Feinstein reveals shingles complications: What to know about encephalitis and Ramsay Hunt syndrome

 Democratic Sen. Dianne Feinstein’s office has confirmed reports detailing new health complications that may have resulted from the congressional giant’s bout with shingles.

Her spokesman Adam Russell confirmed to The Associated Press on Thursday that the 89-year-old had encephalitis, or brain inflammation, while recovering from the virus and continues to suffer from Ramsay Hunt syndrome.

Feinstein had not disclosed those medical details upon her return to the Senate last week, though she said in a statement that she had suffered complications.

The longtime California senator returned from a more than two-month absence May 10 after weeks of questions about her health and whether she would be back in the Senate at all.

Here’s what to know about shingles and some of its complications.

What is shingles? What are shingles symptoms?

Shingles, or herpes zoster, is a viral infection caused by the varicella zoster virus, the same virus that causes chickenpox, according to the Centers for Disease Control and Prevention.

People who have had chickenpox before are at increased risk of developing shingles. After a person recovers from the infection, the virus stays inactive in the body and can become reactive years later, causing shingles, the CDC said. Signs and symptoms include:

• Pain, itching or skin tingling
• Painful rash of blister-like sores
• Fever
• Headache
• Chills
• Upset stomach

About 1 in 3 people in the U.S. will develop shingles in their lifetime, according to the CDC, and an estimated 1 million people in the country develop the disease each year. The disease causes less than 100 deaths a year.

The agency says shingles rates have been increasing in the United States for reasons that are unclear. Though the trend continues for young and middle-aged adults, rates have steadied among older adults since 2008.

What is encephalitis?

Encephalitis is brain inflammation and can be caused by viral infections, autoimmune inflammation, bacterial infection and insect bites, among other causes, according to the Mayo Clinic.

The condition can cause confusion, personality changes, seizures, problems with movement, and changes in sight and hearing. Other symptoms of encephalitis related to an infection include:

• Headache
• Fever
• Aches in muscles or joints
• Fatigue or weakness

The Mayo Clinic says common viruses that can cause encephalitis include:

• Herpes viruses
• Enteroviruses
• Mosquito-borne viruses
• Tick-borne viruses
• Rabies viruses

Encephalitis occurs in about 15 people per 100,000 each year, according to Johns Hopkins Medicine, but doctors are unable to identify the cause behind up to 40% of cases. The key to treatment is early detection and effective therapies, which depends on the underlying cause and can include antivirals, antibiotics or immunotherapy.

What is Ramsay Hunt syndrome?

Ramsay Hunt syndrome is caused by the same virus the causes chickenpox and shingles and occurs when a shingles outbreak impacts the facial nerve near one of the ears, according to the Mayo Clinic, often causing facial paralysis and hearing loss.

Besides the shingles rash and facial paralysis, people with Ramsay Hunt syndrome may experience:

• Ear pain
• Hearing loss
• Ringing in your ears
• Difficult closing one eye
• A change or loss of taste
• Dry mouth and eyes

Early detection and treatment can reduce the risk of long-term complications, the Mayo Clinic said. Effective therapies can include antivirals, steroids and pain relievers.

Recovery depends on severity of symptoms, according to the Cleveland Clinic. Patients could see improvement in as little as a few weeks to a full year.

What are other complications of shingles?

Besides encephalitis and Ramsay Hunt syndrome, the CDC said the shingle virus can cause other complications during an outbreak, such as postherpetic neuralgia.

Postherpetic neuralgia, or long-term nerve pain, can occur even when the shingles rash clears up and can last for months or years. The agency said about 10% to 18% of people who get shingles will experience this pain, and the risk of developing it increases with age.

Other complications from a shingles outbreak can include pneumonia and hearing problems.

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Is shingles contagious? Is it OK to be around someone with shingles?

Shingles is not contagious, the CDC said, but the virus that causes shingles can be transmitted and cause chickenpox in someone who has never had the disease or was never vaccinated.

The virus can transmit through direct contact with fluid from shingles blisters or rash. To prevent transmission, the CDC recommends:

• Covering the rash
• Avoiding contact with the rash
• Washing hands often

The shingles vaccine: Who should get it?

The CDC recommends adults 50 and older get two doses of the Shingrix vaccine to prevent shingles and complications form the disease. The agency said people should still get vaccinated even if they’ve had shingles or received the chickenpox vaccine.

The vaccine is also recommended for adults 19 and older who have weakened immune systems.

Contributing: The Associated Press. Follow Adrianna Rodriguez on Twitter: @AdriannaUSAT.

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