Introduction
Shingles, also called zoster, is caused by the varicella zoster virus. This virus is also responsible for causing chickenpox, which usually occurs in childhood. The rate of infestation of the population with this pathogen, i.e. what percentage of the population is infected with the virus (carrying it), is up to 90% regionally after childhood.
Chickenpox (varicella) is not a dangerous disease for children. However, an outbreak is a sign that the virus has infested the body and remains in the host until the end of the child’s life. The viruses settle in nerve nodes and can be reactivated if the immune system is weakened – shingles breaks out.
The role shingles plays for an expectant mother depends on the immune status of the pregnant woman. Shingles or contact with infected persons can be completely harmless for the mother and the unborn child, but if the mother is not immunized, it can be very dangerous for both. Almost all pregnant women are immune to the varicella zoster virus, namely if they have had a chickenpox infection in childhood or if they have been vaccinated against varicella.
If shingles then occurs during pregnancy, this is a sign of reactivation of the virus from the nerve roots and not a sign of a new infection. This reactivation is usually not dangerous for the child. However, if there is no adequate immune defence, an initial infection with Varicella zoster virus can occur during pregnancy.
Both chickenpox and shingles can not only be dangerous for the mother, but can also be very harmful to the unborn child. Complications rarely occur in adulthood, but are possible in principle. There is a risk of pneumonia (pneumonia) and otitis (inflammation of the ears), nephritis (inflammation of the kidneys) but also involvement of the nervous system in the form of meningoencephalitis (inflammation of the brain and its meninges) or inflammation of the nerves.
In some cases (1 – 2%) “fetal varicella syndrome” may develop in the unborn child if the mother becomes infected at the beginning of pregnancy. The syndrome includes harmful changes in the skin, developmental deficits affecting the extremities and brain, and unhealthy low birth weight. The infection often leads to miscarriage (abortion) in the early stages of pregnancy.
During most of the pregnancy, the child is protected from the viruses by the mother’s immune system. If an infection occurs around the time of birth it becomes critical. During this period the nest protection is missing, which is guaranteed by maternal antibodies. If signs of a varicella infection are detected at birth or shortly afterwards, prophylactic treatment with antivirals must be carried out immediately. If such an infection has broken out, the mortality rate among newborns is 30% – this explains the efforts to immunize against the varicella zoster virus within the framework of the six-fold vaccination.
