herpes zoster precautions

[LoveNursing1]

In preparing for NCLEX I find that many questions state that herpes zoster requires standard precautions. However, the saunders book states that I for "disseminated varicella zoster" AIRBORNE precautions is required.

Whats the difference between the two???

Thanks.

[BookwormRN]

Yes, when a pt comes in with shingles (herpes zoster-which is an acute infection caused by reactivation of the latent varicella zoster virus) and there are open vessicles, that pt is put on airborne precautions until the vessicles are scabbed over.

Does that help?

[EmmaG, RN]

Zoster vesicles follow a nerve path; in disseminated zoster, the lesions are wide-spread and don't follow a particular nerve tract. (think chicken-pox) Disseminated zoster can be spread via airborne route because it can infect the lungs (and other organs) as opposed to being limited to the nerve root.

We put our immunocompromised patients in airborne/contact for both types; they are at highest risk for disseminated type.

http://www.cdc.gov/ncidod/dhqp/gl_isolation.html

Appendix A lists all the CDC guidelines for isolation. I printed off a copy and keep it on my clipboard :)

[WSU_Ally_RN, BSN, RN]

We have had debates in my unit lately on this same subject. Per policy at our hospital, if the shingles are on one or two nerve tracts, just standard precautions are used. If they have disseminated herpes zoster, they are placed in negative pressure rooms until their lesions are all scabbed over, then just standard precautions.