What is the best way to launder clothing that has come into contact with shingles (varicella-zoster virus) vesicles?

Laundering Clothing Contaminated with Shingles Vesicles

For clothing contaminated with shingles vesicles, handle with minimal agitation, bag immediately at the point of contact, and wash using either hot water (>160°F/71°C for >25 minutes) with detergent OR use low-temperature washing with appropriate chemical disinfectants, followed by thorough drying.

Immediate Handling

• Handle contaminated clothing with minimum agitation to prevent aerosolization of viral particles 1
• Bag or contain the contaminated items immediately at the point of use 1
• Do not sort or prerinse contaminated textiles in living areas 1
• Use leak-resistant containment for items contaminated with body substances (vesicular fluid qualifies as body substance) 1

The varicella-zoster virus in shingles vesicles is an enveloped virus 2, which makes it more susceptible to detergents and heat than non-enveloped viruses, but proper laundering technique remains critical to prevent transmission 3.

Washing Process: Two Effective Options

Option 1: Hot Water Method (Preferred if fabric tolerates)

• Wash with detergent in water >160°F (>71°C) for >25 minutes 1
• This temperature-time combination is the gold standard for pathogen inactivation in healthcare settings 1
• Temperature exceeding 40-60°C is required for proper viral inactivation 3

Option 2: Low-Temperature Method (If hot water damages fabric)

• Use chemicals suitable for low-temperature washing (<160°F/<70°C) at proper use concentration 1
• Consider enzymatic detergents or bleach additives for enhanced viral inactivation at lower temperatures 3
• Detergents are particularly effective against enveloped viruses like varicella-zoster 3
• For respiratory viruses (which includes varicella-zoster transmission via respiratory route), advanced enzymatic detergents can achieve significant pathogen reduction even in cold water 4

Drying Process

• Thoroughly dry all laundered items 5, 3
• Do not leave damp textiles in machines overnight 1, 5
• Drying at 80°C for 2 hours provides additional decontamination beyond washing alone 6
• Machine drying on high heat is preferable to air drying for pathogen control 3, 4

Critical Hand Hygiene Points

Hand hygiene is the single most important infection prevention measure during the laundering process 4. Practice hand hygiene:

• After handling contaminated clothing 4
• After loading the washing machine 4
• After transferring items to the dryer 4
• After folding clean laundry 4

Hand hygiene can reduce infection risks by up to 6 log10, making it more impactful than any single laundering parameter 4.

Important Caveats

• Follow fabric-care instructions to prevent damage while achieving adequate disinfection 1
• If hot water would damage the fabric, the low-temperature method with appropriate chemicals is acceptable, but ensure proper chemical concentration 1
• Detergent washing alone without adequate temperature or chemical additives produces only limited microbial reductions 6
• Disinfection of the washing machine itself is not necessary as long as proper washing and drying procedures are followed 1

Personal Protection During Handling

• Wear appropriate personal protective equipment (gloves at minimum) when handling contaminated items 5
• Avoid touching your face during the laundering process 4
• Clean any surfaces that contacted the contaminated clothing with EPA-registered disinfectant 5