Herpes zoster is classified under Category B of infectious diseases in China. The categorization of infectious diseases is primarily based on transmission routes, severity, and control measures, with legally notifiable diseases in China divided into three categories: A, B, and C.
Category B Infectious Disease
Herpes zoster is caused by the varicella-zoster virus, which initially manifests as chickenpox. After recovery, the virus lies dormant in the nerve ganglia and reactivates as herpes zoster when immunity is compromised. According to the Law of the People’s Republic of China on the Prevention and Treatment of Infectious Diseases, herpes zoster is managed as a Category B infectious disease and requires online reporting within 24 hours.
Transmission Characteristics
The virus is mainly transmitted through direct contact with vesicle fluid or respiratory droplets, with lower contagiousness than chickenpox. During the active phase, patients have a high viral load in their lesions, which diminishes once the lesions crust over. Individuals with normal immune function typically develop chickenpox rather than directly contracting herpes zoster upon exposure.
High-Risk Groups
Children who have not been vaccinated, pregnant women, and immunocompromised individuals are at higher risk of infection. Middle-aged and elderly people over 50, cancer patients, and those on long-term immunosuppressive therapy are more susceptible to developing herpes zoster, with some experiencing complications like postherpetic neuralgia.
Prevention and Control Measures
Patients should be isolated until the vesicles crust over to avoid contact with pregnant women and infants. Healthcare workers recommend vaccination with the recombinant zoster vaccine, and antiviral prophylaxis can be used within 72 hours of exposure. Contaminated items should be disinfected with chlorine-containing agents.
Differential Diagnosis
Herpes zoster needs to be distinguished from other skin conditions like simplex herpes and contact dermatitis. Typical symptoms include unilateral, band-like distribution of erythematous vesicles accompanied by neuralgia. Laboratory tests may reveal elevated viral DNA or antibody titers.
Management During Acute Phase
During the acute phase, patients should keep the affected skin clean and dry, wear loose cotton clothing to reduce friction, and consume a diet rich in vitamin B complex from whole grains, lean meats, and dark green vegetables. Spicy foods should be avoided. Low-intensity aerobic exercises like walking and Tai Chi can be beneficial during recovery, but overexertion should be avoided. Cold compresses can help relieve neuralgic pain, and elevating the affected limb at night can improve comfort. Individuals over 50 are encouraged to get vaccinated against herpes zoster, and diabetic patients should pay special attention to blood sugar control to reduce the risk of developing the condition.
Conclusion
Herpes zoster, classified as a Category B infectious disease, requires prompt reporting and management. By understanding its transmission routes, identifying high-risk groups, and implementing effective prevention and control measures, the spread and impact of herpes zoster can be significantly reduced.
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