Transplant patient and shingles?

The chance of you or your friend getting the shingles from this visit is really nothing to worry about at all since you had no physical contact. You would have to have contact with the fluid from the blisters that break open in order to get the shingles and that just never happened at your visit.

I might add that I had a liver transplant 6 years ago and did get the shingles myself last year. It was no worse for me than it was for anyone else that gets them. They do cause terrible pain and I had them for 2 months before they cleared up. It's when the blisters from them open up that they are the most contagious. I've known quite a number of people who have had them and even worked with some pretty severe cases since I'm a nurse. I would say mine was pretty much normal and that there was no real difference due to my compromised immune system. I didn't get mine from someone else. They just suddenly popped up since I had chicken pox when I was a child. You or your friend can actually get them at any time for no specific reason if you ever had chicken pox. Nobody really knows what makes them suddenly appear.

Neither you nor your friend has anything to worry about. Your friend's immune system isn't compromised from the transplant itself (which is the surgical procedure), it's suppressed by the medications that must be taken to prevent transplant-rejection. I felt the distinction was an important one to make.

"Shingles" is herpes zoster. This condition is caused by varicella-zoster virus, or VZV, which also causes chicken pox. VZV belongs to the herpesvirus family and so it is with you for life, like all other members of the herpesvirus family. Now, the mutual friend you ran into, had chicken pox once upon a time and probably as a child. As he recovered, VZV retreated into spinal nerve tissue and went dormant. Spinal nerves are nerves that branch off the spinal cord and provide sensory and motor function to the head, eyes, face, neck, trunk, arms & legs, everything including internal organs. Specifically, it's sensory aspect that is affected by VZV. Herpes zoster, or h. zoster, occurs when VZV is reactivated. Although the precise reasons why aren't completely known yet, it's believed that stress may be a factor. Stress can be physical, mental or emotional. A severe illness, for example, is one type of physical stress.

Anyway, when it reactivates, VZV moves out along the pathway of a spinal sensory nerve and causes the tingling, burning pain and characteristic one-sided rash that blisters. When the blister break open and drain, the virus (VZV) is in the drainage. The people most at risk are those who have never had chicken pox and those who are immune compromised but there has to be contact with the drainage, which contains VZV, so that the virus can be transferred to the respiratory tract. For someone who's never had chicken pox, VZV will cause chicken pox. Remember, h. zoster is a reactivation of an existing virus from a previous infection, not an initial infection in which the virus has never before been encountered.

This is not your friend's case and it would make little difference if she had previous immunity, all bets are off now. But she had no physical contact, I'm pretty sure the mutual friend was wearing clothing that covered any outbreak, and the mutual friend didn't have draining blisters yesterday and may not have them yet today either.

I know of one study currently ongoing to determine whether a gradual withdrawal of immunosuppressants is feasible. It would be nice if your friend no longer had to take these drugs. Everyone should be so lucky as to have a friend like you!

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