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Hi All,
We are currently reviewing our Transmission Based Precautions for Herpes Zoster (shingles). Traditionally we have cared for people using contact precautions and added in airborne precautions if the patient has disseminated shingles or respiratory involvement.
However the 2019 edition of the Australian Guidelines for the Prevention and Control of Infection in Healthcare, whilst acknowledging airborne transmission is recommending Standard precautions and adding in contact and airborne precautions in the case of disseminated disease.
[cid:image003.jpg@01D54919.17F15680]I am interested to know how other facilities / jurisdictions manage herpes zoster.
Kind regards,
Fiona De Sousa CICP-E| Nurse Manager | Infection Prevention & Control Unit
Launceston General Hospital, Level 2, Launceston TAS 7250
phone: 6777 6715 | mobile: 0408 487 197 | fax: 6777 5170 | email: fiona.de.sousa@ths.tas.gov.au |
intranet: http://www.dhhs.tas.gov.au/intranet/thon/infection_controlIPCU – ‘By working together we promote a culture of safety to reduce preventable infections and transmission of multi-resistant organisms’
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Hi Fiona
If the shingles lesions are dry and crusted over then Standard Precautions are suitable as the disease is not transmissible. If the lesions are moist and disseminating then Contact and Droplet remain appropriate.
If there is evidence to suggest otherwise, then forward to NHMRC for review. Providing feedback to the NHMRC with evidence supporting your concern facilitates action. I recently provided feedback with documented evidence supporting the need for Droplet Precautions for RSV (the new 2019 Guidelines recommended Standard Precautions). I received a response within 4 weeks advising they had reviewed the feedback and are updating the Guidelines to show Droplet Precautions for RSV.
Kind regards
Meredith Southon
Meredith Southon RN MInfecPrevCont QualNursImm
Clinical Nurse Consultant | Infection Prevention & Control | Staff Health | Murwillumbah District Hospital
PO Box 821, Murwillumbah NSW 2484
Tel 02 6672 0232 | Fax 02 6672 0226 | Meredith.Southon@health.nsw.gov.au
http://www.health.nsw.gov.au[Description: http://internal.health.nsw.gov.au/communications/e-signatures/images/NSW-Health-Northern-NSW-LHD.jpg%5D
Hi All,
We are currently reviewing our Transmission Based Precautions for Herpes Zoster (shingles). Traditionally we have cared for people using contact precautions and added in airborne precautions if the patient has disseminated shingles or respiratory involvement.
However the 2019 edition of the Australian Guidelines for the Prevention and Control of Infection in Healthcare, whilst acknowledging airborne transmission is recommending Standard precautions and adding in contact and airborne precautions in the case of disseminated disease.
[cid:image003.jpg@01D54919.17F15680]I am interested to know how other facilities / jurisdictions manage herpes zoster.
Kind regards,
Fiona De Sousa CICP-E| Nurse Manager | Infection Prevention & Control Unit
Launceston General Hospital, Level 2, Launceston TAS 7250
phone: 6777 6715 | mobile: 0408 487 197 | fax: 6777 5170 | email: fiona.de.sousa@ths.tas.gov.au |
intranet: http://www.dhhs.tas.gov.au/intranet/thon/infection_controlIPCU – ‘By working together we promote a culture of safety to reduce preventable infections and transmission of multi-resistant organisms’
________________________________
CONFIDENTIALITY NOTICE AND DISCLAIMER
The information in this transmission may be confidential and/or protected by legal professional privilege, and is intended only for the person or persons to whom it is addressed. If you are not such a person, you are warned that any disclosure, copying or dissemination of the information is unauthorised. If you have received the transmission in error, please immediately contact this office by telephone, fax or email, to inform us of the error and to enable arrangements to be made for the destruction of the transmission, or its return at our cost. No liability is accepted for any unauthorised use of the information contained in this transmission.
MESSAGES POSTED TO THIS LIST ARE SOLELY THE OPINION OF THE AUTHOR, AND DO NOT REPRESENT THE OPINION OF ACIPC.The use of trade/product/commercial brand names through the list is discouraged by ACIPC. If you wish to discuss specific reference to products or services by brand or commercial names, please do this outside the list.
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Views expressed in this message are those of the individual sender, and are not necessarily the views of NSW Health or any of its entities.
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Hi Fiona
If you think about the transmissibility of the varicella-zoster virus via shingles lesions, unless the vesicles are draining and you subject them to high pressure or an aerosol generating procedure (like diathermy), the only mechanism of transmission is direct contact with the draining vesicles and subsequent transfer to mucous membranes or non-intact skin of a susceptible person (you basically have to stick your fingers in a lesion and lick ’em! 🙂 ). So Standard Precautions is actually quite suitable in most instances, although if you are performing aerosol generating procedures on lesions, airborne precautions is required (as it should be for any aerosol generating procedure anyway).
To mitigate risk even further, we say for known non-immune staff they should not come into direct contact with draining shingles lesions even wearing gloves, as an added precaution, and I note the guidelines also recommend that.
Disseminated shingles is totally different as the likelihood of lesions in the respiratory tree is very high (like chickenpox). So Airborne and Contact Precautions are definitely required.
We have been following these recommendations for many years and have never had a known transmission of varicella-zoster virus from a patient with shingles to a staff member.
Cheers
MichaelMichael Wishart | Infection Control Coordinator, CICP-E
St Vincent’s Private Hospital Northside | 627 Rode Road CHERMSIDE QLD 4032
T +61 7 3326 3068 | F +61 7 3607 2226
E michael.wishart@svha.org.au |
W https://www.svphn.org.au[cid:image001.jpg@01D46C86.4CDB6090]
[2019 conference email signature]Hi All,
We are currently reviewing our Transmission Based Precautions for Herpes Zoster (shingles). Traditionally we have cared for people using contact precautions and added in airborne precautions if the patient has disseminated shingles or respiratory involvement.
However the 2019 edition of the Australian Guidelines for the Prevention and Control of Infection in Healthcare, whilst acknowledging airborne transmission is recommending Standard precautions and adding in contact and airborne precautions in the case of disseminated disease.
[cid:image003.jpg@01D54919.17F15680]I am interested to know how other facilities / jurisdictions manage herpes zoster.
Kind regards,
Fiona De Sousa CICP-E| Nurse Manager | Infection Prevention & Control Unit
Launceston General Hospital, Level 2, Launceston TAS 7250
phone: 6777 6715 | mobile: 0408 487 197 | fax: 6777 5170 | email: fiona.de.sousa@ths.tas.gov.au |
intranet: http://www.dhhs.tas.gov.au/intranet/thon/infection_controlIPCU – ‘By working together we promote a culture of safety to reduce preventable infections and transmission of multi-resistant organisms’
________________________________
CONFIDENTIALITY NOTICE AND DISCLAIMER
The information in this transmission may be confidential and/or protected by legal professional privilege, and is intended only for the person or persons to whom it is addressed. If you are not such a person, you are warned that any disclosure, copying or dissemination of the information is unauthorised. If you have received the transmission in error, please immediately contact this office by telephone, fax or email, to inform us of the error and to enable arrangements to be made for the destruction of the transmission, or its return at our cost. No liability is accepted for any unauthorised use of the information contained in this transmission.______________________________________________________________________
This email and any attachments to it (the “Email”) is confidential and is for the use only of the intended recipient, and may not be duplicated or used by any other party without the express consent of the sender. If you are not the intended recipient of the Email, please notify the sender immediately by return https://clicktime.symantec.com/38sJ13JR58CDuQMEHbLbNcv7Vc?uemail%2C%20delete%20the%20Email%2C%20and%20do not copy, print, retransmit, store or act in reliance on the Email. St Vincent’s Health Australia (“SVHA”) does not guarantee that the Email is free from errors, viruses or interference. Emails to and from SVHA or its related entities may be scanned and filtered in locations outside Australia.
MESSAGES POSTED TO THIS LIST ARE SOLELY THE OPINION OF THE AUTHOR, AND DO NOT REPRESENT THE OPINION OF ACIPC.The use of trade/product/commercial brand names through the list is discouraged by ACIPC. If you wish to discuss specific reference to products or services by brand or commercial names, please do this outside the list.
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______________________________________________________________________
This email and any attachments to it (the “Email”) is confidential and is for the use only of the intended recipient, and may not be duplicated or used by any other party without the express consent of the sender. If you are not the intended recipient of the Email, please notify the sender immediately by return email, delete the Email, and do not copy, print, retransmit, store or act in reliance on the Email. St Vincent’s Health Australia (“SVHA”) does not guarantee that the Email is free from errors, viruses or interference. Emails to and from SVHA or its related entities may be scanned and filtered in locations outside Australia.MESSAGES POSTED TO THIS LIST ARE SOLELY THE OPINION OF THE AUTHOR, AND DO NOT REPRESENT THE OPINION OF ACIPC.
The use of trade/product/commercial brand names through the list is discouraged by ACIPC. If you wish to discuss specific reference to products or services by brand or commercial names, please do this outside the list.
Archive of all messages are available at http://aicalist.org.au/archives – registration and login required.
Replies to this message will be directed back to the list. To create a new message send an email to acipclist@acipc.org.au
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