When someone in a household has shingles, a common concern arises about the safety of newborns. Understanding the nature of shingles and its transmission is important for protecting these very young infants. This requires knowing how the virus spreads, why newborns are particularly susceptible, and implementing specific preventive actions. Being aware of potential symptoms in a newborn and knowing when to seek medical attention is crucial for their well-being.
Understanding Shingles and How It Spreads
Shingles, also known as herpes zoster, is caused by the varicella-zoster virus (VZV), the same virus responsible for chickenpox. After a person recovers from chickenpox, VZV remains inactive in their nerve tissue and can reactivate years later, causing shingles. While shingles itself is not directly contagious, the VZV within the shingles blisters can spread to others through direct contact with the fluid from active blisters. If someone who has never had chickenpox or the chickenpox vaccine comes into contact with this fluid, they may develop chickenpox, not shingles. The contagious period typically lasts from when blisters form until they crust over, which usually takes about 7 to 10 days; once all lesions have scabbed, the person is generally no longer contagious.
Why Newborns Face Greater Risk
Newborns are especially vulnerable to VZV infection, which manifests as chickenpox, because their immune systems are still developing. They lack the robust immune defenses of older children or adults. While some maternal antibodies can pass through the placenta, offering temporary protection, this is often not enough to prevent infection, especially with direct exposure to active lesions; these protective antibodies can fade quickly, leaving infants susceptible within a few months. If a newborn contracts chickenpox, complications can be severe, including widespread infection, pneumonia, inflammation of the brain (encephalitis), or even death. The risk of severe, disseminated disease is particularly high if the mother developed chickenpox shortly before or after delivery, as the newborn may not have received sufficient protective antibodies.
Crucial Protective Measures
Minimizing the risk of VZV transmission to newborns requires careful attention to specific preventive actions. The most important measure involves avoiding direct contact between the person with shingles and the newborn until all the shingles lesions have crusted over. If contact cannot be entirely avoided, such as when a parent has shingles, all blisters must be completely covered with clothing or a dressing, as covering the rash helps contain the virus and reduces the chance of transmission. Strict hand hygiene is also important; frequent and thorough handwashing with soap and water is necessary after any contact with the rash or before handling the newborn. Personal items such as towels or clothing should not be shared. While a shingles vaccine is available for adults to prevent the illness, it does not prevent transmission from active lesions if someone already has shingles.
Recognizing Signs and Seeking Care
If a newborn shows symptoms after exposure to someone with shingles, prompt medical attention is necessary. Signs of chickenpox in a newborn include a rash with itchy, fluid-filled blisters that eventually crust over, often accompanied by fever, decreased appetite, fussiness, or increased sleepiness. The rash often begins as small red spots on the face, chest, or stomach before spreading. If a newborn exhibits these symptoms, contacting a healthcare provider immediately is important, as early intervention can help prevent severe complications. In some cases, antiviral treatment, such as intravenous acyclovir, may be prescribed for newborns due to their increased vulnerability, and medical professionals can assess the situation and determine the appropriate course of action.