Varicella-zoster virus epidemiology--a changing scene?

Area of Science:

• Infectious Diseases
• Epidemiology
• Public Health

Background:

• Chickenpox (varicella) is typically mild in children but can be severe or fatal in immunocompromised individuals, neonates, and adults, particularly smokers.
• Smokers face a high risk of varicella pneumonia, a serious complication of chickenpox.

Purpose of the Study:

• To analyze the changing epidemiology of chickenpox.
• To assess the implications of this shift for public health, including mortality rates and risks for specific populations.
• To evaluate the potential role of the varicella vaccine in mitigating these risks.

Main Methods:

• Review of epidemiological data on chickenpox cases over the past 20 years.
• Analysis of trends in general practice consultations and mortality data in England and Wales.
• Examination of hospital admission data for chickenpox in young adults in the United States.

Main Results:

• An unexplained upward shift in the age distribution of chickenpox cases has been observed over the last two decades.
• This trend is evidenced by increased consultations in general practices and a rise in deaths in England and Wales.
• Hospital admissions for chickenpox in young adults suggest a similar pattern in the United States.

Conclusions:

• The changing epidemiology of chickenpox has significant implications for future mortality rates.
• Healthcare workers and pregnant women may face increased infection risks due to this demographic shift.
• The varicella vaccine should be considered to reduce nosocomial transmission and manage the evolving risk profile of varicella.