Varicella-zoster virus (VZV) is a highly contagious infectious agent that causes outbreaks in institutional settings. Transmission of VZV is felt to occur following direct contact with an infected individual and by aerosol spread. To document the aerosolization of VZV, a polymerase chain reaction (PCR) assay was used to detect VZV DNA in air samples obtained from hospital rooms of patients with active VZV infection. VZV DNA was detected in 64 (82%) of 78 air samples from rooms housing patients with active varicella and 9(70%) of 13 samples from rooms of patients with herpes zoster. VZV was detected 1.2-5.5 m from patients' beds and for 1-6 days following onset of rash. On some occasions, VZV DNA could be detected outside the hospital isolation rooms housing patients. This PCR-based method allows the detection and semiquantitation of VZV aerosolization and can be a useful tool for monitoring efforts to control VZV aerosols in the environment.

The polymerase chain reaction (PCR) was used to detect varicella-zoster virus (VZV) DNA in respiratory epithelial cells and in peripheral blood leukocytes from adults with varicella. VZV DNA was detected in oropharyngeal epithelium in 62% of patients early in the course of varicella; the amount of VZV DNA declined with time and was detectable in only 22% of patients for greater than 6 days. VZV DNA was also detected in peripheral blood leukocytes in 74% of patients early in disease and was detected in both polymorphonuclear and mononuclear leukocytes. PCR demonstrated the presence of VZV DNA in the oropharynx and blood of most patients during varicella, in contrast to the ability to detect VZV in these tissues by viral culture.