Abstract
BackgroundMore detailed understanding of herpes zoster (HZ) is called for in the context of an increasing observed frequency of disease, and ongoing discussions regarding potential consequences of the disease. Thus, population-based data on incidence and complications of HZ are needed.MethodsWe conducted a register-based cohort study in Västra Götaland County (population 1.5 million) in Sweden. We collected data on all patients diagnosed with HZ during the years 2008 to 2010 from population-based registers. Incidence rates (IR) of HZ and related complications were calculated and stratified by age and sex.ResultsThere were 13 269 new HZ cases during the study period. Overall, the IR of herpes zoster in both genders was 3.25 (95 % CI: 3.16–3.34) per 1000 person years in 2010. The incidence was consistently higher in women than in men and in older than in young. A history of immunosuppression was more common than in the general population. The incidence was highest in individuals over 80 years of age (IR 9.2 per 1000 person years, 95 % CI: 8.8–9.6) during 2008–2010. The most common complications to HZ were ocular engagement and postherpetic neuralgia; risks for stroke and sepsis were significantly elevated during the one year following diagnosis, especially in the youngest age group of patients 0–39 years.ConclusionsHerpes zoster is more common in women, the elderly and immunosuppressed individuals. We verify a population-based association between herpes zoster and risk for stroke and sepsis, which may merit concern.Electronic supplementary materialThe online version of this article (doi:10.1186/s12879-015-1170-y) contains supplementary material, which is available to authorized users.
Highlights
More detailed understanding of herpes zoster (HZ) is called for in the context of an increasing observed frequency of disease, and ongoing discussions regarding potential consequences of the disease
The Swedish Patient Register (SPR) was used to identify complications related to herpes zoster, as this register holds more detailed information on such compared to the Primary Health Care Register (PHCR), and to identify potential associated outcomes after herpes zoster as well as underlying immunosuppressive conditions
Case validation A total of 73 % of the randomly sampled herpes zoster cases could be directly verified through chart review (81/112) as having ≥3 out of 5 pre-specified symptoms (Additional file 1: Table S3)
Summary
More detailed understanding of herpes zoster (HZ) is called for in the context of an increasing observed frequency of disease, and ongoing discussions regarding potential consequences of the disease. Population-based data on incidence and complications of HZ are needed. Called shingles, is a spontaneous reactivation of a latent infection with varicella zoster virus (VZV). Primary infection with VZV causes chickenpox, a common and typically benign exanthematous childhood rash, after which VZV becomes latent in nerve ganglia. Re-activation of VZV usually manifests as herpes zoster with pain, rash, and vesicles in the area of skin supplied by the affected nerve (dermatome). Over 90 % of the Swedish population will have had chickenpox before 12 years of age, which is more common than in southern Europe [8] and corresponds to about a birth cohort every year (~100 000/ year in Sweden). In this study we investigated herpes zoster incidence, complications, associated events, and the economic burden incurred; using population-based health care registers in Sweden
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