The Epidemiology of Herpes Zoster in Immunocompetent, Unvaccinated Adults ≥50 Years Old: Incidence, Complications, Hospitalization, Mortality, and Recurrence. (12th December 2019)

• Record Type: Journal Article
• Authors: Tseng, Hung Fu; Bruxvoort, Katia; Ackerson, Bradley; Luo, Yi; Tanenbaum, Hilary; Tian, Yun; Zheng, Chengyi; Cheung, Bianca; Patterson, Brandon J; Van Oorschot, Desiree; Sy, Lina S
• Is Part Of: Journal of infectious diseases. Volume 222:Number 5(2020)
• Page Start: 798
• Page End: 806
• Publication Date: 2019-12-12
• Subjects: herpes zoster -- epidemiology -- older adults -- incidence -- complications -- mortality -- hospitalization -- recurrence; Communicable diseases -- Periodicals; Diseases -- Causes and theories of causation -- Periodicals; Medicine -- Periodicals; Communicable Diseases -- Periodicals; Electronic journals; 616.9
• DOI: 10.1093/infdis/jiz652
• Languages: English
• ISSNs: 0022-1899

Abstract

Abstract: Background: Data on the epidemiology of herpes zoster (HZ), particularly in the unvaccinated immunocompetent population, are needed to assess disease burden and the potential impact of vaccination. Methods: The study at a large health care organization comprised: (1) incidence estimated from immunocompetent adults aged ≥50 years unvaccinated with zoster vaccine live who had incident HZ in 2011–2015; (2) proportion of HZ-related nonpain complications assessed by double abstraction of electronic health records (EHRs) of 600 incident patients 2011–2015; (3) HZ-related hospitalizations among HZ patients diagnosed in 2015; (4) HZ-related death determined from automated data and EHRs; and (5) recurrent HZ identified from a cohort initially diagnosed with HZ in 2007–2008 and followed through 2016. Results: HZ incidence rate was 9.92/1000 person-years (95% confidence interval [CI], 9.82–10.01). Proportions of cutaneous, neurologic, and other complications were 6.40% (95% CI, 1.73%–11.07%), 0.77% (95% CI, .00%–2.36%), and 1.01% (95% CI, .00%–2.93%), respectively. Only 0.86% of patients had an HZ-related hospitalization. The case-fatality rate was 0.04%. Recurrence rate was 10.96/1000 person-years (95% CI, 10.18–11.79) with 10-year recurrence risk of 10.26% (95% CI, 9.36%–11.23%). Conclusions: These recent HZ epidemiology data among an immunocompetent, unvaccinated population measure real-world disease burden.