Herpes Zoster

My wife works at an elderly care facility a few days a week. One of her clients has developed Herpes zoster. We are wondering what the chances are of her bringing the disease home to our 10 week old son. My wife has had chicken pox, but can she still carry the disease?

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Robert Steele

Robert W. Steele, MD, is a board certified pediatrician at St. John's Regional Health Center in Springfield, MO. He graduated from medical... Read more

Herpes zoster is a painful rash that is caused by the same virus as chicken pox. However, it usually occurs after the person has had chicken pox. The reason for this is that after we get chicken pox, the virus may not be entirely eliminated from the body. The virus may, instead, reside dormant in certain nerves of the body. Then for reasons not entirely understood, the virus becomes active again, but this time only causes problems in certain parts of the body rather than all over the body like in chicken pox. The symptoms of herpes zoster depend upon which area of the body is affected. It usually manifests itself as a painful rash occurring along the chest, abdomen, or back. However, it may occur anywhere on the body. The rash is red and has little fluid filled vesicles which eventually pop and crust over much like the vesicles in chicken pox do.

Because the virus that causes herpes zoster is the chicken pox virus, persons with active herpes zoster are at risk for transmitting chicken pox. Like chicken pox, the person is considered infectious until the rash has crusted over. Persons who have not had chicken pox are at risk for getting it if they come in contact with the fluid oozed from the vesicles. Those with chicken pox transmit the virus most effectively by respiratory means (sneezing, runny nose, saliva, etc.) However, unlike chicken pox, those with herpes zoster do not transmit the virus by respiratory means. It is only transmitted by the fluid from the vesicles of the rash. Therefore, transmission of the virus may be substantially minimized by covering the rash well and being very careful to wash hands thoroughly.

Ed, because your wife has had chicken pox, she will most likely be immune to contracting the disease. Therefore, as long as your wife either does not come in contact with the rash or dressings over the rash of her client, the chances of her bringing home the virus to your daughter is almost nil. The only way she can "carry" the disease is by bringing home a part of her body or clothing that has been contaminated with the fluid from the client's rash. Therefore, any bodily contact with the client ought to be done with disposable gloves and gown. And remember to wash hands thoroughly.

Good luck to you.

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