From the Guidelines
Airborne isolation is recommended for patients with shingles (herpes zoster) in a hospital setting, particularly when disseminated zoster is suspected or the patient is immunocompromised, as stated in the 2020 study 1.
Key Considerations for Isolation
- Patients should be placed in a negative pressure room with the door closed to prevent the spread of the varicella-zoster virus.
- Healthcare workers should wear appropriate personal protective equipment, including N95 respirators, when entering the room to minimize the risk of transmission.
- For localized shingles in immunocompetent patients, standard precautions may be sufficient if the rash can be completely covered, as suggested by the guidelines 1.
- However, for disseminated shingles (lesions outside the primary dermatome) or in immunocompromised patients, airborne plus contact precautions are necessary to prevent the spread of the virus.
Duration of Isolation
- Isolation should continue until all lesions have crusted over, which typically takes 7-10 days from rash onset, as the varicella-zoster virus can become airborne and potentially infect susceptible individuals, causing chickenpox in those who have never had it or are immunocompromised.
- The 2007 study 1 provides guidance on the restriction of healthcare workers with certain infections, but the most recent and relevant guidance for shingles isolation is found in the 2020 study 1.
Additional Precautions
- Healthcare facilities should also consider restricting visits from pregnant women and immunocompromised individuals who lack immunity to varicella to minimize the risk of transmission.
- Antiviral agents have been shown to decrease viral shedding and lower the duration of herpes zoster lesions, as noted in the 2020 study 1, and should be considered as part of the treatment plan.
From the Research
Isolation for Shingles in Hospital
- There is no specific information in the provided studies regarding the type of isolation for shingles in a hospital setting.
- However, the studies suggest that shingles can be a serious condition, especially in immunocompromised patients, and requires prompt antiviral therapy to reduce the incidence of cutaneous and visceral dissemination 2.
- The studies focus on the treatment of herpes zoster with antiviral agents such as valacyclovir, famciclovir, and aciclovir, and their efficacy in reducing pain and preventing post-herpetic neuralgia 3, 4, 5, 6.
- It can be inferred that patients with shingles may require isolation to prevent the spread of the virus to other patients, especially those who are immunocompromised, but the specific type of isolation is not mentioned in the studies.