Why does chicken pox cause shingles later on in life?
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It’s the same virus. You get chickenpox first at some point (usually childhood or adolescence). The virus is quite widespread and you get the typical rash (you can be asymptomatic or only have one or two spots so don’t realise you’ve had it. I had this as I had my blood checked before I started medical school to see if I should get vaccinated before seeing immunocompromised patients, but blood work shows I’ve had the virus before). You then recover from the chickenpox
The virus however remains in your body in one or more dorsal root of spinal nerves or cranial nerves. Here it is relatively protected from the immune system. Later on in life something triggers re-emergence of the virus and you get chickenpox again, but only in the area that that nerve innervates. And this is shingles.
You need to have had chickenpox earlier to get shingles and something is needed to happen to trigger shingles developing. These things are more likely to occur as we age so they happen later. Shingles in childhood is uncommon/rare. The trigger may not be identified but mostly are things that reduce the immune response (eg immunosuppressive drugs or disease, psychological stress, aging)
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