Which combination of precautions is recommended for open shingles lesions?

• 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 can shed varicella-zoster virus, so preventing spread requires stopping transmission from directly touching the lesions or contaminated surfaces (contact precautions). Airborne precautions come into play when there is a risk of viral particles spreading through the air, such as with disseminated herpes zoster or varicella, especially in immunocompromised patients. A negative-pressure room is used to contain airborne particles. Therefore, when open shingles lesions raise concern for potential airborne spread or dissemination, both contact and airborne precautions are used to minimize transmission through either route. In typical localized shingles, only contact precautions are usually needed, but the combination is appropriate if dissemination or airborne risk is present.