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Herpes Zoster (Shingles) — MRCGP AKT MCQ

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HardInfectious DiseasesHerpes Zoster (Shingles)MRCGP AKTUKMLAPARA

An immunocompetent care worker has localized truncal shingles. The lesions are weeping but can be completely covered by clothing. A pregnant colleague is unsure whether she has previously had chickenpox. Which advice is most accurate?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: D — Cover lesions and seek occupational-health advice until they have crusted

D is correct. A person with shingles can transmit varicella-zoster virus from active lesions to a susceptible contact, causing chickenpox rather than shingles. Infectivity persists until lesions are dry and crusted. Localized lesions that can be securely covered reduce transmission risk, but a healthcare worker should follow occupational-health policy and avoid exposing susceptible high-risk contacts, including a pregnant colleague whose immunity is uncertain. The colleague requires prompt exposure assessment rather than automatic live vaccination, which is contraindicated during pregnancy. Pain may outlast infectivity and does not determine return to work. A mask does not replace covering lesions and appropriate contact precautions.

Reference: NICE CKS, shingles advice and infection control: https://cks.nice.org.uk/topics/shingles/management/management/