SBA — Single Best Answer · Review
Question 742
Obstetric infection → Viral
Classification
Question
SSBAQuestion Header
Significant exposure to shingles
Question Stem
A pregnant woman with uncertain varicella immunity reports contact with a relative who has shingles. Which circumstance is most clearly associated with a significant risk of VZV transmission?
Options
A
Completely covered thoracolumbar shingles in an immunocompetent person
B
A remote history of shingles with no active lesions
C
Post-herpetic neuralgia after all lesions have healed
D
Disseminated shingles with exposed lesions
E
Previous shingles vaccination without a rash
Explanation
Shingles can represent a significant VZV exposure when it is disseminated, occurs in an exposed area such as ophthalmic shingles, or occurs in an immunocompromised individual where viral shedding may be greater. Transmission following contact with shingles confined to a non-exposed area, such as covered thoracolumbar shingles, is considered remote although it can occur.
Option Validity
A) transmission from shingles confined to a non-exposed area is considered remote, although possible.
B) a remote history without active infection does not constitute current infectious exposure.
C) healed lesions with post-herpetic neuralgia do not represent the characteristic infectious exposure described.
E) vaccination without active shingles lesions is not the exposure described.
Further Reading
RCOG Green-top Guideline No. 13, Chickenpox in Pregnancy, section 4.3.