The first thing you need to do to control herpes contagious zoster is to make certain that all healthcare personnel is insusceptible to chickenpox in the course of their employment. For healthcare personnel who haven’t been immunized or don’t have serologic proof of immunity, screening for disease history is vital.
Immunity May Not Always Work
Anybody with an unclear history (irrespective of age) shouldn’t be deemed as immune. In healthcare establishments, serologic screening of employees who have an uncertain or negative history of chickenpox will possibly be cost-effective and reliable. Routine screening for chickenpox immunity following two vaccine doses is not required because 99% of adults are positive following the second dose. However, seroconversion doesn’t constantly result in full disease protection.
Measures for Immunocompromised Patients
For vaccinated healthcare personnel in LTCFs (long-term care facilities) who are subsequently exposed to chickenpox (or shingles), most must be considered protected. On the other hand, the following measures could be considered if immuno-compromised individuals are present:
• Serologic immunity test right after exposure. LA or latex agglutination can be performed rapidly and could be a helpful post-exposure test. But, new evidence has revealed that false positive can take place, erroneously categorizing a susceptible individual as immune. Hence, EIAs that are less sensitive are suggested for screening grounds when possible.
• Retest 5 to 6 days following exposure to discern if an anamnestic response is present.
• That personnel who stay susceptible must be excluded.
• Alternatively, consider reassignment or exclusion of personnel who don’t have the detectable antibody.