Nova Scotia

Too young for shingles? Think again

While shingles typically affects people ages 50 and older, it can happen in younger adults — but because those numbers aren't tracked in Nova Scotia, it's hard to know exactly how many under 50 are affected.

'It was the worst pain I've ever felt — and I have three kids,' says 36-year-old Lindsay Levy

A man with a rash on his back
Symptoms of shingles include a blistering, painful rash, fever and headaches. (Shutterstock)

At 36, Lindsay Levy was shocked to find out she had shingles.

Levy believed the pain in her right shoulder last October was a pulled muscle.

But the next day, when the red marks turned into blisters, the nursing student said she knew it was shingles.

"It was the worst pain I've ever felt — and I have three kids." Levy said. "I'd never want to go through that pain again."

Lindsay Levy, 36, was diagnosed with shingles in October 2018. (Submitted by Lindsay Levy)

She immediately went to the emergency room, where the doctor diagnosed her. "She goes, 'My goodness, you're awfully young to get shingles.'"

Shingles is a viral infection that can cause a painful, blistering and itchy rash, often with other symptoms such as fever and headaches.

While shingles typically affects people 50 and older, it can happen in younger adults. But because those numbers aren't tracked in Nova Scotia, it's hard to know how many under that age are affected.

Levy said the pain lasted almost four weeks and she still has red marks on her shoulder that may never go away, according to her doctor.

Viral infection

Shingles is caused by the chickenpox virus, which lies inactive in a person's nerve tissue.

"Anyone who was infected with chickenpox as a child, will have the chickenpox virus living in their body for the rest of their lives," said Shelly McNeil, chief of infectious diseases at the Nova Scotia Health Authority.

"As we get older, the immune system is less able to control that virus in the nerve roots around the spine and it can reactivate and cause this linear rash that many people are familiar with as shingles."

Close up view of shingles rash.
Vaccination can help prevent shingles, which is caused by the same virus that causes chickenpox. (Centres for Disease Control and Prevention)

McNeil said only about 10 per cent of shingles cases occur in people ages 15-30.

She hasn't heard of an increase in Nova Scotia, but said she does hear of the odd case of a younger person having shingles.

"There's not been an observed increased rate of shingles in the young adult population. It's not a reportable illness so ... we may not necessarily know that."

'Intensely itchy'

Heather Costley, 48, found out she had shingles two weeks ago.

"I just had an itchy spot on my neck all of a sudden," she said. Within hours, it was bumpy, blistering and "intensely itchy."

"It felt like little needles being pushed into my skin," said Costley, who lives in Tantallon, N.S.

"Shingles actually crossed my mind but I thought, 'No, it can't be, I'm too young.'"

Stress can be a factor

McNeil said there can be a number of reasons why a person under 50 would get shingles.

One is if people are on medication that suppresses the immune system, such as for Crohn's disease or arthritis.

Another cause, she said, is if people are experiencing a particularly stressful time, are sleep deprived or have recently undergone surgery.

"But sometimes even healthy young adults will get shingles and it's not entirely clear [why]," McNeil said.

Vaccine for those over 50

McNeil said people can't catch shingles if they've never had chickenpox.

But because of the chickenpox vaccine, which started in the Maritimes between 2000 and 2004, the number of children with chickenpox has dropped dramatically.

When it comes to preventing shingles, McNeil said the only options are a healthy diet, exercise and adequate sleep.

There are also two shingles vaccines available in Canada: Zostavax and Shingrix, which came out in 2017.

But both are only recommended for people 50 and over.

The newest shingles vaccine, Shringrix, costs $300 for the required two doses. (Eloy Alonso/Reuters)

Curtis Chafe, chair of the board of the Pharmacy Association of Nova Scotia, said there isn't much research being done for people with shingles under the age of 50.

But in the last decade or so, Chafe said there's been an increase in shingles for people 50 and above.

"Young people shouldn't have to worry too much about getting shingles, it really is still rare. Even though we're probably hearing a little bit more about it," Chafe said.

"Maybe it's because we live in such a connected age that we're hearing about more cases."

Chafe and McNeil both say a person can get shingles more than once, but that's even more unlikely for younger people.

"It would be almost like getting struck by lighting twice," McNeil said. "It would be very unusual for someone who was 25 to have an episode of shingles and then get it again until they're much older, unless there's something else going on."

Shingles vaccine not covered

Chafe said his advice for Nova Scotians who are 50 and over is to visit their local pharmacy and get vaccinated.

But Shingrix isn't covered — and costs about $300 for the two required doses.

While it's not normally recommended for people under 50, those who have had shingles before can speak to their doctor about being vaccinated.

Chafe said it usually has to be done a year after diagnosis.

Levy said her doctor mentioned the vaccine, but told her she couldn't get it while she had shingles.

"It's something I'm going to seriously look into, because I never want to get it again."

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