiety, depression, insomnia and unexplained weight loss.

Ophthalmic Shingles

If shingles develops on the face, there is a risk of the eyes being affected. Potential complications involving the eye include the following:

Glaucoma or pressure in the eyes
Inflammation, causing redness and discharge
Permanent scarring of the cornea
Vision problems

Patients must get prompt treatment if blisters occur in or around the eyes to avoid the risk of vision loss.

Ramsey Hunt Syndrome

Shingles infections near or within the ear can cause Ramsey Hunt syndrome, which leads to hearing or balance problems, dizziness, earache, and paralysis of the face.

Around 75 percent of individuals with Ramsey Hunt syndrome will make a full recovery if they receive antiviral medication with 72 hours of the onset of their symptoms. However, some patients may be left with long-term hearing loss or facial paralysis.

Prevention of Shingles Varicella-Zoster Virus (VZV)

Shingles prevention strategy will depend on the patients age and whether they have had chickenpox. If you’re an older adult who had chickenpox as a child, the best way to avoid getting shingles is to get a shingles vaccine, which is approved for individuals aged 50 and older.

A shingles vaccine may help prevent shingles. People who are eligible should get the Shingrix vaccine, which has been available in the United States since its approval by the Food and Drug Administration in 2017.

Shingrix is a nonliving vaccine made of a virus component. It’s given in two doses, with 2 to 6 months between doses. The most common side effects of the shingles vaccine are redness, pain and swelling at the injection site. Some people also experience fatigue, headache and other side effects.

Stress can trigger shingles, so managing stress can help prevent this condition. Children can get the chickenpox vaccine, which will prevent the varicella virus from entering the body and potentially reactivating to cause shingles later in life.

The shingles vaccine doesn’t guarantee that you won’t get shingles. But this vaccine will likely reduce the course and severity of the disease. And it will likely lower your risk of postherpetic neuralgia. Studies suggest that Shingrix offers protection against shingles for more than five years.

Vaccination

There are two vaccines for shingles. One, called Zostavax (zoster vaccine live), was licensed by the U.S. Food and Drug Administration (FDA) in 2006. The other shingles vaccine, Shingrix (zoster vaccine—recombinant, adjuvanted) debuted in 2017.

Both vaccines also protect against PHN and typically are covered by health insurance or Medicare. However, the Zostavax vaccine is no longer available in the U.S., but other countries may still use it..

Here’s how the two vaccines compare:

Types of Vaccines

Zostavax is a live attenuated virus. This means that it contains a weakened version of live varicella, which stimulates the immune system to produce antibodies against the virus.
Shingrix is a non-live vaccine known that is made from a part of the virus. This makes it safer for people with immune-system problems who could become sick from a live vaccine.

Number of Doses

Zostavax is a one-shot vaccine.
Shingrix is given in two doses, two to six months apart.

Effectiveness

According ti the CDC, Zostavax reduces the risk of shingles by 51% and lowers the risk of PHN by 67%.
Two doses of Shingrix provide more than 90% effectiveness at preventing shingles and PHN.
For at least four years after receiving Shingrix, protection against both conditions stays above 85%.

Recommend Age For Vaccination

Zostavax is recommended by the CDC for people 60 and older, but the agency does not have a recommendation for people between 50 and 59.
This is because the vaccine provides protection for only about five years, so getting it before age 60 can put you at risk of losing protection by the time you reach the age when the risk of shingles is highest.
Shingrix is approved for people who are age 50 and older.

Side Effects

Both shingles vaccines are safe, though they have side effects—redness, soreness, swelling, or itching of the skin where the shot was given, in particular.
Some people may also experience muscle pain, headache, fatigue, shivering, low-grade fever, or an upset stomach after receiving either vaccine.

Stress Relief

There’s evidence the varicella virus sometimes re-emerges due to stress. While there’s little you can do to prevent the unexpected negative turns that life can throw at you, such as job loss or a loved one’s severe illness, there are sevaral strategies for protecting yourself from general stress and anxiety.

Managing your stress is one of the most important ways you can keep the varicella virus from reactivating.

There are many proven ways to reduce stress, which means there are several options to try until you find the strategies that offer the most calming benefits to you. Yoga, meditation, a hobby, or another activity that you find relaxing are just a few of the possibilities.

Tai Chi may be especially helpful. There’s preliminary evidence that this gentle form of exercise, which began as a martial art in China, may improve immune function and health in older adults who are at risk for shingles.

Lifestyle Changes

Lifestyle habits can help you stay strong and healthy, both physically and mentally.

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