Shingles at a young age? The post by Chen Amsalem that surprised the web

Shingles is perceived by many as a disease that appears mainly in old age, but a post published this week by Chen Amsalem raised the question of how frequently it can appear among young people. Amsalem shared with her hundreds of thousands of followers on Instagram that she is dealing with the disease, and following the publication, responses appeared from other young women who said they too had contracted it.

One commenter wrote: "It's strange, a lot of people are sick lately with shingles, myself included." However, it is important to emphasize that online testimonies do not in themselves indicate a rise in morbidity or an outbreak. Shingles is indeed more common as one ages, but it can certainly affect young people.

The virus that wakes up years later

Shingles, or herpes zoster, is caused by the Varicella Zoster virus—the same virus that causes chickenpox. After a person recovers from chickenpox, the virus does not disappear completely from the body; it remains dormant in the nervous system and can wake up years later to cause shingles.

According to the Ministry of Health, the disease manifests mainly as a rash that can appear on the back, chest, head, or limbs, developing into blisters accompanied by itching and significant pain. Even after the rash clears, some patients experience pain that lasts for weeks or even months. The risk increases with age and is especially high among those with weakened immune systems. However, the appearance of the disease in a young person is not an impossible phenomenon and does not inherently indicate an underlying immune system disorder.

Why now?

The discourse following the post raises an obvious question: what causes a dormant virus to wake up at a specific time? The primary factor is a decrease in the immune system's ability to keep the virus dormant. This is why the disease is more common in older populations and the immunocompromised. However, a specific trigger cannot always be identified. Therefore, a multitude of stories on the web is not enough to confirm a real increase in cases; this requires organized morbidity data and comparisons to previous periods.

Complications and prevention

One known complication of shingles is prolonged nerve pain, known as post-herpetic neuralgia. The risk increases with age and among those with weakened immune systems. When the disease affects certain areas, such as the eyes, other complications may arise, making diagnosis and medical treatment essential. The main way to reduce the risk is vaccination. In Israel, the vaccine is available, and the Ministry of Health emphasizes its importance, especially for older populations and the immunocompromised.

The American CDC recommends two doses of Shingrix for all individuals aged 50 and over, as well as those aged 19 and over suffering from immunosuppression or immunodeficiency. The vaccine is over 90% effective in preventing shingles and post-herpetic neuralgia in those aged 50 and over with normal immune systems. Amsalem's post may have made headlines, but it carries a broader medical message: shingles is not reserved for the elderly. It can appear at a young age, and for those in risk groups, familiarity with symptoms and prevention is vital.