School And Daycare Exclusion Policies For Chicken Pox Flashcards
What is the incubation of chicken pox?
Typically regarded as 14-16 days but can be 10-21
How is chicken pox transmitted?
Contracted by respiratory route
Replicates in the nasopharyngeal and upper respiratory tract
Vesicular fluid within the first three days of the rash
If you wanted virology confirmation, how can you isolate the virus?
Vesicular fluid for the first three days of the rash
You cannot isolate the virus from culture of the nasopharyngeal secretions. More recently, there is newer PCR methods can detect VZV DNA in nasopharyngeal secretions. Detectable the day before the rash. The highest quality if VZV is detectable in the throat on day one of the rash.
Is this right: you should exclude kids from daycare for five days after the onset of the rash?
No
This rule is too late to prevent VZV exposure to the classmates
Kids are the most contagious in the day before the rash appears
Which kids are the most contagious?
Kids with the highest viremia are the most infectious. Higher viremia is associated with more severe symptoms (higher fever)
When is transmission the strongest?
In the prodomal period, the day prior to the onset of the rash
How do hospitals treat children exposed to chicken pox?
They isolate from day eight to 21 after known contact to prevent the children on the ward from being exposed to VZV in the days before the exposed child develops symptoms.
Eight days is chosen because it is two days before. The shortest incubation period.
This type of exclusion is not practical for daycares
What are the recommendations for a child with mild illness re exclusion from daycare?
Allowed to return as soon as he or she is well enough to participate in normal activity regardless of the rash
If a child has severe illness, when can they return to daycare?
When they are well enough to participate in regular activity
What is the reservoir for VZV?
Humans are the only reservoir
