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Prevention and control of varicella-zoster virus in hospitals

Authors
David J Weber, MD, MPH
William A Rutala, PhD, MPH
Section Editor
Martin S Hirsch, MD
Deputy Editor
Jennifer Mitty, MD, MPH

INTRODUCTION

Varicella-zoster virus (VZV) infection causes two clinically distinct forms of disease: varicella (chickenpox) and herpes zoster (shingles). Primary VZV infection results in the diffuse vesicular rash of varicella, or chickenpox. Endogenous reactivation of latent VZV typically results in a localized skin infection known as herpes zoster, or shingles. Varicella is generally a mild disease in children, although serious complications can sometimes occur (eg, secondary bacterial skin infections and pneumonia). Complications from VZV infection are more common in neonates, adults, or immunocompromised persons.

Because varicella is highly contagious and may cause serious disease, the Centers for Disease Control and Prevention (CDC), the American Academy of Pediatrics (AAP), and infectious disease experts have published recommendations regarding the prevention of VZV among health care personnel, isolation of patients with VZV infection, and the management of patients and health care personnel exposed to VZV. Issues specific to infection control and care of exposed health care personnel are discussed below.

The epidemiology and clinical manifestations of VZV have changed significantly since the introduction of the varicella vaccine. These issues, as well as the diagnosis, treatment, and prevention of varicella infection are discussed elsewhere. (See "Epidemiology of varicella-zoster virus infection: Chickenpox" and "Vaccination for the prevention of chickenpox (primary varicella infection)" and "Clinical features of varicella-zoster virus infection: Chickenpox" and "Treatment of varicella (chickenpox) infection" and "Clinical manifestations of varicella-zoster virus infection: Herpes zoster" and "Treatment of herpes zoster in the immunocompetent host".)

IMPORTANCE OF INFECTION CONTROL

Control of VZV is important in health care facilities for the following reasons:

VZV is highly contagious. This is particularly true of patients who present with varicella, compared to those with zoster, who are generally less infectious.

                                 

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Literature review current through: Apr 2017. | This topic last updated: Jul 21, 2016.
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