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Shingles herpes are large encapsulated viruses that have a double-stranded genome that encodes approximately 70 proteins. Eight types of herpes viruses, belonging to three groups, have been isolated from humans.

Natural History of Herpes

Natural History of Herpesvirus – 1 (HSV-1) and Herpesvirus – 2 (HSV-2) Infections
HSV – 1 and HSV -2 are genetically similar and cause a similar set of primary and recurrent infections. Both viruses replicate in the skin and the mucous membranes at the site of entrance of the virus (oropharynx or genitals).

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Patients with Shingles

Patients with shingles (disseminated) and immuno-compromised patients with shingles (disseminated or localized) require standard, contact, and airborne precautions. Other than the standard precautions mentioned above, the precautions below should be followed as well:

• The room must have an air-pressure ventilation that’s negative. But, if this isn’t available, staying in a private room is tolerable. If a private room isn’t available, make certain roommates are protected, and visitors are tested for the history of varicella vaccine or chickenpox.

• Gowns and gloves must be worn all the time.

• Susceptible visitors or staff must not enter the patient room. If not, masks must be worn. Individuals immune to varicella do not have to wear masks.

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Identify Exposed Persons

• Exposure to uncomplicated shingles is described as lesions contact; for instance, through hugging, touching, or close patient care.

• Exposure to disseminated shingles, and disseminated or localized shingles in an immuno-compromised individual is described as 1) lesions contact (for instance, through hugging, touching, or close patient care); or 2) sharing internal space with the infectious individual (for instance, occupying one room).