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Fact Check-Recent monkeypox cases are not mistaken shingles, and not caused by shingles virus

Shingles is not the same disease as monkeypox, the two diseases are caused by viruses from different families, and they are unlikely to be mistaken for each other based on laboratory tests or physical symptoms, despite online claims that suspected monkeypox cases reported around the world in recent weeks are really shingles episodes.

Shingles, also known as herpes zoster, is caused by reactivation of the dormant Varicella Zoster Virus, which causes chickenpox. Varicella Zoster is a member of the Herpesviruses family, unlike monkeypox, a member of the Poxviruses family, and the rashes caused by the two viruses manifest differently on the skin, experts confirmed to Reuters.

Some individuals have posted false claims online that recently-detected cases of monkeypox were really cases of shingles occurring as a side-effect of COVID-19 vaccination.

One user took to Twitter on May 21, 2022, and said: “Is Monkeypox really shingles from the jab?” (here)

Another said on Twitter: “Monkey pox = shingles. Shingles is a well-known side effect of the jab. You are being played. This narrative will not hold” (here).

An individual who shared the claim on Facebook said: “Pssst !! Monkeypox is really Shingles which is ramped now in people that got the cvd shot !! Wakie wakie...” (here).

After COVID vaccines rolled out widely in 2021, studies and news articles documented rare reports of shingles episodes following vaccination (here), here), (here), (here), (here). It remains unclear whether or how vaccination might have provoked those shingles cases.

But shingles and monkeypox are caused by different viruses.

VERY DIFFERENT VIRUSES

Like all Herpesviruses, Zoster remains in the body following an active infection, usually a bout of chickenpox during childhood. Shingles typically emerges during middle and old age, when the immune system is thought to weaken and to no longer be able to keep the Zoster virus dormant. It causes a painful rash, usually on just one part of the body, and can be treated with antiviral medications. (here).

Shingles and monkeypox differ in many aspects, experts told Reuters, including risk factors associated with the diseases and how the respective rashes manifest on the skin.

“There are major differences between monkeypox and shingles. Although both are viruses, they belong to different viral families,” Don Vinh, associate professor in the Division of Experimental Medicine at McGill University, told Reuters.

“Shingles is caused by the same virus that causes chickenpox called Varicella Zoster Virus VZV, this virus is not of the same family as the virus that causes monkeypox,” Boghuma Kabisen Titanji, infectious diseases fellow at Emory University School of Medicine, told Reuters (here).

VZV belongs to the Herpesvirus family and is a cousin of ‘cold sores’, Dr Don Vinh explained. “VZV causes chickenpox mostly in children in North America, and then stays dormant in the body’s nerve roots,” he added.

Monkeypox, though, belongs to the Orthopoxvirus genus in the Poxviridae family, which is unrelated to VZV (here).

“Monkeypox is a cousin of smallpox. Monkeypox has historically been restricted to Western and Central Africa. Monkeypox is a zoonosis (infection primarily transmitted to humans from animals): Exposure to rodents usually underlies the start of human outbreaks,” Vinh said (here).

“Monkeypox is a primary infection caused by contact with a person or animal with active disease. Shingles is reactivation of the virus that causes chickenpox,” said Seth Blumberg, associate professor of medicine at the University of California, San Francisco. “The known risk factors of monkeypox are mostly related to exposure to infected people or animals, whereas the risk factors for shingles are older age, and immunosuppression,” he added.

Although both diseases cause a rash with small blisters, there are differences in the type of rash caused and the distribution of the rash on the skin.

“Shingles tends to affect one narrow strip of the skin on just one side of the body, whereas monkeypox can affect the entire body,” Blumberg said.

“Shingles usually causes pain, tingling or discomfort before the appearance of the skin lesions (called "vesicles," which are small blisters of fluid). The lesions of shingles are typically localized to one skin distribution (called "dermatome"), although in some rare instances, it can involve more than one dermatome or even involve the entire body,” Vinh explained, while monkeypox does not stay localized to a dermatome (here).

The skin lesions caused by monkeypox, and shingles also look very different, Vinh said, with monkeypox usually associated with swollen lymph nodes while chickenpox and shingles are not (here), (here).

“Chickenpox and Shingles usually have their skin lesions in different stages at the same time (you get vesicles and scabs, at the same time), whereas Monkeypox has synchronous lesions (all the lesions usually look at the same at any given stage of the disease),” he added.

Specific tests can also distinguish between the two. “DNA amplification techniques such as PCR test can be used to test for these conditions and can help distinguish which virus is causing the rash,” Titanji said.

VERDICT

False. Shingles and monkeypox are not the same disease, despite widely spread claims online by social media users. Shingles is caused by the Varicella Zoster Virus, which is a different virus, belonging to a different family, from the virus that causes monkeypox. Lesions caused by shingles are typically localized to one skin distribution while monkeypox does not stay localized to one distribution on the body.

This article was produced by the Reuters Fact Check team. Read more about our fact-checking work here .

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