Herpes Zoster in the Long-Term Care Setting
This article reviews the epidemiology, clinical features, diagnosis, infection control, and treatment of herpes zoster (HZ) with special reference to the long-term care facility. HZ is caused by the reactivation of varicella-zoster virus (VZV) in sensory ganglia in the setting of age-, disease-, and drug-related decline in cellular immunity to VZV. HZ afflicts millions of older adults worldwide annually and causes substantial suffering via acute and chronic pain or postherpetic neuralgia. In the long-term care facility, VZV may be transmitted to seronegative, susceptible individuals and cause varicella. The use of varicella-zoster immune globulin (VZIG) and the varicella vaccine for susceptible individuals is discussed.
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