Ask the Doctor: ‘Can a child with chickenpox spread shingles to elderly family members?’

“Over the past few days it has become apparent that chicken pox is going around my son’s creche. We have a big birthday coming up for his 80-year-old grandmother and are hosting a family party. All the family has had chicken pox, but I am worried about shingles. Is it true that if a child is carrying chicken pox he can spread shingles to elderly family members? Should I postpone the party? I do not want to risk my parent’s health by having them around him if he could pass on shingles.”

Answer from Dr Abhilash Sahadevan, Consultant in Respiratory & General Internal Medicine

Though shingles result from the same virus (varicella-zoster virus) that causes chickenpox, it is not possible to catch shingles. This is no reason to postpone the family party. It is not true that a child carrying chickenpox can spread shingles to anyone, especially elderly family members.

People usually get exposed to the varicella-zoster virus earlier in their lives, which results in chickenpox. Once a person recovers from chicken pox, the varicella-zoster virus becomes dormant or inactive in the body, causing no symptoms. Shingles result from reactivation of the varicella-zoster virus, usually at a later age, resulting in a painful blistering rash.

The shingles rash usually appears in a band or belt-like pattern, which gave the Latin word “cingulum”, meaning belt or girdle, from which the modern term shingles is derived. Shingles is especially common in adults over the age of 50, with 1 in 5 people developing it over a lifetime.

Shingles can be prevented by vaccination. Elderly people who are vaccinated have reported better ageing as their risk of shingles and its painful complications is reduced.

Returning to the chicken pox outbreak in your son’s creche, chicken pox blisters are no longer infectious after they scab over. This usually occurs a week after the blisters’ onset. Note that even though it is not true that children with chickenpox can spread shingles, chicken pox is extremely infectious and can easily infect people who have never had chickenpox. You can easily catch chickenpox if you have never been exposed just by being around someone.

Anyone with a fever, headache, loss of appetite, malaise and skin blisters should not be at a party where naïve guests may turn up inadvertently and risk exposure to the virus. Pregnant mothers and people of any age with weakened immune systems are particularly at risk. Similarly, if you have never had chickenpox, you should not be near someone with shingles.

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