Difference Between Chickenpox and Shingles

Chickenpox and shingles are two viral infections caused by the varicella-zoster virus. While they are caused by the same virus, they have different symptoms, causes, and treatment options. In this essay, we will discuss the differences between chickenpox and shingles.

What is Chickenpox?

Chickenpox is one of the most common infections in childhood. All ages are susceptible to the disease, but it is much more severe in adults.

People are the only reservoir of varicella-zoster virus. The transmission of the virus is by an air-droplet pathway. The contagion occurs when droplets containing the virus, formed by the sneezing or coughing of an infected person, fall in the airways or the eyes of other people. In case of contact with patients with shingles, the virus can be transmitted if infecting material falls in the respiratory tract or conjunctivitis of the eye. Another way of transmitting the infection is intrauterine during pregnancy.

Upon contact with a patient with chicken pox, 80% of the people who have not suffered from it get ill.

The virus enters the body via the respiratory system and the conjunctiva. Through them, it falls into the bloodstream and reaches all tissues and organs, including the skin. There it causes characteristic changes in epithelial and subepithelial cells and the appearance of a rash. The incubation period of chickenpox is between 12 and 21 days. The patients are most contagious 1-2 days before a rash occurs.

The symptoms of the disease start abruptly.

• The temperature rises to 39°C and a characteristic rash appears, starting from the corpse and always affecting the hairy part of the head.

• On the face, the rash is scarce; at the palms and soles, it is almost missing. The rash is accompanied by strong and persistent itching.

• At the beginning, small reddish round spots appear on the skin. They are called macules. Gradually, they rise above the skin and evolve in papules.

• After a few hours, the papules evolve to vesicles – small bubbles filled with transparent liquid content. The vesicles are localized on all mucous membranes in the oral cavity, the genitals, and the conjunctiva.

• After 1-2 days, the vesicles are cracked, the secretion dries up and forms a brownish crust that drops after about 2 weeks.

After the chickenpox disease, sustained immunity is obtained. Repeated illness is observed in 1% of the patients.

What is Shingles?

Approximately 10-20% of the patients, which have had chickenpox, develop shingles later in life as a result of a recurrence of the virus. The reasons for the recurrence of the virus are most often reduced immunity and / or re-encounter with the virus (contact with a person with chickenpox).

• Shingles proceeds with very severe pain and rash. The rash affects a skin area innervated from a particular peripheral nerve.

• There may be so-called pre-existing symptoms such as fatigue, muscle pain, burning, and tingling in the area of the skin, which will later be affected by the rash. This can be accompanied by fever. With or without previous symptoms, burning pain occurs in a broad area of the skin of the body or face (depending on the affected nerve). The pain may be burning, sharp or dull.

• Usually, about 1 to 3 days after the onset of the pain appears a characteristic rash. At this stage, the patient is most contiguous. By the seventh day from the beginning of the disease, the vesicles are cracked, the secretion dries up and forms a brownish crust.

• Unlike chickenpox, the shingles’ rush is always one-sided and consists only of grouped vesicles with a clear content, located on a red-colored base. They are localized on skin that is innervated by a particular nerve. The most frequently affected skin areas are those innervated by nervus trigeminus, nervus facialis, and intercostal nerves.

• Possible complications of the shingles infection are damage to vision and hearing as well as post- shingles neuralgia – severe pain in the affected area, continuing for a long time after the skin rash disappears.

• The treatment of shingles virus infection depends on the severity of the disease. For mild and moderate forms, symptomatic treatment is given – against fever, itching or pain. Severe forms of the disease require the use of antiviral drugs or immunoglobulins.

Most people suffering from shingles are over 50 years of age or have a weakened immune system. Usually, after shingles, there is no second episode of development of the disease, which implies building up immunity. In patients with severely impaired immune system, a tendency to repeated, multiple occurrences of shingles are observed.

Differences: Chickenpox and Shingles

One of the main differences between chickenpox and shingles is that chickenpox is highly contagious, while shingles is not. Chickenpox is most contagious from one to two days before the rash appears until all the blisters have crusted over. Shingles, on the other hand, is not contagious unless someone comes into contact with the fluid from the blisters. Even then, the risk of contracting shingles is low.

Another difference between chickenpox and shingles is the age group they typically affect. Chickenpox is most common in children under the age of 10, while shingles is more common in adults over the age of 50. However, anyone who has had chickenpox can develop shingles later in life.

The symptoms of chickenpox and shingles are also different. Chickenpox typically causes a fever, headache, and itchy rash of small blisters. Shingles, on the other hand, usually starts with a burning, tingling, or painful sensation in a specific area of the body, followed by a rash of small blisters. The rash usually appears on one side of the body, often on the trunk or face. The blisters can be painful, and they can take several weeks to heal.

The treatment options for chickenpox and shingles are also different. Chickenpox is usually treated with over-the-counter pain relievers and antihistamines to relieve itching. In severe cases, antiviral medication may be prescribed. Shingles is usually treated with antiviral medication to reduce the severity and duration of the infection. Pain relievers and anti-inflammatory medications may also be prescribed to relieve pain and inflammation.

The following table highlights the major differences between Chickenpox and Shingles −

Characteristics	Chickenpox	Shingles
Definition	Chickenpox is a contagious disease caused by infection with varicella-zoster virus.	Shingles is an infection of a nerve and the skin around it, caused by the reactivation of the varicella-zoster virus.
Age of the patients	All ages are susceptible to chickenpox, but it is much more common in children.	The shingles occurs in adults.
Transmission	The transmission of the virus is by an air-droplet pathway. The contagion occurs when droplets containing the virus, formed by the sneezing or coughing of an infected person, fall in the airways or the eyes of other people.	After chickenpox, the infectious agent remains latent in the nerve ganglia of the body. Under certain conditions, the virus is reactivated and shingles is induced.

Conclusion

While chickenpox and shingles are caused by the same virus, they have different symptoms, causes, and treatment options.

Chickenpox is a highly contagious infection that typically affects children, while shingles is a viral infection that typically affects adults.

Chickenpox causes a fever, headache, and itchy rash of small blisters; while shingles starts with a burning, tingling, or painful sensation in a specific area of the body, followed by a rash.