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Infection Control-Related Administrative Policies and Work Restrictions

Course Number: 473

OHCP Exposed to or Infected with Herpes Simplex and Varicella Zoster

The herpes simplex and varicella zoster viruses are transmitted primarily from person-to-person by direct contact with vesicular exudates, contaminated saliva, genital fluids (herpes simplex); inhalation of droplet nuclei from infected respiratory tract (varicella zoster); and less frequently, by contact with freshly contaminated articles and environmental surfaces.50,51 In oral healthcare settings, administrative policies and work restrictions are primarily predicated on the mode of transmission of these pathogens and the period of infectivity of exposed or infected OHCP (Table 8).1,2

Table 8. Work Restrictions: Herpes Simplex and Varicella Infections.1,2

Infectious StateRestrictions
Herpes simplex
  • OHCP with acute orofacial herpes
  • Cover lesions
  • Restrict from the care of high-risk patients
    • Until lesions heal
  • OHCP with acute herpetic whitlow
  • Exclude from duty
    • Until all lesions heal
  • OHCP with acute genital herpes
  • No Restrictions
Varicella (chicken pox)
  • Susceptible OHCP
    • Post-exposure
  • Exclude from duty
    • From the 10th day after first exposure through the 21st day after last exposure
  • OHCP with acute infection
  • Exclude from duty
    • Until all lesions dry and crust
Varicella zoster (shingles)
  • Susceptible OHCP
    • Post-exposure
  • Exclude from duty
    • From the 5th day after first exposure through the 21st day after last exposure.
  • Healthy OHCP with acute infection
  • Cover lesions
  • Restrict from the care of high-risk patients
    • Until all lesions dry and crust
  • Immunocompromised OHCP with acute infection
  • Exclude from duty
    • Until all lesions dry and crust