The epidemiology of varicella hospitalizations in the U.S. Army

Varicella infections affect the U.S. Army, but the extent has not been quantified recently. We obtained 1990 to 1997 hospitalization data from the U.S. Army Medical Command and calculated rates using data from the Army Medical Surveillance Activity and the U.S. Army Training Command. There was a decline in the number and incidence of varicella hospitalizations for U.S. Army active duty soldiers from 1990 to 1997. Varicella incidence rates for active duty soldiers are significantly higher for females, blacks, those younger than 20 years, and those whose home of record were tropical island regions. Army initial entry training hospitalizations constitute 11.8% of active duty Army hospitalizations and have also declined. Varicella continues to affect the training and health of the U.S. Army; however, the impact has diminished over the years. A feasible approach to limit varicella in the U.S. Army is to target trainees for screening or vaccination. Refinement of this strategy should be determined from a follow-up cost-effectiveness analysis.