Shingles has been recognized as a distinct medical condition for at least 2,000 years. The Roman encyclopedist Celsus used the term “herpes zoster” sometime between 25 BCE and 50 AD, making it one of the oldest named diseases still diagnosed today. But the virus behind it is almost certainly far older than any written record, likely coexisting with humans for thousands of years before anyone thought to describe it.
The Earliest Descriptions
The first clinical description that clearly matches what we now call shingles came from Aretaeus of Cappadocia, a Greek physician practicing in the second century AD. He documented a painful skin eruption that followed a band-like or “girdle-like” pattern across one side of the body. That description still holds up remarkably well. The hallmark of shingles is a rash that wraps around the torso (or follows a nerve path on the face, arm, or leg) in exactly the pattern Aretaeus described nearly 1,900 years ago.
The name itself reflects this belt-shaped pattern. “Zoster” comes from the Greek word for belt or girdle. “Shingles” traces back to the Latin “cingulus,” also meaning belt. So two different languages independently named the disease after its most recognizable feature.
Centuries of Mystery
For most of recorded history, physicians could describe shingles but had no idea what caused it. They recognized the painful blistering rash and noticed it tended to strike older adults, but the connection to chickenpox remained invisible. The two diseases look different, strike at different ages, and can be separated by decades in the same person. Without microscopes or any concept of viruses, there was no reason to suspect they were related.
This gap in understanding lasted well into the modern era. Chickenpox was common in children, shingles in older adults, and the idea that the same pathogen could hide silently in the body for 40 or 50 years before reappearing was, for most of medical history, completely unimaginable.
Connecting Chickenpox and Shingles
The breakthrough came in the mid-20th century. In 1954, virologist Thomas Weller isolated the varicella-zoster virus from the blister fluid of both chickenpox and shingles patients using cell culture techniques. This was the definitive proof that a single virus caused both diseases. Weller’s work earned him recognition that extended well beyond this discovery (he had already shared a Nobel Prize in 1954 for growing poliovirus in cell culture).
The isolation of the virus raised an obvious next question: where does it go between childhood chickenpox and adult shingles? Researchers suspected the virus hid somewhere in the nervous system, but pinning down exactly where and how took decades of additional work.
Understanding How the Virus Hides
By the 1990s, researchers had the molecular tools to answer this question with precision. A landmark 1995 study published in the Proceedings of the National Academy of Sciences examined nerve tissue from autopsy patients and confirmed that after a childhood chickenpox infection, the virus takes up permanent residence in nerve cell clusters along the spine called dorsal root ganglia. Both the nerve cells themselves and the support cells surrounding them harbor the dormant virus.
The virus doesn’t actively replicate during this dormant phase. It simply sits in the nerve tissue, evading the immune system for years or decades. When the immune system weakens, whether from aging, stress, illness, or immune-suppressing medications, the virus can reactivate. It travels back down the nerve fiber to the skin, producing the characteristic painful rash along the path of that specific nerve. This is why the rash appears in a stripe or band rather than spreading across the whole body.
The Rise of Vaccines
Once scientists understood the virus and its behavior, prevention became possible. The first shingles vaccine, Zostavax, was a live but weakened version of the virus. It reduced the risk of shingles but its protection faded over time, particularly in the oldest adults who needed it most.
In October 2017, the FDA approved Shingrix, a newer vaccine that uses only a protein fragment of the virus rather than a live version. Shingrix proved dramatically more effective, maintaining over 90% protection even in adults over 70. It largely replaced Zostavax and is now the standard recommendation for adults 50 and older.
Shingles Rates Over Time
Interestingly, shingles became more common in recent decades, not less. CDC data tracking adults 30 and older from 1998 through 2019 shows a gradual, sustained increase in shingles rates across the United States. The reasons remain unclear. Some researchers have speculated that widespread childhood chickenpox vaccination, which began in 1995, may have reduced adults’ natural immune “boosting” from casual exposure to chickenpox in children. Others point to an aging population or rising rates of immune-suppressing conditions and treatments. Whatever the cause, the trend has recently plateaued or started to decline across age groups, possibly reflecting the uptake of Shingrix.
About 1 in 3 Americans will develop shingles at some point in their lifetime. The risk climbs sharply after age 50 and continues rising with each decade. So while the virus has been with humanity for millennia, the burden of disease it causes is very much a present-day concern.