Which statement about chickenpox transmission is NOT true?

Which statement about chickenpox transmission is NOT true?

• A. Susceptible individuals can contract chickenpox from patients with varicella zoster (shingles)
• B. Children with chickenpox are infectious only during the period of time when skin lesions are present
• C. Children with chickenpox are no longer infectious once crusting of skin lesions has occurred
• D. Varicella-zoster immune globulin (VZIG) should be administered to susceptible immunocompromised individuals who are exposed to a patient with varicella zoster infection

Answer: (B)

The key idea is how contagious varicella is and when transmission can occur. Varicella-zoster virus is spread not only when the rash is visible but also beforehand, through respiratory droplets, and it can be shed in vesicular fluid. A child is capable of transmitting the virus starting about one to two days before the rash appears and continuing until all vesicles have crusted over. Because of that, saying they are only infectious during the period when skin lesions are present understates the actual infectious window. That’s why the statement is not true: infectiousness begins before the rash and can continue after lesions begin to crust, lasting until the last lesion has formed a crust. This concept is why household contacts of a child with varicella must be mindful not just during the visible illness but from the pre-eruptive period onward, and why post-exposure measures like VZIG are used for high-risk exposed individuals. For context, it’s also correct that varicella can be transmitted from someone with shingles to susceptible people, because shingles and chickenpox are caused by the same virus. And varicella-zoster immune globulin is recommended for susceptible immunocompromised individuals who have been exposed, to help prevent or lessen disease after exposure. The idea about crusting aligns with the notion that contagiousness ends when all lesions have crusted, not merely when some crusting has begun.

The key idea is how contagious varicella is and when transmission can occur. Varicella-zoster virus is spread not only when the rash is visible but also beforehand, through respiratory droplets, and it can be shed in vesicular fluid. A child is capable of transmitting the virus starting about one to two days before the rash appears and continuing until all vesicles have crusted over. Because of that, saying they are only infectious during the period when skin lesions are present understates the actual infectious window.

That’s why the statement is not true: infectiousness begins before the rash and can continue after lesions begin to crust, lasting until the last lesion has formed a crust. This concept is why household contacts of a child with varicella must be mindful not just during the visible illness but from the pre-eruptive period onward, and why post-exposure measures like VZIG are used for high-risk exposed individuals.

For context, it’s also correct that varicella can be transmitted from someone with shingles to susceptible people, because shingles and chickenpox are caused by the same virus. And varicella-zoster immune globulin is recommended for susceptible immunocompromised individuals who have been exposed, to help prevent or lessen disease after exposure. The idea about crusting aligns with the notion that contagiousness ends when all lesions have crusted, not merely when some crusting has begun.