California’s U.S. Sen. Dianne Feinstein fought a extra harrowing battle with shingles than was beforehand disclosed, her workplace stated Thursday, because it revealed that the situation result in problems that partially paralyzed her face and induced her mind to swell.

Final week Feinstein, 89, stated in an announcement that she had suffered problems from the situation, which happens when the varicella-zoster virus—liable for chickenpox—reactivates later in life. 

The Democratic stalwart skilled encephalitis, or irritation of the mind, which “resolved shortly after she was launched from the hospital in March,” a spokesman for the senator advised The Related Press.

And she or he continues to battle Ramsay Hunt syndrome, a uncommon neurological dysfunction seen in some individuals who have, or have not too long ago had, shingles. The syndrome happens when the reactivated varicella-zoster virus spreads to a facial nerve, in response to the Nationwide Group for Uncommon Issues. Whereas the syndrome, like shingles, is usually solely seen in seniors, pop star Justin Bieber, 29, introduced final yr that he was affected by the situation. His situation has since improved.

When Feinstein returned to the Senate on Could 10 after greater than two months away, her face appeared partially paralyzed, resulting in hypothesis that she had suffered a stroke. She continues to be recovering from Ramsay Hunt syndrome and can function on a diminished schedule, aides advised the AP final week.

The senator’s sickness has put shingles again within the highlight—and a spotlight to the matter is way wanted, consultants say. A staggering 99% of individuals born earlier than 1980 have skilled chickenpox—and anybody who has is in danger for growing shingles later in life.

Listed below are seven issues it is advisable to know in regards to the exceedingly painful situation, recognized for placing with out a lot warning—even amongst those that assume they by no means had chickenpox.

Shingles happens as your immune system weakens, normally with age.

As soon as somebody is contaminated with the varicella-zoster virus, a sort of herpes virus that isn’t sexually transmitted, it retreats to the nervous system, the place it stays perpetually. It might probably reactivate because the immune system weakens—typically attributable to ageing, and usually after age 50, Dr. Sajida Chaudry, a main care doctor and the Workplace Medical Director at Johns Hopkins Group Physicians at Odenton, not too long ago advised Fortune’s Alex Vance.

However it may possibly happen at age, at any level, in anybody who’s had chickenpox.

Those that are immunocompromised—together with these present process chemotherapy and different most cancers therapies, and people who have HIV—are amongst these at increased danger, Chaudry stated.

“I’ve seen very wholesome individuals get shingles, and typically there isn’t any [specific] purpose,” she added.

Don’t assume you had chickenpox? Suppose once more.

Should you don’t bear in mind experiencing chickenpox as a toddler, don’t assume you’re

within the clear. It’s doable to have a light course of the virus with no signs,

in response to Chaudry.

One early signal of shingles: an odd tingling sensation.

Shingles happens because the dormant virus reactivates from inside your physique’s nerves. As this occurs, you would possibly really feel an odd tingling sensation, Chaudry stated.

“The pores and skin simply feels totally different,” she defined. “Some days later, [you may] discover a rash. It’s normally purple spots that slowly turn out to be [similar to] blisters, normally an entire crop of them. They’ll vary from mildly uncomfortable to very painful.” 

The primary symptom of shingles is a rash—however extra uncommon problems can happen, like in Feinstein’s case.

A shingles rash normally happens in a single space of the physique, just like the chest, again, or stomach. Those that are older or immunocompromised could expertise a extra extreme rash. The rash usually clears in every week or two, however can take longer to heal if it’s extra extreme. When you have shingles, your physician will seemingly prescribe you an antiviral, and likewise suggest symptomatic remedy like over-the-counter ache remedy, calamine lotion, and oatmeal baths.

Different frequent signs embrace fatigue, headache, fever, chills, and/or an upset abdomen. Extra uncommon signs embrace ocular shingles, which might result in lack of imaginative and prescient, eye irritation, and extreme ache; listening to issues; encephalitis; and pneumonia.

Those that have shingles can’t go it on—however they may give somebody chickenpox.

Contact with fluid from a shingles rash can transmit the varicella-zoster virus, probably leading to chickenpox—not shingles—in somebody who has by no means been uncovered. After experiencing chickenpox, the newly uncovered individual might later develop shingles.

When you have shingles, bear in mind that your rash is contagious till it scabs over. Preserve it coated, keep away from scratching or touching it, and wash your fingers incessantly, Chaudry advises.

There’s a shingles vaccine—and everybody age 50 and older ought to get it.

As with all vaccines, the shingles jab isn’t a assure that you just received’t expertise the blisteringly painful situation. Nevertheless it reduces your probability of growing it, and it ought to make your signs extra delicate in case you do, Chaudry says.

It additionally reduces your danger of growing post-herpetic neuralgia, or power shingles ache, which happens in about 10% to twenty% of those that’ve had shingles. That situation could cause ache for months and even years after the pores and skin has healed, she advises.

Chaudry recommends that anybody aged 50 and older make getting the two-dose vaccine a prime precedence—even when they’ve already had singles, because it’s doable to get it a number of instances.

“Prevention is at all times higher than remedy, and we’ve got the posh of timing this stuff,” she stated. “If you go to the physician to your annual, that’s the greatest time. It truly is one of the best factor to your well being and [for] taking good care of your self.”