Shingles, herpes zoster, is a reactivation of the chickenpox virus (the varicella-zoster virus). After having chickenpox, the varicella-zoster virus retreats to nerve cells in the body, where it often lies dormant for many years. Like other members of the herpes family (such as the herpes simplex viruses that cause cold sores and genital herpes), the varicella-zoster virus that causes chickenpox never leaves the body.
Certain factors, such as stress, aging, or low immunity, can reactivate the virus and it begins to reproduce. The virus travels along the path of a nerve (where the virus "slept") to the skin's surface and becomes visible as shingles. Shingles causes numbness, tingling, itching, or pain before a blistery rash appears. This rash appears as fluid-filled blisters. Because shingles occurs in an area of the skin that is supplied by sensory fibers of a single nerve, called a dermatome, the rash usually appears in a strip on one side of the body, typically the torso, face, nose, and eyes.
Diagnosis is difficult before the rash appears and may be mistaken for conditions such as appendicitis or heart attack. Treatments focus on shortening the duration of the shingles outbreak and controlling the associated pain, but there is not currently a vaccine distributed to prevent shingles. Shingles may lead to a chronic painful condition called post-herpetic neuralgia (PHN) that can be difficult to treat, and many individuals who experience shingles have pain in the affected area during periods of short-term stress. A small percentage of people have more than one occurrence of shingles.
Shingles and the Americans with Disabilities Act
The ADA does not contain a list of medical conditions that constitute disabilities. Instead, the ADA has a general definition of disability that each person must meet. A person has a disability if he/she has a physical or mental impairment that substantially limits one or more major life activities, a record of such an impairment, or is regarded as having an impairment. For more information about how to determine whether a person has a disability under the ADA, see How to Determine Whether a Person Has a Disability under the Americans with Disabilities Act Amendments Act (ADAAA).
Accommodating Employees with Shingles
People with shingles may develop some of the limitations discussed below, but seldom develop all of them. Also, the degree of limitation will vary among individuals. Be aware that not all people with shingles will need accommodations to perform their jobs and many others may only need a few accommodations. The following is only a sample of the possibilities available. Numerous other accommodation solutions may exist.
Questions to Consider:
- What limitations is the employee experiencing?
- How do these limitations affect the employee and the employee’s job performance?
- What specific job tasks are problematic as a result of these limitations?
- What accommodations are available to reduce or eliminate these problems? Are all possible resources being used to determine possible accommodations?
- Has the employee been consulted regarding possible accommodations?
- Once accommodations are in place, would it be useful to meet with the employee to evaluate the effectiveness of the accommodations and to determine whether additional accommodations are needed?
- Do supervisory personnel and employees need training?
Situations and Solutions:
A professor with shingles had pain in his neck when cold air hit from the air conditioning vent.
She experienced chronic pain due to having shingles around the back of her neck. She was accommodated with a directional air vent to move the cool air away from where she sat.
A finance manager with shingles was required to attend a training on workplace violence.
She was still considered contagious the day before the training began. As an accommodation, the employer set up a remote training platform so that she could attend the training from home.
A journalist had difficulty recovering from shingles.
She was experiencing chronic migraines and depression from six weeks of shingles, which manifested around her right eye. Her employer granted her extended leave to work on her recovery.
A federal employee experience neuralgia from shingles when trying to sleep.
His physician stated that the most severe effects should pass within two months. He was granted telework with a flexible schedule to accommodate his fatigue and lack of sleep.
A chef could no longer wear latex gloves due to an allergy that developed from shingles on her arm.
He was accommodated with latex-free gloves.