rewrite this title NBA Star Tyrese Haliburton Has Shingles. What to Know About the Condition

Indiana Pacers guard Tyrese Haliburton has been diagnosed with shingles, his coach said on Feb. 22. The 25-year-old all-star player was already out for the season after tearing his Achilles tendon in June, but he’d been a visible presence on the sidelines, enthusiastically cheering on his teammates. Now, however, he’s being kept away from team facilities for two to three weeks.

“It’s a very painful thing,” Pacers coach Rick Carlisle told reporters. “He will make a full recovery, but this happened over the last few days. He was meeting us in D.C. and had some odd symptoms and he came back here. It’s a unique case and a unique situation, but I talked to him a few times and he’s always in a good mood, so he’ll get through it.”

Shingles is a common condition: About 1 million cases occur in the U.S. each year, according to the U.S. Centers for Disease Control and Prevention, and 1 in 3 people nationwide will develop it during their lifetime. It’s also known as herpes zoster, and refers to a painful rash caused by the reactivation of the virus that causes chickenpox.

Yet many don’t associate the illness, which is most common in older populations, with healthy, 20-something young people—let alone professional athletes. That perception overlooks how the virus behaves, experts say. Research has found that shingles incidence increased across age groups over several decades, with some analyses noting continued increases among younger adults even as rates in older adults have stabilized.

Here’s what to know about shingles—and why even young people in peak physical health aren’t immune.

When dormant viruses wake up

Shingles is a direct consequence of a previous chickenpox infection. Though they’re distinct illnesses, both are caused by the varicella-zoster virus. “We recover from chickenpox, but the virus remains within our bodies, and 20, 30, 40 years later, it can wake up and come out as shingles,” says Dr. William Schaffner, a professor of medicine in the division of infectious diseases at the Vanderbilt University School of Medicine. “The virus is hibernating in us.”

When the virus reactivates, people often report strange nerve pain—tingling, itching, or burning—for a couple days, but have no idea what’s causing it. “You get the sensation that something’s not right,” Schaffner says. “Then the virus comes out on the skin and makes chickenpox-like blisters on the part of the body that’s being affected.”

Read More: 12 Weird Symptoms Dermatologists Say You Should Never Ignore

It’s impossible to pinpoint one exact reason why someone develops shingles, but researchers have identified a range of potential causes. Older age is the No. 1 risk factor—about half of shingles infections occur in people ages 60 or older. But reduced immunity also plays a role, says Jennifer Moffat, an associate professor of microbiology and immunology at SUNY Upstate Medical University in Syracuse, N.Y. That includes people who are undergoing chemotherapy or taking medications like steroids that reduce immunity; people recovering from another infection, such as the flu or COVID-19; and those living with HIV or autoimmune diseases.

“In young people, it’s more mysterious,” Moffat says. “It can be completely out of the blue. Lack of sleep, stress, physical stress, having had the flu or COVID, having had a virus infection—these are all things that can cause a momentary gap, and that’s enough for the virus to say, ‘I’m going to take this chance to wake up now.’”

What it feels like to have shingles

Most of the time, fluid-filled blisters form on one side of a person’s body, following the path of a single nerve. They most commonly show up on the chest or abdomen, back, or along the waist, but can also pop up on the face or around one eye. For a professional athlete whose job depends on peak physical condition, even a short bout can be disruptive.

“The pain is overwhelming,” Moffat says. “People describe it as one of the most painful things they’ve ever felt, because it’s coming from inside the nerve.” Some people find relief by wearing loose-fitting clothes until the blisters heal.

In addition to ongoing tingling, burning, and sensitivity, people tend to feel generally unwell. Shingles is often accompanied by virus-like symptoms such as fatigue, a headache, and lack of appetite, Moffat says.

For some people, the pain unleashed by the virus lingers. About 10% to 18% of people who get shingles develop postherpetic neuralgia (PHN), and the risk increases sharply with age. The condition refers to nerve pain that persists for 90 days or more after the rash clears, leading to burning, stabbing, or shooting pain in the nerves and skin. The pain associated with PHN can be so debilitating that some people stay inside because too much movement, touch, and light stimulation could trigger a flare, Schaffner says. While uncommon, it’s also possible to develop shingles more than once, he adds.

“Younger people get over their shingles more completely than older people,” Schaffner says. “Generally speaking, they have less severe initial infections, and they’re less apt to get the post-shingles pain.”

How shingles is treated

If you develop a rash and suspect you might have shingles, it’s important to see a doctor right away. Antiviral treatments like valacyclovir are most effective when started within three days of rash onset. (Even if more time has passed, doctors may still consider treatment, especially if new blisters are forming.) These medications can “shorten the time it takes to heal and reduce the person’s pain,” Moffat says.

In certain cases, especially if the rash affects the face or eye, doctors may prescribe steroids to reduce swelling, Moffat says. Shingles affecting the eye can threaten vision and requires urgent medical care. For pain, options are limited. Some patients try medications including gabapentin, but results vary. “There’s not a lot of good treatment for the pain,” she says.

Schaffner’s patients often wonder if shingles is contagious. You can’t “catch” shingles from someone else, he says, but the varicella-zoster virus inside the blisters can be transmitted to people who have never had chickenpox or been vaccinated against it.

A highly effective vaccine

Preventing shingles starts at a young age. All children are advised to get two doses of the varicella (chickenpox) vaccine: a first shot at 12 to 15 months, and another when they’re 4 to 6 years old. While the chickenpox vaccine doesn’t eliminate the risk of developing shingles later in life—because it uses a weakened version of the virus that can still lie dormant in nerve cells—research has found it reduces the risk by 70% to 80% compared with those who had natural chickenpox infection.

Meanwhile, the Shingrix vaccine—which was specifically designed to prevent shingles in adults—is recommended for those ages 50 and up, as well as immunocompromised adults over age 19.

“Shingrix is turning out to be a miracle vaccine in that it’s super effective at preventing shingles, which is always a good thing, but it also protects your brain,” Moffat says. Observational studies have found that people who receive Shingrix are about 20% less likely to be diagnosed with dementia in subsequent years, though the data show association, not proof of cause and effect.