From the Guidelines
Airborne and contact precautions are required for patients with varicella-zoster infections, and these precautions should be maintained until lesions are dry and crusted. According to the most recent and highest quality study available, 1, patients with varicella or disseminated zoster, as well as immunocompromised patients with localized zoster, should be placed in negative air-flow rooms or isolated in closed rooms with no contact with persons without evidence of immunity to varicella.
Key Precautions
- Airborne precautions, such as negative air-flow rooms, should be employed for all patients with varicella or disseminated zoster and for immunocompromised patients with localized zoster until disseminated infection is ruled out.
- Contact precautions, including the use of gowns and gloves for direct patient contact, should also be employed to prevent transmission through skin lesions.
- For immunocompetent persons with localized zoster, standard precautions with good hand hygiene and complete covering of the lesions are recommended.
Duration of Precautions
These precautions should be kept in place until lesions are dry and crusted, as indicated by 1.
Importance of Precautions
The varicella-zoster virus is highly contagious and can spread through both airborne transmission (respiratory secretions) and direct contact with fluid from skin lesions, potentially causing severe disease in vulnerable populations, highlighting the necessity of strict isolation measures.
From the Research
Isolation Precautions for Varicella-Zoster Infection
To prevent the spread of varicella-zoster infection, proper isolation precautions are essential. The following measures can be taken:
- Place patients with varicella-zoster infection in strict isolation in negative-pressure rooms to reduce the risk of nosocomial transmission 2, 3.
- Use appropriate precautions, such as airborne precautions, when caring for patients with localized herpes zoster, as it can still spread to others 4.
- Ensure that patient rooms are at negative pressure with respect to the corridor to prevent the spread of the virus through the air 2.
- Consider the use of varicella zoster immune globulin (VARIZIG) for postexposure prophylaxis in high-risk individuals, such as immunocompromised people, preterm infants, and pregnant women, to prevent or attenuate varicella-zoster virus infection 5.
Key Considerations
- Airborne spread of varicella-zoster virus can occur, even with strict isolation procedures in place 2.
- The risk of nosocomial transmission can be reduced with the use of negative-pressure ventilation systems in patient rooms 3.
- Varicella-zoster virus can be transmitted through contact with an infected person, even if they have localized herpes zoster 4.
- Postexposure prophylaxis with VARIZIG can be effective in preventing varicella-zoster virus infection in high-risk individuals, even when administered up to 10 days after exposure 5.