Frank Montana is not your average shingles patient. He's only 32 years old — not even close to the age of eligibility for Zostavax, the shingles vaccine, which is recommended for people who have reached 60.
Shingles is a very painful reactivation of the chickenpox virus, which remains dormant, usually for decades, in people who had the disease in childhood.
It's relatively rare in young adults — but not unheard of.
“I’ve seen many cases under the age of 60,” said Dr. Joseph Rahimian, an infectious disease specialist at St. Vincent’s Hospital in Manhattan. “Basically, it’s not uncommon for young people to develop the disease, since increased stress can cause a weakened immune system. But it’s not worth vaccinating young people yet since it doesn’t happen enough in young people.”
Montana, a project manager of medical facilities in Albany, N.Y., certainly has stress in his life. A married father of three kids -- all under the age of 6 -- he travels an hour to work each day and often incurs another two or three hours of driving time for projects once he gets to work.
So perhaps it was not a surprise to him when the doctors told him the rash on his mid-abdomen that circled around to his mid-back was shingles.
“I did have some symptoms beforehand, some tingling in my abdomen, that made me feel ‘weird;’ it kind of let me know something wasn’t right,” Montana said.
This is not uncommon for shingles patients.
The chickenpox virus, known as varicella, usually reactivates as shingles when people's immune systems become weakened. For some, it can be triggered by stress; for others, it’s because their immune systems have been weakened by infections. The disease often strikes the elderly, who have naturally weakened immune systems.
If you have never had chickenpox, you will not get shingles — a good reason to get the chickenpox vaccine, which became available in 1995.
But the disease is so contagious, most adults have had it at some point in their lives. And if they had a mild case, they might not even remember it, Rahimian said. A simple blood test can determine if the varicella virus lives within your body.
Once his rash broke out, Montana said, the pain was very uncomfortable, which is why doctors encourage older patients to get the vaccine.
Montana had what is known as postherpetic neuralgia (PHN), which is uncommon in healthy young adults, Rahimian said, but not as uncommon for older adults who experience shingles.
“I had itching, burning, constant discomfort, especially when the skin tightened,” Montana said. “During the first week of the breakout, I had limited contact with my kids, as you can spread this to infants and children, and basically I slept apart from my wife.”
PHN is a condition that affects the nerve fibers and skin. It usually occurs in the area where the rash happens, and that leads to the extreme pain. For some people, PHN can linger long after the shingles have cleared up and lead to scarring.
Shingles occurs on a localized nerve, as opposed to chicken pox, Rahimian said. So it's hard to transmit the disease, unless someone touches that localized site.
Montana’s rash lasted for nearly six weeks, but since it was in a place that could be easily concealed, he didn’t miss any time from work. He took painkillers, and an antibiotic, which made him feel sick to his stomach.
“I don’t ever want it again, it was constant discomfort,” he said. “And, it scarred my back and abdomen.”
Rahimian said once you come down with the shingles, it's unlikely you will get the disease again, but not impossible.
"It's a myth that you can't get it again," he said. "You are less likely to get it once you've had it, because your body builds up an immunity toward it. But, I have seen cases where you can get it again."
There are an estimated 1 million cases of shingles each year in the United States, according to the Centers for Disease Control and Prevention's Web Site.
If you suspect you may have shingles contact your health care provider to immediately start an antiviral medication, Rahimian said.