Guidelines on Infection Control for Shingles Herpes Zoster

Shingles herpes zoster is an excruciating blistering rash which is caused by the reactivation of VZV (varicella zoster virus), the chickenpox’s causative agent. Typically, shingles presents in a single area on the body’s one side, in a nerve distribution. There are frequently no fever or any systemic symptoms.

Itching and pain in the shingles’ area could persist after lesions have resolved (postherpetic neuralgia). Herpes zoster can be treated with quite a few antiviral agents. Occasionally, it can become very serious in persons who have compromised the immune system, with generalized dermal eruptions as well as central nervous system, pancreatic, hepatic, and pulmonary involvement.

Shingles or Herpes Zoster
Shingles or Herpes Zoster

Shingles are Globally Found

Shingles are globally found and do not have seasonal variation. The most remarkable feature of the shingles epidemiology is the rise in rate found with increasing age. Decreasing CMI or cell-mediated immunity associated with increased aging is believed to be accountable for these increased occurrences.

Also, the loss of cell-mediated immunity among individuals with HIV infection and malignancies is believed to be accountable for higher occurrences of herpes zoster among those populations. About 20% of the general population experience shingles throughout their lifetime, and approximately 500,000 shingles episodes occur yearly in the United States. Approximately 4% of people will experience a second shingles episode.

A shingles prevention vaccine in people who have had chickenpox already has just been licensed for use for those 60 years and older. It’s contraindicated in individuals with particular immune-compromising conditions.

Infectious Agent: Varicella-zoster virus (chickenpox virus, VZV)

Reservoir: Humans

Transmission Mode: VZV infection is passed on to susceptible persons (no history of varicella or chickenpox vaccine) by the means below:

1. From cases of shingles:

• direct contact with lesions

2. From cases of disseminated shingles, or cases of localized shingles in the immune-compromised:

• direct contact with lesions

• airborne

herpes zoster virus

Exposure to shingles can cause chickenpox in a susceptible individual, but can’t cause shingles. Exposure to chickenpox doesn’t cause shingles.

Incubation Period: Shingles does not have incubation period; it’s due to reactivation of a latent infection from major chickenpox disease. Herpes zoster is infectious until every lesion has crusted over.

In patients with compromised immune system, the infectiousness can be prolonged.
Diagnosis: Clinical diagnosis. Usually, laboratory confirmation isn’t indicated. On the other hand, VZV isolation, or a positive DFA (Direct Fluorescence Antibody), PCR (Polymerase Chain Reaction), or test from a specimen can be useful.

Treatment: Antiviral drugs and analgesics can be utilized to treat herpes zoster.

If you want to prevent the spread of shingles, then you need to:

  • Keep your skin clean.
  • Avoid contacting people who have not had chickenpox or those who have weak immune systems.
  • Wash any items you’ve touched with the infected area using boiling water to destroy the virus.

Keep these prevention methods in mind to avoid spreading the disease to other people. If you haven’t been infected by the virus yet, it would be ideal to still keep these prevention methods in mind to avoid getting infected by those who have the disease.


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