Rescue of Severely Immunocompromised HIV‐Positive Persons. Part 5
Outbreak control measures. Case patients were kept in their bedrooms or on their residential floor until their lesions scabbed over, although bedroom doors remained open at all times to allow staff to monitor residents. Non‐case residents living in apartments with case patients were not allowed to leave their apartments for 14 days following rash onset in the last case. Due to the limited number of rooms, facility A did not isolate cases from their non–case roommates. There were 2 rooms where both roommates became cases, although in both instances, rash onset dates were within 3 days of each other, indicating that transmission did not occur between roommates. Facility A recommended that all staff (healthcare and non‐healthcare) check their varicella immunity status with their private healthcare provider and undergo vaccination if susceptible; however, evidence of immunity was not required to continue working.
Facility A vaccinated 55 (93%) of 59 residents who had not developed a varicella‐like rash from 30 December 2008 through 6 January 2009 because information on history of varicella disease was incomplete on medical records and could not be accurately obtained from guardians. In addition, it was challenging to obtain a serology specimen from all residents to assess susceptibility. A second dose of varicella vaccine was given 28 days later to 50 of these residents. On 17 January 2009, a maculopapular vesicular rash with Canadian pharmacy no rx
Environmental testing. Of the 71 environmental samples collected in January 2009, we detected wild‐type (WT) VZV DNA from 9 (82%) of the 11 case patients’ beds and belongings, from the bedroom floor and wheelchair of the possible herpes zoster case patient, and from the common areas of building 1. No VZV DNA was detected in samples collected from building 2, where there were no cases. An additional 25 environmental specimens were collected in March 2009: VZV DNA remained detectable in samples from the bedrooms of 6 (75%) of 8 varicella case patients and from the common area of building 1. In addition, Oka‐ (vaccine) strain VZV was detected in environmental samples collected in January and March 2009 from the bedroom of the resident with vaccine‐associated rash.