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).
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.
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).