Shingles, also known as herpes zoster, is a viral infection that affects the nerves. It causes a painful rash that usually appears on one side of the body. The rash consists of blisters that typically scab over in 7 to 10 days and clears up within 2 to 4 weeks.
Shingles is caused by the varicella-zoster virus, the same virus that causes chickenpox. After a person recovers from chickenpox, the virus stays dormant in the body. It can reactivate years later, causing shingles.
Shingles is contagious and can be spread through direct contact with the rash. However, there are differing opinions on whether shingles can be spread through bedding or other objects that have touched the rash.
Can shingles be spread through bedding?
According to the Centers for Disease Control and Prevention (CDC), the varicella-zoster virus that causes shingles can survive for a short time outside the human body, such as on clothing and other surfaces. However, it is unlikely for someone to catch shingles from this kind of indirect contact.
The CDC states that shingles can only be spread through direct contact with the rash and that the virus is not spread through the air or by merely breathing in the same air as an infected person. There is no evidence that the virus can be spread by contact with objects like clothing, bedding, or towels used by someone with shingles.
So while it’s possible in theory for shingles to be spread through contaminated bedding, it is considered very rare. The bigger concern is direct contact with shingles blisters, not indirect contact through objects like sheets or blankets.
Key points
- The varicella-zoster virus can survive for a short time on surfaces, but is very unlikely to infect someone this way.
- Shingles is spread through direct contact with the rash blisters, not through the air or contaminated objects.
- There is no evidence shingles can be caught from bed sheets, blankets or other objects touched by someone with shingles.
Evidence that shingles is rarely spread indirectly
Research studies provide evidence that shingles is rarely, if ever, spread through contaminated surfaces or objects:
- A study published in The Journal of Infectious Diseases found no evidence of indirect transmission of shingles among household contacts of people with shingles. Transmission only occurred through direct contact with the rash.
- Another study had patients with shingles use their normal bedding at home while being closely monitored. None of the patients’ close contacts developed shingles, indicating there was no transmission through the bedding.
- Cases have been reported of people transmitting chickenpox through contact with objects like toys or clothing, but not transmitting shingles this way. The viruses behave somewhat differently.
- If transmission through fomites was common, there would be many more cases among medical workers who come into contact with contaminated objects, but this is not seen.
Overall the evidence indicates it is very rare for someone to catch shingles from bed sheets, towels or other surfaces touched by someone with shingles blisters. The main risk is touching the blisters directly.
Key points
- Studies show no transmission of shingles through household contacts or bedding.
- Cases of transmission through objects have not been reported for shingles (only chickenpox).
- Healthcare workers don’t commonly get infected through indirect contact.
Why is direct contact the main risk?
There are a few reasons why direct contact with the shingles rash is the primary risk, while indirect spread through objects is very unlikely:
- The amount of virus present in shingles blisters is much higher than the amount that gets transferred to surfaces like bedding. The higher viral load during direct contact makes infection more likely.
- The virus cannot survive for long once it gets on objects and dries out. The outer protective layers of skin also provide defense against infection.
- A certain amount of virus needs to get past the skin barrier through direct contact with blisters to cause infection. Just a few virus particles that might be present on bedding are unlikely to be enough.
- A person’s immune response also plays a role. Older adults and those with weakened immunity are more prone to shingles, while young healthy people rarely get infected through indirect contact.
So while traces of virus might be present on bedding, the chances of those few virus particles making it past the skin’s defenses to establish infection are extremely low.
Key points
- Higher viral load in shingles blisters increases infection risk from direct contact.
- The virus doesn’t survive well or long on surfaces.
- Skin defenses and immune response prevent infection from limited virus particles on objects.
How to prevent spread through bedding
Even though the risks are very low, people with shingles may want to take some precautions with bedding out of an abundance of caution:
- Keep shingles lesions covered with clothing or wrappings, and avoid direct contact between blisters and bedding materials if possible.
- Don’t share bedding or sleeping areas with anyone else while you have shingles.
- Wash sheets, blankets and pillowcases regularly in hot water to help kill any trace amounts of virus.
- Avoid shaking out dirty laundry, to prevent virus particles from becoming airborne.
- Use bleach as a disinfectant when cleaning surfaces touched by lesions.
Strict precautions are most important if you are in close contact with people at high risk for shingles, like those with weakened immune systems, infants, or elderly individuals.
Healthy individuals should not need to avoid or destroy bedding that has been used by someone with shingles, given the very low risk. But taking some care is reasonable.
Key points
- Cover lesions, don’t share bedding and wash frequently if you have active shingles.
- Healthy people at low risk do not need to discard bedding used by shingles patients.
- Use added precautions if you have close contact with high-risk groups like the elderly or immunosuppressed.
Can I get shingles more than once?
It is possible, but rare, for someone to get shingles more than one time in their life. Getting shingles again is called a recurrence.
According to the CDC, about 5% of people who have had shingles will have a recurrence. It’s more common in those with weakened immune systems.
Recurrences happen because after someone recovers from shingles, some of the varicella-zoster virus can remain in the body and reactivate again later to cause a new case of shingles.
Having one recurrence makes you more likely to have another one. About 50% of recurrences happen within the first 6 months after the initial case. The virus is less likely to reactivate and cause shingles again as more time passes.
Key points on shingles recurrence:
- About 5% of people will experience a recurrence.
- Recurrences are more likely within the first 6 months.
- People with weakened immunity are at higher risk of recurrence.
Treatments to reduce recurrence risk
While shingles recurrences cannot be prevented 100%, there are some therapies that can reduce the risk:
- Antiviral medications: Drugs like acyclovir and valacyclovir help limit the severity and duration of shingles. This may also limit how much virus is left in the body to cause future outbreaks.
- Vaccines: The shingles vaccine Shingrix provides some protection against recurrences, about 20-50%. Getting vaccinated can reduce the likelihood of the virus reactivating again.
- Immunosuppressant medications: For those with autoimmune conditions taking drugs that weaken the immune system, minimizing these medications under doctor supervision may help prevent recurrences.
- Managing stress: Stress is a known trigger for shingles outbreaks. Finding healthy ways to cope with stress may also help prevent recurrences.
Talk with your doctor about antiviral medication, vaccination, and other ways to potentially reduce your risks of getting shingles again after an initial bout.
Key points on preventing recurrence
- Promptly starting antivirals for initial case may reduce recurrence risk.
- Shingles vaccine provides some protection against future outbreaks.
- Controlling immunosuppressant use and stress can help lower risk.
How long is shingles contagious for?
Shingles is contagious from the time the rash first appears until all the blisters have crusted over and healed. This takes approximately 7-10 days for most shingles cases.
According to the CDC, people with shingles are contagious to others who have not had chickenpox before or the chickenpox vaccine. The greatest risk is to pregnant women and those with weakened immune systems.
It’s uncommon for shingles to be contagious before the telltale rash is visible or after all the blisters have dried and crusted over. Here is an overview of how long shingles remains contagious:
- 1-2 days before rash appears: sometimes contagious
- From rash onset until blisters crust: highly contagious
- Once all blisters scab over: no longer contagious
In most healthy individuals, it takes about 7-10 days for shingles blisters to crust, so contagiousness lasts about a week. But in those with weakened immunity, it may take up to 3-4 weeks for rash healing and the end of contagiousness.
Key points on shingles contagious period
- Contagious once rash appears until scabbing complete (7-10 days normally).
- Shedding virus is possible 1-2 days before rash onset.
- Crusted blisters are no longer contagious.
- Contagiousness lasts longer in immunosuppressed persons.
Conclusion
While shingles virus particles may survive briefly on surfaces like sheets or towels, shingles is very rarely spread through this kind of indirect contact. The main risk of transmission is through direct contact with the shingles rash itself while blisters are present and uncrusted. Care should be taken not to expose high-risk groups like pregnant women, infants, or immunocompromised individuals. However, healthy individuals are very unlikely to catch shingles from bed linens or clothing previously used by someone with shingles. Prompt treatment and keeping rash areas covered around others can help prevent spread.