How contagious is shingles?
November 23, 2016 12:23 PM   Subscribe

One guest has shingles. One (adult) guest has not had chicken pox. Would you tell one of them to stay home?

The outbreak is ten days old and has progressed to itchy stage, and is being treated with meds, and is covered by clothing. It seems okay to me to have these people in the same room...but chicken pox in adults is serious. What should we do?
posted by pipti to Health & Fitness (33 answers total) 1 user marked this as a favorite
Has the non-infected guest been vaccinated against chicken pox? (I would guess/hope yes, but people take weird risks with their health).
posted by brainmouse at 12:25 PM on November 23, 2016

No, I don't think so...
posted by pipti at 12:25 PM on November 23, 2016

Which I suppose is to say: inform the non-infected guest of the situation and allow them to choose. They are allowed to choose their own risk tolerance.
posted by brainmouse at 12:26 PM on November 23, 2016 [10 favorites]

Is anyone pregnant? Because if you get varicella while pregnant it's super unbelievably devastating.

I believe you should tell everyone and let them make their own decisions, that said, the person with varicella should stay home and I can't believe this is even a question!!
posted by jbenben at 12:26 PM on November 23, 2016 [18 favorites]

No, no one's pregnant.
posted by pipti at 12:28 PM on November 23, 2016

I wouldn't tell the infected person to say home - shingles is not especially contagious, and then only by contact. This is assuming that nobody involved is especially immunocompromised, but generally people with shingles are not supposed to avoid going out in public and whatnot (as long as they can cover the blisters).
posted by brainmouse at 12:29 PM on November 23, 2016 [3 favorites]

(but geez suggest that the other person get vaccinated! there's a reason we have modern health care! But it's a two dose four-week-apart situation so it's not going to apply for now).
posted by brainmouse at 12:30 PM on November 23, 2016 [1 favorite]

Let the non-immune person decide what they want to do.
posted by metasarah at 12:31 PM on November 23, 2016 [3 favorites]

Not easily spread if you follow some safe procedures (i.e. a compliant adult isn't going to give it to anyone).

Here's the Center for Disease Control's take: "The virus is spread through direct contact with fluid from the rash blisters caused by shingles."

They advise that if you have shingles:
  • Keep the rash covered.
  • Avoid touching or scratching the rash.
  • Wash your hands often to prevent the spread of varicella zoster virus.
  • Until your rash has developed crusts, avoid contact with
    • pregnant women who have never had chickenpox or the chickenpox vaccine;
    • premature or low birth weight infants; and
    • people with weakened immune systems, such as people receiving immunosuppressive medications or undergoing chemotherapy, organ transplant recipients, and people with human immunodeficiency virus (HIV) infection.

posted by zippy at 12:31 PM on November 23, 2016 [4 favorites]

OK I'm apparently commenting a million times, but according to what I just read, vaccination against chicken pox within 3 days of exposure to chicken pox itself (which is much more contagious than shingles) is 90% effective against getting infected. The uninfected guest should make an appointment post haste for the first dose, because that is the responsible thing to do. And the infected guest should take common-sense precautions against spreading it (by covering the rash and being vigilant about hand washing and whatnot).
posted by brainmouse at 12:33 PM on November 23, 2016 [1 favorite]

Forgot to add, the CDC also says "Once the rash has developed crusts, the person is no longer contagious."
posted by zippy at 12:33 PM on November 23, 2016 [1 favorite]

one of these people is ill; the other not. ill person stays away.
posted by andrewcooke at 12:41 PM on November 23, 2016 [17 favorites]

The way this question is written makes me think that the infected person is a member of the hosting household. In that case, you should email or call your doctor and ask if it's safe to host. If not, it'll be a scramble to put together an alternative but it will be fine. (We once had Thanksgiving at Mimi's Cafe because a kitchen renovation went very wrong. Another year my cousin misunderstood about how long it took to cook a turkey and we didn't eat until 2 A.M. Both are great memories.)

In any event, all guests should be informed about the situation. You don't know everyone's medical chart and the medical history of others with whom they are in close proximity. (Who knows, maybe the sister-in-law who they're going to visit for dessert is pregnant.)
posted by 26.2 at 12:51 PM on November 23, 2016 [3 favorites]

Adult chicken pox is far, far, far worse than childhood chicken pox. Adult chicken pox accounts for a tiny percent of cases, yet it also accounts for the majority of deaths from chicken pox. Even when you don't die from it, it lasts much longer and is drastically more miserable.

I would not be comfortable exposing these two people to each other under these circumstances.
posted by Michele in California at 12:56 PM on November 23, 2016 [8 favorites]

The sick person should definitely, absolutely stay home. Even putting the unvaccinated person aside; you don't know whose immune system isn't up to par, you don't know if someone had a less-effective vaccine, and I've known plenty of people who got shingles after chickenpox.
posted by kimberussell at 1:10 PM on November 23, 2016 [9 favorites]

I had shingles and was breastfeeding a 4 month old baby. So lots of opportunity for passing it along.

I kept it covered with medical gauze and tape and my baby was fine.

Your guests will be fine. Don't share bath towels, keep it covered, don't get all nekkid like.

People here are overreacting. Your guests will be fine.
posted by St. Peepsburg at 1:19 PM on November 23, 2016 [6 favorites]

With respect to all the people aghast at the non-exposed person not having been vaccinated, there are going to be a lot of people old enough for the vaccine to have not been available when they were small but not old enough that doctors are thinking about the likelihood of them getting shingles. If they're not on top of it of their own accord, it's entirely likely no one has ever asked them about exposure or vaccination. I've certainly never been asked and I'm in the age group that was only vaccinated if they hadn't been exposed by 2nd or 3rd grade when the vaccine became available. The state I grew up in didn't start requiring varicella vaccination for school until after I finished college.
posted by hoyland at 1:34 PM on November 23, 2016 [8 favorites]

When I went to get vaccinated, they did a test to see if I was already immune. That test came back in a day, showing that I already had chicken pox! It was a huge surprise to me, given that my sister had a horrible time with it, but I never got sick. Apparently this is very common; so I would second the recommendation to go ahead and get the vaccine.
posted by wnissen at 1:56 PM on November 23, 2016 [2 favorites]

you don't know whose immune system isn't up to par, you don't know if someone had a less-effective vaccine,

You also don't know who is faking not being pregnant. As a person who had to order "something that looks alcoholic but isn't" in a bar last night (thanks waitress for instantly understanding me) I would want to know if someone was coming with Shingles so that I could suddenly come down with a cold and be unable to attend.
posted by magnetsphere at 2:09 PM on November 23, 2016 [16 favorites]

I sat in a room with a coworker who had shingles, a few days later, i broke out in full blown chickenpox (apparently Ive never had it as a kid), so yeah, I believe its highly contagious, especially to people who haven't had chickenpox, or people who don't remember if they had or not.

It wasn't a pleasant experience.
posted by edman at 2:15 PM on November 23, 2016 [8 favorites]

A baby being breastfed by someone with an active outbreak is likely receiving antigens in the breast milk that are protecting the infant from the infection. This likely does not equate one-for-one with the situation the OP is trying to address.

I have previously spent some time trying to figure out just how much more deadly chicken pox is in adults and at that time I was unable to come up with any kind of firm numbers. This article gives the following blurb: average of 20 in all age groups each year from 1998 to 2000. Seventeen adults died in each of those years.
That still does not tell me relative mortality because it does not give me a comparison of percentages. But it does suggest that nearly six times as many adults die from it as do children, in spite of there being vastly more children who get the condition every year. So the mortality rate difference is quite substantial.

My ex husband had adult onset chicken pox just before he turned 32. It was not pretty.
posted by Michele in California at 2:16 PM on November 23, 2016 [3 favorites]

I caught chickenpox as a young adult while living in a small building with a child with chickenpox, with whom I had no direct contact. On the other hand, I was barely sick at all, which I gather is not what usually happens.
posted by glitter at 2:46 PM on November 23, 2016

If the person with shingles has a health plan with a free nurse advice line, I'd ask them to call that and get clarification. If the rash has developed crusts, they're not contagious anyway, so it's a moot point and they are not going to transmit the disease regardless.

But, my general advice would be that it's uncool to punish someone for being sick because of a person who made the choice not to receive a vaccine. My calculation might differ if the unvaccinated person can't get it for some legit reason (allergy to the vaccine, another illness that makes it unwise to get the chicken pox vaccine, can't afford health insurance/cost of vaccine, etc.) but absent that, I think it's obnoxious to say the sick person has to skip the event to protect someone who has -- either intentionally or through laziness -- chosen not to protect themselves. Unless you are aware of some legit reason why the unvaccinated person has chosen to remain unvaccinated, I would just let them know the situation and allow them to make their own risk calculation about whether or not to come.

I'm not sure why there is concern about pregnant women here -- random pregnant women are in no way at risk. This is only a concern if the unvaccinated guest is ALSO a pregnant woman (which there is no suggestion of here!)
posted by rainbowbrite at 4:07 PM on November 23, 2016 [1 favorite]

In my experience shingles is fairly contagious. I had shingles (a very light case) and didn't know it. I went to work not realizing what I had. A guy I worked with (we shared a camera at work) had never had chicken pox, he caught my shingles in the form of a devastating case of chicken pox and was out for weeks. I felt horrible!
posted by WalkerWestridge at 4:09 PM on November 23, 2016 [4 favorites]

I'm in the UK where the varicella vaccine isn't provided on the nhs and shingles is not regarded as particularly scary.

If the rash is crusted over already the contagious stage is over. If the rash is kept covered, the individual doesn't scratch and they have washed their hands after putting the dressing on, then it's very unlikely anyone could catch it.

My in-laws and dad have had repeated shingles attacks. Once my FIL revealed AFTER attending a birthday party with 14 four year olds at it that he had started an attack the day before. Nobody caught it.

If nobody is pregnant, your guests aren't going to roll about naked or French kiss and nobody is immunocompromised then I would have no concerns at all.
posted by intergalacticvelvet at 4:46 PM on November 23, 2016 [2 favorites]

I caught chicken pox as a teen from my sister who had shingles. I would not wish that misery on anyone. (Having chicken pox everywhere, including internally ... in my throat .... ugh). So, to my mind, I would not expose the non immune person, even if proper precautions are being taken. With that said, at the very least, they should be fully informed before they come (and they might want to consult their doctor about it.)
posted by gudrun at 5:14 PM on November 23, 2016 [4 favorites]

Sure my baby would be getting antigens from breast milk but during my outbreak my husband also didn't get the pox and neither did his unvaxed parents and we stayed with them for a week.

If the rash is well covered and no mixing of towels then it is a non issue.
People are way over thinking this one.
posted by St. Peepsburg at 5:25 PM on November 23, 2016

Person with shingles stays home, or goes away, if they live there and the other person was invited. I had chicken pox at 17 and it was awful.
posted by roomthreeseventeen at 6:37 PM on November 23, 2016 [4 favorites]

I am close to someone who takes immunosuppressants. Not wanting to appear different, they tell very, very people about their medication, or the medical condition which the medication helps manage. Moral of this story? Best not to assume that you know your guests' medical history. At the very least you should give them enough information so that they can protect their health if required.
posted by brushtailedphascogale at 7:02 PM on November 23, 2016 [12 favorites]

The person with a contagious illness needs to take responsibility for not infecting others! They need to call their doctor or a nurse helpline, explain things, and ask "Am I contagious to others?" And if they are they need to stay home until they're noncontagious!

And if you, as the host, don't trust them to be a responsible, ethical adult about this, you should consider un-inviting them.
posted by Hypatia at 8:42 PM on November 23, 2016 [2 favorites]

Some people have episodes of shingles that last for months; please consider this before you isolate them. I would call your doctor, ask for advice, and allow the individuals to make informed decisions.
posted by theora55 at 8:55 PM on November 23, 2016

I honestly checked to see if we are related.

My husband got diagnosed with shingles Tuesday afternoon. Small patch on the torso, not painful, on meds now. No blisters that I can see. He did not mention to the doctor that he was intending to drive 2+ hours and have a hotel for two nights to spend Thanksgiving with 20+ people. He called the doctor's office Wednesday (after prompting) to inquire about contagiousness. He got essentially the same info as on the CDC website. Our plan was to leave Wednesday for the hotel near where Thanksgiving dinner is, and we did so. I had shared in a group text about the diagnosis, but got no useful response.

Our dinner will have 20+ people, at least one baby (~13 months), potentially 2 other babies (~6 months) and possibly some adults who have not had chicken pox. I have been running through scenarios in my head. Should we have both stayed home (so he wasn't alone)? Should I have gone independently? Should I go by myself and leave him at the hotel? Should he come and eat separately?

I read all the comments, and still don't know what the hell you should do. I will say this: be clear about a decision instead of depending on others to "make the right choice". From everything we have heard and read, this is not contagious assuming basic precautions (avoiding kisses/hugs, staying away from babies, frequent hand washing, etc.) and so we continued with our plans. I got a text while we were on the road from my dad, inquiring about risk to people who have not had chicken pox. If you are fine having the person with shingles there, say so but warn guests. If you want them to stay away, tell them. I'm now freaking out that we are unwanted because of potential risk of infection, even though nothing we have read indicates a risk.
posted by booksherpa at 2:56 AM on November 24, 2016 [1 favorite]

booksherpa: babies don't get the chickenpox vaccine until after 12 months, so for a party with babies under age one I would DEFINITELY have the infected person stay home. It's true that babies used to get chicken pox all the time, but it sucked and now they don't have to anymore! Getting the vaccine instead of the virus also means you are less likely get shingles later in life because you don't have the dormant virus in your system.

I was hospitalized because of shingles as a kid and I sure wish I had been able to get the vaccine instead of the virus.
posted by insoluble uncertainty at 10:07 AM on November 24, 2016 [2 favorites]

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