Shingles (herpes zoster) is an infection that causes a painful rash. It is caused by the varicella-zoster virus (VZV). This is the same virus that causes chickenpox. After you have chickenpox, the virus stays in your body. It may not cause problems for many years. But as you get older, the virus may become active again and cause shingles.

Shingles is not contagious. You cannot get shingles from someone else. But you can catch chickenpox from someone with shingles if you have direct contact with fluid from their shingles rash.

The risk of spreading the virus is low if the shingles rash is kept covered. People with shingles cannot spread the virus before their rash blisters appear or after the rash crusts.

Anyone who has had chickenpox can get shingles. But the risk of shingles goes up as you get older. Shingles is most common in people over age 50.

People with weakened immune systems are at higher risk of getting shingles. This includes those who:

• Have immune system diseases such as HIV
• Have certain cancers
• Take medicines that weaken their immune system, such as steroids and medicines you take after an organ transplant

Your immune system may be weaker when you have an infection or are stressed. This can raise your risk of shingles.

It is rare, but possible, to get shingles more than once.

Early signs of shingles include burning or shooting pain and tingling or itching. It is usually on one side of the body or face. The pain can be mild to severe.

Up to several days later, you will get a rash. It consists of blisters that typically scab over in 7 to 10 days. The rash is usually a single stripe around either the left or the right side of the body. In other cases, the rash is only on one side of the face. In rare cases (usually among people with weakened immune systems), the rash may be more widespread. It might look similar to a chickenpox rash.

Some people may also have other symptoms:

• Fever
• Headache
• Chills
• Upset stomach

Shingles can cause other problems (complications):

• Postherpetic neuralgia (PHN) is the most common complication of shingles. It causes severe pain in the areas where you had the shingles rash. It usually gets better in a few weeks or months. But some people can have pain from PHN for many years, and it can interfere with daily life.
• Vision loss can happen if shingles affects your eye. It may be temporary or permanent.
• Hearing or balance problems are possible if you have shingles within or near your ear. You may also have weakness of the muscles on that side of your face. These problems can be temporary or permanent.

Very rarely, shingles can also lead to pneumonia, brain inflammation (encephalitis), or death.

Usually your health care provider can diagnose shingles by taking your medical history and looking at your rash. In some cases, your provider may scrape off tissue from the rash or swab some fluid from the blisters and send the sample to a lab for testing.

There is no cure for shingles. Antiviral medicines may help to make the attack shorter and less severe. They may also help prevent PHN. The medicines are most effective if you can take them within 3 days after the rash appears. So if you think you might have shingles, contact your provider as soon as possible.

Pain relievers may also help with the pain. A cool washcloth, calamine lotion, and oatmeal baths may help relieve some of the itching.

There is a vaccine, called Shingrix, to help prevent shingles and its complications. The Centers for Disease Control and Prevention recommends that healthy adults 50 years and older get the vaccine. Your provider might also recommend the vaccine if you are over 19 and have a weakened immune system. The vaccine is given in two doses.

If you have shingles, you can help prevent spreading the virus to others by:

• Staying away from:
  • People with weakened immune systems
  • People who have not had chickenpox or the chickenpox vaccine, especially if they are pregnant
  • Premature or low birth weight babies
• Keeping the rash covered
• Not touching or scratching the rash
• Washing your hands often

Centers for Disease Control and Prevention

Sickle cell disease (SCD) is a group of inherited red blood cell disorders. If you have SCD, there is a problem with your hemoglobin. Hemoglobin is a protein in red blood cells that carries oxygen throughout the body. With SCD, the hemoglobin forms into stiff rods within the red blood cells. This changes the shape of the red blood cells. The cells are supposed to be disc-shaped, but instead they are crescent, or sickle, shaped.

The sickle-shaped cells are not flexible and cannot change shape easily. Many of them burst apart as they move through your blood vessels. The sickle cells usually only last 10 to 20 days, instead of the normal 90 to 120 days. Your body may have trouble making enough new cells to replace the ones that you lost. Because of this, you may not have enough red blood cells. This is a condition called anemia, and it can make you feel tired.

The sickle-shaped cells can also stick to vessel walls, causing a blockage that slows or stops the flow of blood. When this happens, oxygen can't reach nearby tissues. The lack of oxygen can cause attacks of sudden, severe pain, called pain crises. These attacks can occur without warning. If you get one, you might need to go to the hospital for treatment.

SCD is caused by a variant (change) in a gene that has instructions for your body to make one part of the hemoglobin. This changed gene is sometimes called a sickle cell gene. People with SCD are born with two sickle cell genes, one from each parent.

If you are born with one sickle cell gene, it's called sickle cell trait. People with sickle cell trait are generally healthy, but they can pass the defective gene on to their children.

In the United States, most of the people with SCD are African Americans:

• About 1 in 13 Black or African American babies are born with sickle cell trait
• About 1 in every 365 Black or African American babies are born with sickle cell disease

SCD also affects some people who come from Hispanic, southern European, Middle Eastern, or Asian Indian backgrounds.

People with SCD start to have signs of the disease during the first year of life, usually around 5 or 6 months of age. Early symptoms of SCD may include:

• Painful swelling of the hands and feet
• Fatigue or fussiness from anemia
• A yellowish color of the skin (jaundice) or the whites of the eyes (icterus)

The effects of SCD vary from person to person and can change over time. Most of the signs and symptoms of SCD are related to complications of the disease. They may include severe pain, anemia, organ damage, and infections.

A blood test can show if you have SCD or sickle cell trait. Genetic tests can tell if you have one or two copies of the sickle cell gene. Genetic tests can help confirm an SCD diagnosis if the results from blood tests are not clear.

All states now test newborns for SCD (as well as many other treatable conditions) as part of their screening programs. These programs help find the conditions early, so treatment can be started right away.

Health care providers can also diagnose SCD before a baby is born. That test uses a sample of amniotic fluid (the liquid in the sac surrounding the baby) or tissue taken from the placenta (the organ that brings oxygen and nutrients to the baby).

People who are thinking about having children can have the test to find out how likely it is that their children will have SCD.

There are many ways to manage sickle cell disease. Your medical team will probably include a hematologist, a doctor who specializes in blood diseases. You will work with your medical team to set up a treatment plan. Possible treatment options may include:

• Treatments that can help relieve symptoms and lessen complications, including:
  • Hydroxyurea, a medicine to reduce sickling of red blood cells. This can help prevent serious symptoms of sickle cell disease. This medicine can be used in adults and in children as young as 9 months old. But this medicine is not safe during pregnancy.
  • Voxelotor, another medicine to prevent the sickling of red blood cells. It can be used in adults and children ages 4 years and older.
  • Pain relievers for acute or chronic pain.
  • Antibiotics to try to prevent infections in younger children.
  • Blood transfusions for severe anemia. If you have had some serious complications, such as a stroke, you may have transfusions to prevent more complications.
  • Other treatments for specific complications, such as medicines to lower blood pressure and vitamins to treat a vitamin deficiency.
• Bone marrow or stem cell transplantation, which can cure SCD. Because these transplants are risky and can have serious side effects, they are usually only used in children with severe SCD. For the transplant to work, the bone marrow must be a close match. Usually, the best donor is a brother or sister.
• Gene therapies to treat SCD in people who are 12 years and older and have had repeated sickle cell crises. These new therapies involve taking some of your blood stem cells and either adding new DNA to them or changing their existing DNA. Then these cells are given back to you, and they can make a type of hemoglobin that is healthy. This can reduce the complications of SCD, including the SCD crises.

Complementary and alternative medicine (CAM) seems to help some people deal with pain caused by SCD. These types of CAM may lower your pain, especially if it is not well managed with medicines::

• Cognitive behavioral therapy (a type of counseling)
• Acupuncture
• Exercise or movement programs, such as yoga
• Massage
• Meditation and mindfulness practices
• Virtual reality, a computer-generated 3D environment you can see with special goggles

It's also important to take steps to keep yourself as healthy as possible:

• Get regular medical care
• Get your routine vaccinations
• Live a healthy lifestyle
• Avoid situations that may set off a pain crisis

NIH: National Heart, Lung, and Blood Institute

Sjogren's syndrome, also called Sjogren's disease, is a chronic (long-lasting) autoimmune disease. When you have an autoimmune disease, your immune system attacks healthy tissues and organs by mistake. In Sjogren's syndrome, your immune system attacks the glands that make moisture in the eyes, mouth, and other parts of the body. This causes a dry mouth and dry eyes. You may have dryness in other places that need moisture, such as your nose, throat, and skin. Sjogren's can also affect other parts of the body, including your joints, lungs, kidneys, blood vessels, digestive organs, and nerves.

Normally, your immune system protects the body from infection and disease. But with Sjogren's syndrome and other autoimmune diseases, your immune system attacks healthy tissues and organs. Researchers don't know for sure what causes the immune system to do this. But they think that it is caused by a combination of genetic and environmental factors. Studies have linked Sjogren's syndrome to gene changes in several genes. Some researchers also think that the disease may be triggered by something in the environment. For example, they think that one possible trigger could be a previous infection with a virus or bacteria.

Most people with Sjogren's syndrome are women. You can get it at any age, but it is most common in people in their 40s and 50s.

Sjogren's syndrome is more common in people who have other autoimmune diseases such as rheumatoid arthritis and lupus. This is known as a secondary form of Sjogren's syndrome. People who don't have another autoimmune disease have a primary form of Sjogren's syndrome.

Sjogren's syndrome may have different effects on the body. Not everyone will have the same symptoms. Some people have cycles of mild and then severe symptoms.

The two main symptoms are:

• Dry eyes. Your eyes may burn or itch or feel like they have sand in them. Sometimes your vision may be blurry, or you could be bothered by bright lights.
• Dry mouth. Your tongue and your throat may feel dry. You might have trouble swallowing, speaking, and tasting.

Sjogren's syndrome can also affect other parts of the body, causing symptoms such as:

• Joint and muscle pain
• Dry skin
• Rashes on the skin of hands or feet
• Numbness or tingling in the hands or feet
• Vaginal dryness
• Dry cough that doesn't go away
• Fatigue that doesn't go away

There is no single test for Sjogren's syndrome. To find out if you have it, your provider:

• Will ask about your medical history and symptoms.
• Will do a physical exam, which includes checking for signs of dry mouth and signs of related autoimmune diseases.
• May order tests, including:
  • Eye tests to see if you produce a normal amount of tears and to find out if your eyes have been damaged by dryness.
  • Salivary gland tests to measure how much saliva your mouth produces. They could include imaging tests and a biopsy.
  • Blood tests.

There is no cure for Sjogren's syndrome. Treatment focuses on relieving your symptoms. The treatments can be different for each person, depending on which parts of the body are affected. They may include:

• Eye drops (artificial tears) or ointments to relieve dryness in the eyes.
• Saliva substitutes.
• Prescription medicines that cause your salivary glands to make more saliva.
• A minor procedure that places small plugs in the tear duct in the corners of the eyes. The plugs block your tears from draining so they stay in your eyes longer.
• Medicines to help with other symptoms caused by Sjogren's syndrome, such as medicines for pain and inflammation.
• Medicines that suppress (weaken) your immune system (for severe cases).

You can also try to relieve some of your symptoms by sucking on sugar-free candy, drinking water often, increasing the humidity in your room, and not smoking. Because having a dry mouth can raise your risk of cavities, it's important to take good care of your teeth and see your dentist regularly.

Sleep apnea is a common disorder that causes your breathing to stop or get very shallow. Breathing pauses can last from a few seconds to minutes. They may occur 30 times or more an hour.

The most common type is obstructive sleep apnea. It causes your airway to collapse or become blocked during sleep. Normal breathing starts again with a snort or choking sound. People with sleep apnea often snore loudly. However, not everyone who snores has sleep apnea.

You are more at risk for sleep apnea if you are overweight, male, or have a family history or small airways. Children with enlarged tonsils or adenoids may also get it.

Doctors diagnose sleep apnea based on medical and family histories, a physical exam, and sleep study results.

When your sleep is interrupted throughout the night, you can be drowsy during the day. People with sleep apnea are at higher risk for car crashes, work-related accidents, and other medical problems. If you have it, it is important to get treatment. Lifestyle changes, mouthpieces, surgery, and breathing devices can treat sleep apnea in many people.

NIH: National Heart, Lung, and Blood Institute

Many people who chew tobacco or dip snuff think it's safer than smoking. But you don't have to smoke tobacco for it to be dangerous. Chewing or dipping carries risks like:

• Cancer of the mouth
• Decay of exposed tooth roots
• Pulling away of the gums from the teeth
• White patches or red sores in the mouth that can turn to cancer

Recent research shows the dangers of smokeless tobacco may go beyond the mouth. It might also play a role in other cancers, heart disease and stroke.

Smokeless tobacco contains more nicotine than cigarettes. Nicotine is a highly addictive drug that makes it hard to stop using tobacco once you start. Having a quit date and a quitting plan can help you stop successfully.

NIH: National Institute of Dental and Craniofacial Research