What Causes a Shingles Outbreak?

Shingles is a painful disease that is caused by the same herpes virus that causes the chicken pox—the varicella zoster virus.

As herpes viruses go, it is very typical in its pathology. The varicella zoster virus has an initial infectious stage, which is the chicken pox, followed by a dormant stage, and then another active stage.

Estimates suggest about one in five people who had the chicken pox will develop shingles, but the issue becomes pertinent here when a person's immune system is compromised, as can be the case from anti-lymphoma treatments, including monoclonal antibodies such as rituximab. In those instances reactivation of the virus becomes much more common and likely.

The virus lives within nerve tissue, and during an outbreak the inflamed nerves will create itchiness, numbness, and pain on the skin area above the inflamed nerve.

Shingles Outbreaks From Lymphoma

Since lymphoma is a cancer of the lymphocytes, therefore affecting the patient's immune system, people with lymphoma as well as those receiving anticancer treatments for lymphoma are especially susceptible to reactivation of the virus because there is suddenly very little resistance meeting and containing it.

The same is true for organ transplant patients—any situation, in sum, that suppresses the immune system can create an opportunity for the virus to reactivate.

While there is a shingles vaccination available, the U.S. Centers for Disease Control have traditionally urged people with lymphoma not to receive the vaccination, although one should always discuss this with his or her health professional.

The CDC offers a helpful fact sheet regarding herpes zoster virus.