How long should someone with shingles remain in isolation?

From the Guidelines

People with shingles should remain in isolation until all lesions have crusted over, which typically takes 7-10 days after the rash first appears. This recommendation is based on the most recent and highest quality study available, which suggests that the virus can spread through direct contact with the fluid from shingles blisters, potentially causing chickenpox in individuals who have never had chickenpox or the vaccine 1. It's especially important to avoid contact with pregnant women who have never had chickenpox, newborns, and people with weakened immune systems.

While isolated, it is recommended to:

• Cover the rash with clean, dry bandages to reduce the risk of transmission
• Change bandages regularly
• Wash hands thoroughly after touching the affected areas Antiviral medications like acyclovir, valacyclovir, or famciclovir, started within 72 hours of rash onset, can help reduce the duration and severity of symptoms 1. Once all lesions have crusted over and no new lesions are forming, the person is no longer contagious and can safely end isolation.

Key considerations for isolation include:

• The period of contagiousness is estimated to begin 1--2 days before the onset of rash and to end when all lesions are crusted, typically 4--7 days after onset of rash 1
• Immunocompromised patients may be contagious for a longer period, typically 7-14 days 1
• Effective antiviral therapy can help reduce the duration and severity of symptoms, and prevent complications such as secondary bacterial and fungal superinfections 1

From the Research

Isolation Period for Shingles

The isolation period for someone with shingles is not strictly defined, as the risk of transmission to others is generally low. However, there are some guidelines to consider:

• Individuals with shingles can be contagious to people who have not had chickenpox or have not been vaccinated against varicella-zoster virus, especially if they have a weakened immune system 2.
• The virus can be spread through direct contact with the rash or by airborne transmission when the rash is in the vesicular stage 2.
• People with shingles should avoid close contact with others, especially those who are immunocompromised, until the rash has crusted over, which is usually around 7-10 days after the onset of the rash 3.

Factors to Consider

When determining the isolation period, consider the following factors:

• The individual's immune status: Those with weakened immune systems may be more contagious and require a longer isolation period 2.
• The presence of a rash: The rash should be covered, and the individual should avoid touching or scratching it to prevent spreading the virus to others 3.
• The risk of complications: Certain individuals, such as older adults or those with underlying health conditions, may be at higher risk for complications from shingles and may require closer monitoring and a longer isolation period 4, 5.

Treatment and Prevention

While there is no specific treatment to reduce the isolation period, antiviral medications such as acyclovir, valacyclovir, or famciclovir can help reduce the severity and duration of shingles symptoms if started within 72 hours of the onset of the rash 3, 5, 6. Additionally, vaccination against varicella-zoster virus can help prevent shingles and reduce the risk of transmission to others.