{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T05:49:29Z","timestamp":1793166569900,"version":"4.5.0"},"reference-count":32,"publisher":"Cambridge University Press (CUP)","license":[{"start":{"date-parts":[[2021,5,7]],"date-time":"2021-05-07T00:00:00Z","timestamp":1620345600000},"content-version":"unspecified","delay-in-days":126,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Epidemiol. Infect."],"published-print":{"date-parts":[[2021]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Varicella poses an occupational risk and a nosocomial risk for susceptible healthcare personnel and patients, respectively. Patients with varicella are thought to be infectious from 1 to 2 days before rash onset until all lesions are crusted, typically 4\u20137 days after onset of rash. We searched Medline, Embase, Cochrane Library and CINAHL databases to assess evidence of varicella-zoster virus (VZV) transmission before varicella rash onset. Few articles (7) contributed epidemiologic evidence; no formal studies were found. Published articles reported infectiousness at variable intervals before rash onset, between &lt;1 day to 4 days prior to rash, with 1\u20132 patients for each interval. Laboratory assessment of transmission before rash was also limited (10 articles). No culture-positive results were reported. VZV DNA was identified by PCR before rash onset in only one study however, PCR does not indicate infectivity of the virus. Based on available medical literature, VZV transmission before rash onset seems unlikely, although the possibility of pre-rash, respiratory transmission cannot be entirely ruled out.<\/jats:p>","DOI":"10.1017\/s0950268821001102","type":"journal-article","created":{"date-parts":[[2021,5,7]],"date-time":"2021-05-07T08:53:10Z","timestamp":1620377590000},"update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":14,"title":["Communicability of varicella before rash onset: a literature review"],"prefix":"10.1017","volume":"149","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9705-0511","authenticated-orcid":false,"given":"Mona","family":"Marin","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessica","family":"Leung","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adriana S.","family":"Lopez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leah","family":"Shepersky","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D. Scott","family":"Schmid","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne A.","family":"Gershon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2021,5,7]]},"reference":[{"key":"S0950268821001102_ref1","doi-asserted-by":"crossref","first-page":"550","DOI":"10.1542\/peds.70.4.550","article-title":"An outbreak of airborne nosocomial varicella","volume":"70","author":"Gustafson","year":"1982","journal-title":"Pediatrics"},{"key":"S0950268821001102_ref7","first-page":"1","article-title":"Prevention of varicella: recommendations of the advisory committee on immunization practices (ACIP)","volume":"56","author":"Marin","year":"2007","journal-title":"Morbidity and Mortality Weekly Report Recommendations and Reports"},{"key":"S0950268821001102_ref15","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(00)78643-0"},{"key":"S0950268821001102_ref22","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/163.5.1016"},{"key":"S0950268821001102_ref20","doi-asserted-by":"publisher","DOI":"10.1046\/j.1442-200X.1999.4121049.x"},{"key":"S0950268821001102_ref18","first-page":"303","volume-title":"Acute Infectious Diseases","author":"Schamberg","year":"1928"},{"key":"S0950268821001102_ref24","first-page":"1448","article-title":"Study of virus isolation from pharyngeal swabs in children with varicella","volume":"143","author":"Ozaki","year":"1989","journal-title":"The American Journal of Diseases of Children"},{"key":"S0950268821001102_ref19","doi-asserted-by":"publisher","DOI":"10.1542\/peds.103.5.e61"},{"key":"S0950268821001102_ref14","doi-asserted-by":"publisher","DOI":"10.1093\/oxfordjournals.aje.a115828"},{"key":"S0950268821001102_ref9","doi-asserted-by":"publisher","DOI":"10.1086\/527419"},{"key":"S0950268821001102_ref26","doi-asserted-by":"crossref","first-page":"1007","DOI":"10.1542\/peds.37.6.1007","article-title":"On the respiratory spread of varicella-zoster virus","volume":"37","author":"Nelson","year":"1966","journal-title":"Pediatrics"},{"key":"S0950268821001102_ref4","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM198002213020807"},{"key":"S0950268821001102_ref6","first-page":"548","article-title":"Outbreak of varicella in a newborn intensive care nursery","volume":"138","author":"Gustafson","year":"1984","journal-title":"The American Journal of Diseases of Children"},{"key":"S0950268821001102_ref30","doi-asserted-by":"publisher","DOI":"10.1002\/1096-9071(200101)63:1<64::AID-JMV1009>3.0.CO;2-6"},{"key":"S0950268821001102_ref8","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/158.1.238"},{"key":"S0950268821001102_ref17","first-page":"2013","article-title":"The period of infectivitiy and serum prevention of chickenpox","author":"Gordon","year":"1929","journal-title":"Journal of the American Medical Association"},{"key":"S0950268821001102_ref11","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM196601272740403"},{"key":"S0950268821001102_ref29","doi-asserted-by":"publisher","DOI":"10.1016\/j.jviromet.2013.05.019"},{"key":"S0950268821001102_ref32","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm6534a4"},{"key":"S0950268821001102_ref5","doi-asserted-by":"publisher","DOI":"10.1016\/0196-6553(87)90097-6"},{"key":"S0950268821001102_ref10","first-page":"1015","article-title":"Varicella: report of two fatal cases with necropsy, virus isolation, and serologic studies","volume":"32","author":"Cheatham","year":"1956","journal-title":"The American Journal of Pathology"},{"key":"S0950268821001102_ref3","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.78.1.19"},{"key":"S0950268821001102_ref13","doi-asserted-by":"publisher","DOI":"10.1016\/S0033-3506(03)00138-0"},{"key":"S0950268821001102_ref23","doi-asserted-by":"publisher","DOI":"10.1136\/adc.66.3.333"},{"key":"S0950268821001102_ref12","first-page":"1451","article-title":"Transmission of chickenpox in a school setting prior to the observed exanthem","volume":"143","author":"Brunell","year":"1989","journal-title":"The American Journal of Diseases of Children"},{"key":"S0950268821001102_ref27","doi-asserted-by":"publisher","DOI":"10.1086\/590358"},{"key":"S0950268821001102_ref25","first-page":"201","article-title":"Isolation of varicella-zoster virus from pharyngeal and nasal swabs in varicella patients","volume":"28","author":"Trlifajova","year":"1984","journal-title":"Journal of Hygiene, Epidemiology, Microbiology, and Immunology"},{"key":"S0950268821001102_ref28","doi-asserted-by":"publisher","DOI":"10.1086\/653113"},{"key":"S0950268821001102_ref16","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.2.1864.741"},{"key":"S0950268821001102_ref2","first-page":"196","article-title":"Nosocomial varicella. 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Published by Cambridge University Press. This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http:\/\/creativecommons.org\/licenses\/by\/4.0\/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.","name":"license","label":"License","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This content has been made available to all.","name":"free","label":"Free to read"}],"article-number":"e131"}}