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Discussion

Teacher with shingles

We have a teacher just diagnosed with shingles. I've been given conflicting opinions if she's allowed to come back to school. She said she's started on some meds tonight. Thoughts?

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We had a teacher last year get shingles, but he was in so much pain from them, he was out for a good week recovering. I know unvaccinated kids could get chicken pox from them.

If you have any doubt, please contact your local health department for guidance.

Herpes Zoster (shingles)

Herpes Zoster (shingles) is a recurrence of Varicella (chickenpox). Herpes Zoster has a much lower rate of transmission (is less contagious) than Varicella. It is transmitted by contact with the vesicle (blister) fluid of skin lesions, and in disseminated cases, by the respiratory route. Individuals with Herpes Zoster may be sources of infection for a week after the appearance of their skin lesions. Disseminated Herpes Zoster is contagious via the respiratory route during the first six days after the onset of the skin lesions (rash).

If the employee has Herpes Zoster with a local rash he/she may work if the lesions are covered by a dressing and/or clothing. He/she must avoid caring for immune-compromised, pregnant, and pediatric/infant patients. If skin lesions are present on the face or head, the employee is not to work until all of the lesions are scabbed and crusted over. If the employee has disseminated Herpes Zoster, he/she is not to work for the first six days after the rash first appears. He/She will also need to be cleared to return to work by his/her personal physician and by Employee Health Services. If the employee reports to work with a rash that is either suspicious for Herpes Zoster or another infectious rash, he/she must be cleared by employee health or his/her personal physician to work.

Human Resources

What is the rate of varicella vaccination at the school?

I had a varicella case in my school last year and my state's CDC was an excellent resource. I would give them a call (or whatever the equivalent is in your state).

This was a huge deal in my district last year. One of my employees that doesn't come in regular contact with students in IT called in to report that he had shingles. I never spoke to him beyond hearing that he had them and was miserable. A month or two later one of the teachers came in on a monday and said to me that she went to a minute clinic type thing and got dx'ed with shingles over the weekend, but was advised that she was clear to work (she said the pain was manageable and the shingles blisters were located under her bra). I advised her to get and get a note to that effect or have one sent. It blew up into a big thing as they compared one case where one person was in a lot of pain and has blisters lord only know where vs the other person said she felt fine and has blisters in an area that students would not be accessing.

My daughter works in one of my schools and had shingles a few weeks ago. I went with her to the dr . The dr. knows I am the school nurse at her school and I wanted to make sure we were doing the right thing. He said any fluid the would come from the blisters was extremely contagious. But, as long as the areas could be covered, she was ok to be at school. Luckily, we caught hers so early that she never developed blisters, just the clusters of little bumps that looked like they could turn into blisters. I think she was glad that her mama is a nurse and we jumped on it really quickly and got to the dr. :) as a precaution, I let the parent of a student who is pregnant know. Just to be on the safe side.

An interesting side note that he really drilled home to us was to make sure and not get any of the fluid from the blisters in any open skin areas...like hangnails or cracked skin. He said he had a friend who is a health care worker get some of this fluid in her cracked skin and she became very very ill because of this "load" of virus that got in her blood stream.

I ended up with shingles this past September. I had it on my face so it was kind of impossible to cover - so I had to stay home for a week. Once the blisters have scabbed over, you are no longer contagious. If the teacher can cover the rash with a bandage its probably ok for them to be in school - that is if they can.. its quite painful!

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