{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T04:09:17Z","timestamp":1783051757137,"version":"3.54.6"},"reference-count":16,"publisher":"Cambridge University Press (CUP)","license":[{"start":{"date-parts":[[2023,12,19]],"date-time":"2023-12-19T00:00:00Z","timestamp":1702944000000},"content-version":"unspecified","delay-in-days":0,"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":[[2024]]},"abstract":"<jats:title>Abstract<\/jats:title>\n\t  <jats:p>Chickenpox (varicella) is a rare occurrence in healthcare settings in the USA, but can be transmitted to healthcare workers (HCWs) from patients with herpes zoster who, in turn, can potentially transmit it further to unimmunized, immunosuppressed, at-risk, vulnerable patients. It is uncommon due to the inclusion of varicella vaccination in the recommended immunization schedule for children and screening for varicella immunity in HCWs during employment. We present a case report of hospital-acquired chickenpox in a patient who developed the infection during his prolonged hospital stay through a HCW who had contracted chickenpox after exposure to our patient\u2019s roommate with herpes zoster. There was no physical contact between the roommates, but both patients had a common HCW as caregiver. The herpes zoster patient was placed in airborne precautions immediately, but the HCW continued to work and have physical contact with our patient. The HCW initially developed chickenpox 18\u00a0days after exposure to the patient with herpes zoster, and our patient developed chickenpox 17\u00a0days after the HCW. The timeline and two incubation periods, prior to our patient developing chickenpox, indicate transmission of chickenpox in the HCW from exposure to the herpes zoster patient and subsequently to our patient. The case highlights the potential for nosocomial transmission of chickenpox (varicella) to unimmunized HCWs from exposure to patients with herpes zoster and further transmission to unimmunized patients. Verification of the immunization status of HCWs at the time of employment, mandating immunity, furloughing unimmunized staff after exposure to herpes zoster, and postexposure prophylaxis with vaccination or varicella zoster immunoglobulin (Varizig) will minimize the risk of transmission of communicable diseases like chickenpox in healthcare settings. Additionally, establishing patients\u2019 immunity, heightened vigilance and early identification of herpes zoster in hospitalized patients, and initiation of appropriate infection control immediately will further prevent such occurrences and improve patient safety.<\/jats:p>","DOI":"10.1017\/s0950268823001917","type":"journal-article","created":{"date-parts":[[2023,12,19]],"date-time":"2023-12-19T09:49:35Z","timestamp":1702979375000},"update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":6,"title":["Case report: Hospital-acquired chickenpox in a healthcare setting"],"prefix":"10.1017","volume":"152","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-9711-2352","authenticated-orcid":false,"given":"Sandeepa","family":"Utpat","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nishka","family":"Utpat","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vinod","family":"Nookala","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lalitha","family":"Podakula","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kaanchi","family":"Utpat","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2023,12,19]]},"reference":[{"key":"S0950268823001917_r1","unstructured":"[1] Ayoade, F and Kumar, S (2023) Varicella-Zoster Virus (Chickenpox) (Updated 2022 Oct 15). StatPearls (Internet). Treasure Island (FL): StatPearls Publishing; 2023 January. Available from: https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK448191\/."},{"key":"S0950268823001917_r3","doi-asserted-by":"crossref","first-page":"3073","DOI":"10.1080\/21645515.2021.1904760","article-title":"Barriers for vaccination of healthcare workers","volume":"17","author":"Eltvedt","year":"2021","journal-title":"Human Vaccines and Immunotherapeutics"},{"key":"S0950268823001917_r13","doi-asserted-by":"crossref","first-page":"4814","DOI":"10.1016\/j.vaccine.2014.03.097","article-title":"Healthcare providers as sources of vaccine-preventable diseases","volume":"32","author":"Sydnor","year":"2014","journal-title":"Vaccine"},{"key":"#cr-split#-S0950268823001917_r2.1","unstructured":"[2] InformedHealth.org (Internet) (2014). Cologne, Germany: Institute for Quality and Efficiency in Health Care (IQWiG)"},{"key":"#cr-split#-S0950268823001917_r2.2","unstructured":"2006. Chickenpox: Overview. 2014 June 30 (Updated 2019 November 21). Available from: https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK279621\/."},{"key":"S0950268823001917_r6","doi-asserted-by":"publisher","DOI":"10.1186\/s12879-019-4222-x"},{"key":"S0950268823001917_r7","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm7206a1"},{"key":"S0950268823001917_r14","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhin.2017.10.020"},{"key":"S0950268823001917_r12","doi-asserted-by":"crossref","unstructured":"[12] Siegel, JD , Rhinehart, E , Jackson, M , Chiarello, L and the Healthcare Infection Control Practices Advisory Committee (2007) Guideline for Isolation Precautions: Preventing Transmission of Infectious Agents in Healthcare Settings. Available at https:\/\/www.cdc.gov\/infectioncontrol\/guidelines\/isolation\/index.html.","DOI":"10.1016\/j.ajic.2007.10.007"},{"key":"S0950268823001917_r5","doi-asserted-by":"publisher","DOI":"10.1080\/21645515.2015.1082014"},{"key":"S0950268823001917_r4","unstructured":"[4] Centers for Disease Control and Prevention. (2014, November 19). State Immunization Laws for Healthcare Workers and Patients. Centers for Disease Control and Prevention. Available at https:\/\/www2a.cdc.gov\/vaccines\/statevaccsApp\/Administration.asp?statetmp=NJ#4."},{"key":"S0950268823001917_r15","doi-asserted-by":"publisher","DOI":"10.3346\/jkms.2018.33.e252"},{"key":"S0950268823001917_r11","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0269596"},{"key":"S0950268823001917_r9","doi-asserted-by":"crossref","first-page":"S456","DOI":"10.1093\/infdis\/jiac254","article-title":"Prevention and control of nosocomial varicella during the United States varicella vaccination program era","volume":"226","author":"Drees","year":"2022","journal-title":"Journal of Infectious Diseases"},{"key":"S0950268823001917_r8","first-page":"1","article-title":"Immunization of health-care personnel: Recommendations of the advisory committee on immunization practices (ACIP)","volume":"60","year":"2011","journal-title":"MMWR - Recommendations and Reports"},{"key":"S0950268823001917_r10","doi-asserted-by":"publisher","DOI":"10.1016\/j.mjafi.2019.12.004"}],"container-title":["Epidemiology and Infection"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S0950268823001917","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,1,5]],"date-time":"2024-01-05T09:17:05Z","timestamp":1704446225000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S0950268823001917\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,12,19]]},"references-count":16,"alternative-id":["S0950268823001917"],"URL":"https:\/\/doi.org\/10.1017\/s0950268823001917","relation":{},"ISSN":["0950-2688","1469-4409"],"issn-type":[{"value":"0950-2688","type":"print"},{"value":"1469-4409","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,12,19]]},"assertion":[{"value":"\u00a9 The Author(s), 2023. Published by Cambridge University Press","name":"copyright","label":"Copyright","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"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, provided the original article 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":"e3"}}