Remerciez-le!

Remerciez @Admin pour avoir partagé cet document gratuitement, de la manière la plus simple, en partageant sur les réseaux sociaux.

Herpes guide HERPES ZOSTER Infection Control Guidelines for Long-Term Care Facilities Massachusetts Department of Public Health Division of Epidemiology and Immunization - Herpes zoster or shingles is a painful blistering rash caused by reactivation of va

HERPES ZOSTER Infection Control Guidelines for Long-Term Care Facilities Massachusetts Department of Public Health Division of Epidemiology and Immunization - Herpes zoster or shingles is a painful blistering rash caused by reactivation of varicella zoster virus VZV the causative agent in chickenpox Shingles typically presents in one area on one side of the body in the distribution of a nerve There are usually no fever or other systemic symptoms Pain and itching in the area of the shingles may persist after the lesions have resolved post-herpetic neuralgia Shingles can be treated with several antiviral agents It can occasionally become serious in immune-compromised persons with generalized skin eruptions and central nervous system pulmonary hepatic and pancreatic involvement Shingles is found worldwide and has no seasonal variation The most striking feature of the epidemiology of shingles is the increase in incidence found with increasing age Decreasing cellmediated immunity CMI associated with aging is thought to be responsible for these increased rates Similarly the loss of CMI among persons with malignancies and HIV infection is thought to be responsible for higher rates of shingles among those populations Approximately percent of the general population will experience shingles during their lifetime and an estimated episodes of shingles occur annually in the U S Approximately percent of individuals will experience a second episode of shingles A vaccine to prevent shingles in those who have already had chickenpox has recently been licensed for use in adults years of age and older It is contraindicated in persons with certain immunecompromising conditions Infectious Agent Varicella-zoster virus VZV chickenpox virus Reservoir Humans Mode of Transmission VZV infection is transmitted to susceptible individuals no history of chickenpox or varicella vaccine by the following means From shingles cases ? direct contact with lesions From disseminated shingles cases or localized shingles cases in the immunocompromised ? airborne ? direct contact with lesions Exposure to shingles can result in chickenpox in a susceptible person but cannot cause shingles Exposure to chickenpox does not cause shingles Incubation Period Shingles has no incubation period it is caused by reactivation of latent infection from primary chickenpox disease Shingles is infectious until all lesions have crusted over Infectiousness can be prolonged in immunocompromised patients Herpes Zoster Revised April CDiagnosis Clinical diagnosis Laboratory con ?rmation is not usually indicated However isolation of VZV or a positive Direct Fluorescence Antibody DFA Polymerase Chain Reaction PCR or Tzanck smear from a clinical specimen can be helpful Treatment Analgesics and antiviral drugs can be used to treat shingles Control Ensure that all healthcare workers are immune to chickenpox at time of employment See Attachment A Revised Proof of Immunity For healthcare workers who have not been immunized or do not have serologic proof of immunity careful screening for history of disease is important Anyone with an uncertain history regardless of age should be not considered immune In healthcare institutions serologic screening of personnel who have a negative or uncertain history of chickenpox is likely to be reliable and cost-e ?ective Routine testing