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Herpes zoster in general practice.

C A Ross, W K Brown, A Clarke

    The Journal of the Royal College of General Practitioners
    |January 1, 1975
    PubMed
    Summary
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    Herpes zoster, or shingles, affected approximately 2.4 per 1,000 people in Glasgow. Post-herpetic neuralgia was the most common complication, impacting 44% of patients studied long-term.

    Area of Science:

    • Epidemiology
    • Infectious Diseases
    • Dermatology

    Background:

    • Herpes zoster (shingles) is a viral infection caused by the reactivation of the varicella-zoster virus.
    • Understanding the incidence, clinical presentation, and complications of herpes zoster in a general practice setting is crucial for patient management.

    Purpose of the Study:

    • To determine the incidence rate of herpes zoster in a defined population.
    • To describe the clinical characteristics, common anatomical locations, and identified triggers of herpes zoster.
    • To assess the severity of the illness and the prevalence of post-herpetic neuralgia.

    Main Methods:

    • A retrospective study of patients clinically diagnosed with herpes zoster over a one-year period in eight Glasgow general practices.
    • Serological testing was used to confirm active herpes zoster infection.

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  • Patients were followed up to assess complications, particularly post-herpetic neuralgia.

    • Main Results:

    • An incidence rate of approximately 2.4 per 1,000 practice population was observed.
    • Ninety percent of clinically diagnosed cases had serological evidence of active herpes zoster.
    • The most frequent locations for the rash were the fifth cranial nerve, trunk, and thigh.
    • Identified reactivating agents were infrequent (trauma, steroids, irradiation).
    • The acute illness was generally not severe, with limited systemic upset or lesion dissemination.
    • Post-herpetic neuralgia was a significant complication, affecting 44% of patients reviewed 3-18 months later.

    Conclusions:

    • Herpes zoster occurs at a notable rate in general practice populations.
    • While acute illness is often mild, post-herpetic neuralgia represents a substantial long-term morbidity.
    • Further research into preventative strategies and management of post-herpetic neuralgia is warranted.