Open shingles lesions require which precautions?

• A. Both contact and airborne precautions and a negative airflow room
• B. Standard precautions
• C. Contact precautions
• D. Droplet precautions

Answer: (A)

Open shingles lesions shed varicella-zoster virus in the fluid of the vesicles, so transmission can occur through direct contact with the lesions and, in some situations, via airborne particles. Using both contact and airborne precautions provides protection against the two main routes of spread from active lesions, and a negative airflow (negative-pressure) room helps contain any airborne particles that might be dispersed. This combination offers the broadest protection for healthcare workers and others who might be exposed. Standard precautions alone wouldn’t fully prevent contact with lesion fluid, while relying on just one mode (droplet or airborne) wouldn’t cover both potential transmission routes from open shingles lesions.