Zoster (Shingles) for Schools and Child Care

Information on zoster (shingles) reporting, surveillance, and disease control recommendations for school health personnel and child care providers.

On this page:
Zoster (shingles) basics
Reporting for schools and child care
Testing information and promotion
Prevention and control in school and child care

Zoster (shingles) basics

Zoster (Shingles) Basics
General information about shingles, including symptoms, complications, treatment, and vaccination.

Reporting for schools and child care

Schools and child cares are to report all confirmed and suspected cases of zoster (shingles) in children under 18 at their facility. Shingles in staff members over the age of 18 is not reportable to MDH. However, if there is any concern about an outbreak of chickenpox, MDH should be called at 651-201-5414 or 1-877-676-5414. Individual cases of zoster (shingles) can be reported using the following methods:

• Online with REDCap using the Vaccine Preventable Disease (VPD) Reporting Form
• For other ways to report visit Reporting Varicella (Chickenpox).

Testing information and promotion

Clinical diagnosis is generally sufficient to diagnose shingles, as the rash typically presents more characteristically than chickenpox, which tends to be more easily confused with other rash illnesses. However, MDH recommends PCR testing for confirmatory diagnosis of shingles, particularly in patients under 18 since shingles in this age group is uncommon.

MDH will also perform strain-type testing on all pediatric shingles cases submitted to the MDH Public Health Lab. Strain-typing can help us identify whether the disease is due to vaccine strain or wild-type varicella zoster virus and helps track the changing epidemiology of shingles in an era of high varicella vaccination rates.

We encourage schools and child cares to offer MDH’s at-home test kits for suspected shingles cases. Test kits can be requested by completing and submitting the VPD Test Kit Requests form. During the case investigation process, MDH may also offer this option to cases who have not been lab confirmed.

Test kits can be sent directly to a household, or to schools and child cares to distribute to families. Testing at MDH is provided at no charge and results will be shared with the family. People may also seek testing with their health care provider.

Prevention and control in school and child care

• If a person with localized shingles can keep the rash completely covered with a bandage, they do not have to be excluded from school or child care settings.
• If the rash cannot be fully covered (or be kept covered), exclude children or staff with shingles from schools or child care until all blisters have crusted and no new lesions have appeared for at least 24 hours. This is usually seven to 10 days after the rash began.
• Disseminated zoster, a more widespread form of the disease, is more infectious than localized zoster. If a person has been diagnosed with disseminated zoster, they must be excluded from school or child care settings regardless of whether their lesions can be completely covered.
• Persons with active zoster lesions should avoid contact with pregnant people, immunocompromised people, and people not vaccinated for varicella or zoster. If exposure occurs, the same post-exposure prophylaxis options are available as for exposure to chickenpox (varicella).