School and daycare exclusion policies for chickenpox: A rational approach

Question 1

What is the incubation period of chickenpox?

Answer 1

usu. 14-16d (10-21d)

Question 2

How early before the development of rash is chickenpox contagious?

Answer 2

24-96h before development of rash

Question 3

What is higher viremia associated with?

Answer 3

High temperature
Prolonged fever
More vesicles

Question 4

What are the recommendations regarding varicella exclusion policies as per the CPS?

Answer 4

1. A child with mild illness should be allowed to return to school or daycare as soon as he or she is well enough to participate normally in all activities, regardless of the state of the rash. Parents, particularly parents of immunosuppressed children, should be notified that chickenpox is in the class as well as be provided with information on the VZV incubation period and how to detect early VZV.
2. Public health jurisdictions should review their policies.
3. Hospitals should continue their rigid and prolonged isolation precautions (day eight to day 21 from contact) for all hospitalized nonimmune exposed patients and exclusion of nonimmune visitors in order to minimize nosocomial spread