Fact sheets
Chickenpox pamphlet (PDF 190KB)
Public Health action
Notifiable disease data and reports
Additional sources of information
Exclusion
Cases: exclude until all vesicles have crusted.
Contacts: refer any immunosuppressed children (e.g.leukaemia patients) to their doctor. Do not exclude other contacts.
Case definition
Varicella-zoster infection (chickenpox)
Reporting
Both probable and confirmed cases should be notified.
Confirmed case
A confirmed case requires either:
1. Laboratory definitive evidence AND clinical evidence
OR
2. Clinical evidence AND epidemiological evidence
Laboratory definitive evidence
1. Isolation of varicella-zoster virus from a skin or lesion swab. If the case received varicella vaccine between five and 42 days prior to the onset of rash the virus must be confirmed to be a wild type strain.
OR
2. Detection of varicella-zoster virus from a skin or lesion swab by nucleic acid testing from a skin or lesion swab. If the case received varicella vaccine between five and 42 days prior to the onset of rash the virus must be confirmed to be a wild type strain.
OR
3. Detection of varicella-zoster virus antigen from a skin or lesion swab by direct fluorescent antibody from a skin or lesion swab. If the case received varicella vaccine between five and 42 days prior to the onset of rash the virus must be confirmed to be a wild type strain.
OR
4. Detection of varicella-zoster virus-specific IgM in an unvaccinated person.
Clinical evidence
Acute onset of a diffuse maculopapular rash developing into vesicles within 24–48 hours and forming crusts (or crusting over) within 5 days.
Epidemiological evidence
An epidemiological link is established when there is:
1. Contact between two people involving a plausible mode of transmission at a time when:
a) one of them is likely to be infectious
AND
b) the other has illness 10 to 21 days after contact
AND
2. At least one case in the chain of epidemiologically-linked cases is laboratory confirmed.
Probable case
A probable case requires clinical evidence only.
Note: Laboratory confirmation should be strongly encouraged for vaccinated cases. If positive, samples should be referred for identification as a vaccine or wild type strain.
Varicella-zoster infection (shingles)
Reporting
Both probable and confirmed cases should be notified.
Confirmed case
A confirmed case requires laboratory definitive evidence AND clinical evidence.
Laboratory definitive evidence
1. Isolation of varicella-zoster virus from a skin or lesion swab.
OR
2. Detection of varicella-zoster virus from a skin or lesion swab by nucleic acid testing from a skin or lesion swab.
OR
3. Detection of varicella-zoster virus antigen from a skin or lesion swab by direct fluorescent antibody from a skin or lesion swab.
Clinical evidence
A vesicular skin rash with a dermatomal distribution that may be associated with pain in skin areas supplied by sensory nerves of the dorsal root ganglia.
Probable case
A probable case requires clinical evidence only.
Note: Laboratory confirmation should be strongly encouraged for vaccinated cases. If positive, samples should be referred for identification as a vaccine or wild type strain.
Varicella-zoster infection (unspecified)
Reporting
only confirmed cases should be notified.
Confirmed case
A confirmed case requires laboratory definitive evidence in the absence of clinical information.
Laboratory definitive evidence
1. Isolation of varicella-zoster virus from a skin or lesion swab.
OR
2. Detection of varicella-zoster virus from a skin or lesion swab by nucleic acid testing from a skin or lesion swab.
OR
3. Detection of varicella-zoster virus antigen from a skin or lesion swab by direct fluorescent antibody from a skin or lesion swab.
OR
4. Detection of varicella-zoster virus-specific IgM in an unvaccinated person.
