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Plaquing of Herpes Simplex Viruses
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Herpes zoster, active component, U.S. Armed Forces, 2000-2016.

Valerie F Williams, Shauna Stahlman, Saixia Ying

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    Summary

    Herpes zoster (HZ) incidence rose among US service members from 2000-2016, particularly in older females and Air Force personnel. Understanding risk factors is crucial for prevention and treatment strategies.

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    Area of Science:

    • Epidemiology
    • Public Health
    • Infectious Disease

    Background:

    • Herpes zoster (HZ), commonly known as shingles, is caused by the reactivation of the varicella-zoster virus.
    • While typically associated with aging, HZ can affect individuals of any age, especially those with compromised immune systems.
    • Monitoring HZ incidence in specific populations, like active-duty military personnel, is vital for public health surveillance.

    Purpose of the Study:

    • To analyze trends in herpes zoster incidence among active component US service members from 2000 to 2016.
    • To identify demographic and service-specific factors associated with higher HZ rates.
    • To assess the impact of immunocompromised status and seasonal patterns on HZ occurrence.

    Main Methods:

    • Retrospective analysis of incident herpes zoster diagnoses in active component service members between 2000 and 2016.
    • Calculation of unadjusted incidence rates per 1,000 person-years (p-yrs).
    • Stratification of rates by age, sex, race/ethnicity, military branch, and immunocompromised status.

    Main Results:

    • A total of 52,895 incident HZ cases were recorded, with an overall incidence rate of 2.5 cases per 1,000 p-yrs.
    • Higher incidence rates were observed in females, individuals aged 50 years and older, and Air Force members.
    • HZ rates increased with age and were highest among non-Hispanic whites and Asian/Pacific Islanders, and lowest among non-Hispanic blacks. Annual rates showed a steady increase from 2000 to a peak in 2014.
    • Immunocompromised individuals accounted for 2.1% of cases, and peak case numbers occurred during summer months (June-August).

    Conclusions:

    • The study highlights a concerning increase in herpes zoster incidence within the US military population.
    • Demographic factors like age and sex, along with service branch, are associated with varying HZ risk.
    • Further research into risk factors is essential for developing effective prevention and treatment strategies for HZ.