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| __NOTOC__ | | __NOTOC__ |
| {{Herpes zoster}} | | {{Herpes zoster}} |
| {{CMG}}; L. Katie Morrison, MD; '''Associate Editor(s)-In-Chief:''' {{CZ}} | | {{CMG}}; L. Katie Morrison, MD; '''Associate Editor(s)-In-Chief:''' {{CZ}}{{AA}} |
| | ==Overview== |
| | Prompt treatment with antiviral agents (acyclovir, famciclovir and valacyclovir) help reduce the shedding of the virus, decrease the severity and duration of acute pain from zoster and the risk for progression to PHN.<ref name=CDC6> http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5705a1.htm Accessed on October 24, 2016</ref> |
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| ==Secondary Prevention== | | ==Secondary Prevention== |
| ====Management of Patients with Herpes Zoster====
| | Prompt treatment with antiviral agents (acyclovir, famciclovir and valacyclovir) help reduce the shedding of the virus, decrease the severity and duration of acute pain from zoster and the risk for progression to PHN.<ref name=CDC6> http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5705a1.htm Accessed on October 24, 2016</ref> |
| Infection-control measures depend on whether the patient with herpes zoster is immunocompetent or immunocompromised and on whether the rash is localized or disseminated. In all cases, standard infection-control precautions should be followed.
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| If the patient is immunocompetent with:
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| *Localized herpes zoster, then standard precautions should be followed and lesions should be completely covered.
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| *Disseminated herpes zoster (defined as appearance of lesions outside the primary or adjacent dermatomes), then standard precautions plus airborne and contact precautions should be followed until lesions are dry and crusted.
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| If the patient is immunocompromised with:
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| *Localized herpes zoster, then standard precautions plus airborne and contact precautions should be followed until disseminated infection is ruled out. Then standard precautions should be followed until lesions are dry and crusted.
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| *Disseminated herpes zoster, then standard precautions plus airborne and contact precautions should be followed until lesions are dry and crusted.
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| ====Management of Healthcare Personnel====
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| The following steps should be taken when healthcare personnel (HCP) are exposed to someone with varicella or herpes zoster:
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| *HCP who have received 2 doses of varicella vaccine should be monitored daily during postexposure days 8–21 for fever, skin lesions, and systemic symptoms suggestive of varicella. HCP can be monitored directly by employee health program or infection control practitioners or instructed to report fever, headache, or other constitutional symptoms and any atypical skin lesions immediately. If symptoms occur, the HCP should be immediately removed from patient care areas and receive antiviral medication. Healthcare personnel with varicella and disseminated herpes zoster should be excluded from work until all lesions have dried and crusted or, in the absence of vesicular lesions, until no new lesions have appeared for 24 hours.
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| *HCP who have received 1 dose of varicella vaccine should receive the second dose at any interval after exposure to someone with rash (provided 4 weeks have elapsed after the first dose). After vaccination, management is the same as that of HCP who have received 2 doses of varicella vaccine.
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| *Unvaccinated VZV-susceptible HCP are potentially infective from days 8 to 21 after exposure and should be furloughed or temporarily reassigned to locations remote from patient-care areas during this period. Exposed HCP without evidence of immunity should receive postexposure vaccination as soon as possible. Vaccination within 3–5 days of exposure to rash may modify the disease if infection occurred. Vaccination 6 or more days after exposure is still indicated because it induces protection against subsequent exposures (if the current exposure did not cause infection). For unvaccinated VZV-susceptible HCP at risk for severe disease and for whom varicella vaccination is contraindicated (e.g., pregnant HCP), varicella-zoster immune globulin after exposure is recommended.
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| ==References== | | ==References== |
| {{Reflist|2}} | | {{Reflist|2}} |
| [[Category:Infectious skin diseases]]
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| [[Category:Viral diseases]]
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| [[Category:Herpesviruses]]
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| [[Category:Infectious disease]]
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| [[Category:Needs overview]]
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| {{WS}} | | {{WS}} |
| {{WH}} | | {{WH}} |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; L. Katie Morrison, MD; Associate Editor(s)-In-Chief: Cafer Zorkun, M.D., Ph.D. [2]Aysha Anwar, M.B.B.S[3]
Overview
Prompt treatment with antiviral agents (acyclovir, famciclovir and valacyclovir) help reduce the shedding of the virus, decrease the severity and duration of acute pain from zoster and the risk for progression to PHN.[1]
Secondary Prevention
Prompt treatment with antiviral agents (acyclovir, famciclovir and valacyclovir) help reduce the shedding of the virus, decrease the severity and duration of acute pain from zoster and the risk for progression to PHN.[1]
References
Template:WS
Template:WH