What type of isolation precautions are indicated for patients with varicella (chickenpox)?

• A. Droplet
• B. Contact
• C. Airborne
• D. Contact and airborne

Answer: (D)

Varicella spreads through both airborne particles and contact with vesicular fluid, so precautions must address both routes. The virus can be carried in small aerosol droplets that linger and travel beyond immediate proximity, not just in large droplets, and the vesicular fluid on lesions can contaminate surfaces or be transmitted by touch. Because of these dual pathways, the patient should be placed in an airborne isolation setting (private room with negative pressure) and healthcare workers should wear respiratory protection (an N95 respirator or equivalent) when entering the room. In addition, gloves and a gown are needed to prevent contact transmission from vesicular fluid. Droplet precautions alone wouldn’t stop the airborne spread, and contact precautions alone wouldn’t prevent inhalation of aerosols, so combining both types best protects staff and others.