Postexposure Varicella Management of Nonimmune Personnel: An Alternative Approach

Abstract

Varicella exposures in the hospital setting cause problems of management of nonimmune employees. There has been a great deal written about the number of varicella exposures and the problems created by them but few practical recommendations for prevention or management of such exposures, including management of exposed nonimmune employees.In 1983, the Centers for Disease Control and Prevention (CDC) published Guidelines for Infection Control in Hospital Personnel. The CDC is quite clear on their recommendations for personnel exposed to varicella or zoster and state (as a Category I recommendation): “After exposure to varicella or zoster, personnel not known to be immune to varicella (by history or serology) should be excluded from work beginning on the tenth day after exposure and remain away from work for the maximum incubation period of varicella (21 days). Personnel who have onset of varicella should be excluded from work at least until all lesions have dried and crusted.” The CDC suggests it may be useful to screen those personnel who have a negative or equivocal history of varicella for the presence of serum antibodies to varicella zoster virus (VZV) to document susceptibility or immunity.