Can You Test for Past Chickenpox Infection and Shingles Risk?

Is it possible to determine if someone has had chickenpox through testing?

Hello Dr.
Wu, I would like to ask: 1.
Can only those who have had chickenpox develop shingles? 2.
Can individuals who have never had chickenpox not develop shingles? 3.
Is it possible for a 50-year-old adult to determine through testing whether they have had chickenpox?

Dazhong, 50~59 year old female. Ask Date: 2022/11/20

Dr. Wu Yuxin reply Dermatology

1.2.
The vast majority are, but a small portion of vaccinated individuals or those infected in utero may also be possible.
3.
It is only possible to determine the presence of antibodies, but it cannot be confirmed whether they were acquired through natural infection or vaccination.

Reply Date: 2022/11/20

More Info

To address your questions regarding chickenpox (varicella) and shingles (herpes zoster), let's break down each of your inquiries based on medical knowledge.

1. Can a person who has had chickenpox develop shingles?
Yes, individuals who have had chickenpox are at risk of developing shingles later in life. Chickenpox is caused by the varicella-zoster virus (VZV), which remains dormant in the body's nerve tissues after the initial infection. Years later, often triggered by stress, illness, or a weakened immune system, the virus can reactivate, leading to shingles. This condition is characterized by a painful rash that typically appears on one side of the body or face.

2. Can someone who has never had chickenpox develop shingles?
No, a person who has never had chickenpox cannot develop shingles. Shingles is a reactivation of the varicella-zoster virus, which only occurs in individuals who have previously been infected with the virus. However, it is possible for someone who has never had chickenpox to contract the virus through direct contact with the shingles rash. In such cases, they would develop chickenpox, not shingles.

3. Can a 50-year-old adult be tested to determine if they had chickenpox?
Yes, there are blood tests available that can determine if a person has had a past infection with the varicella-zoster virus. These tests measure the presence of antibodies against the virus. If the test is positive, it indicates that the person has had chickenpox at some point in their life. This is particularly useful for adults who may not have a clear recollection of their childhood illnesses or for those who are unsure of their immunity status, especially before considering vaccination against shingles.

Additional Information on Shingles and Vaccination
Shingles can be quite painful and may lead to complications, including postherpetic neuralgia, which is characterized by persistent pain in the area where the rash occurred. The risk of developing shingles increases with age, particularly in individuals over 50.
To mitigate the risk of shingles, the Centers for Disease Control and Prevention (CDC) recommends vaccination. The shingles vaccine is effective in reducing the incidence of shingles and its complications. There are two vaccines available: Zostavax, a live attenuated vaccine, and Shingrix, a recombinant vaccine that is preferred due to its higher efficacy and longer-lasting protection.

If you are over 50 and have had chickenpox, it is advisable to discuss vaccination with your healthcare provider, even if you have had shingles in the past. Vaccination can significantly reduce the risk of future episodes.

Conclusion
In summary, only individuals who have had chickenpox can develop shingles. Those who have never had chickenpox cannot develop shingles but can contract chickenpox if exposed to the virus. Blood tests can confirm past infections, which can be particularly useful for adults considering vaccination. If you have further concerns or specific health conditions, consulting with a healthcare professional is always recommended for personalized advice and treatment options.

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