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Medical Conditions

Shingles (Herpes Zoster)

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What is shingles?

An infection caused by the reactivation of varicella-zoster (chickenpox) virus within the body of someone who previously had chickenpox or, less commonly, someone who received the chickenpox vaccine in the past

What are the signs or symptoms?

Appearance of red bumps and blisters (vesicles), usually in a narrow area on one side of the body. The rash may be itchy or painful.

What are the incubation and contagious periods?

  • Incubation period: The virus remains in the body in an inactive state for many years after the original chickenpox infection. Shingles may occur many years after having chickenpox or the vaccine when the virus (varicella zoster) reactivates.

  • Contagious period: Until the vesicles are covered by scabs.

How is it spread?

The virus in the shingles rash can spread by contact to a person who has never been vaccinated or had chickenpox; this virus will cause chickenpox (not shingles) in that person.

How do you control it?

  • Use good hand-hygiene technique at all the times listed in Chapter 2.

  • Cover skin rash.

What are the roles of the teacher/caregiver and the family?

  • Report the infection to the staff member designated by the child care program or school for decision-making and action related to care of ill children. That person, in turn, alerts possibly exposed family and staff members to watch for symptoms.

  • Inform others of the greater risk to

    • Susceptible adults and children (eg, not adequately vaccinated)

    • Children or adults with impaired immune systems

Exclude from group setting?

No, unless

  • The rash cannot be covered.

  • The child is unable to participate and staff members determine they cannot care for the child without compromising their ability to care for the health and safety of the other children in the group.

  • The child meets other exclusion criteria.

Readmit to group setting?

Yes, when all the following criteria have been met:

  • When rash can be covered or when all lesions have crusted

  • When the child is able to participate and staff members determine they can care for the child without compromising their ability to care for the health and safety of the other children in the group


The virus that causes shingles is the virus that causes chickenpox. Vaccination of susceptible individuals is the best way to prevent or decrease the severity of infection with this virus. A vaccine is currently available to prevent shingles in individuals who previously had chickenpox, but it is recommended for use only in those 60 years and older.

Listing of resources does not imply an endorsement by the American Academy of Pediatrics (AAP). The AAP is not responsible for the content of external resources. Information was current at the time of publication.

The information contained in this publication should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.

Quick Reference Sheet from Managing Infectious Diseases in Child Care and Schools: A Quick Reference Guide.

© 2017 American Academy of Pediatrics. All rights reserved.