Management of varicella-zoster virus-exposed hospital employees

Emergency physicians frequently manage hospital employee health services. A common hospital infection control problem is varicella-zoster virus infection. We reviewed the literature to determine a rational basis for the management of the varicella-zoster virus-exposed hospital employee. Exposed employees include those with direct face-to-face contact with an infected person. The immune status should be determined in those employees with a negative or uncertain history of varicella infection by using a sensitive and specific technique such as the FAMA or ELISA tests. Employees with a positive history or a positive titer are immune and can return to work. Those with a negative titer are susceptible and should avoid patient contact from day eight to 21 following exposure. High-risk, susceptible contacts should be given varicella-zoster immune globulin. Varicella infection will become much less common after the release of varicella vaccine.