People susceptible to herpes zoster infection are those with no reliable shingles or chickenpox history, documentation of serologic proof of immunity or past vaccination against chickenpox. High-risk susceptibles include immunosuppressed individuals because of underlying medical conditions (which includes HIV infection), medications or treatment (which includes steroids), or susceptible pregnant women.
They’re at higher risk for complications and problems from varicella, and should be referred quickly to their healthcare provider. These susceptible high-risk individuals must receive varicella zoster immune globulin or VZIG at once within ninety-six hours of exposure. Bear in mind, recipients of bone marrow transplant must be considered susceptible despite past disease history.
Identify and then Vaccinate other Exposed Susceptible Individuals
Susceptibles are those with no reliable shingles or chickenpox history, documentation of serologic proof of immunity or past vaccination against chickenpox.
If varicella vaccine is provided within 3 to 5 days of VZV exposure, it can prevent the disease. If five days have passed since the case’s exposure, the vaccine must still be provided, as it’ll protect against likely future exposures. Still, chickenpox can take place in susceptible contacts despite vaccination, however, vaccinating somebody who’s incubating chickenpox or who’s immune isn’t harmful.
Isolate or Discharge Exposed Susceptible Patients
Isolate on airborne and contact precautions all exposed, patients who are susceptible and can’t be discharged from before the 10th day after exposure, from the 10th day through 21st after exposure. Individuals who have received VZIG should stay isolated until the 28th day.
Conduct chickenpox surveillance for 21 days following the last shingles exposure. For individuals who received VZIG as well as where immuno-compromised persons are involved, surveillance should carry on for 28 days.