Abstract
In Switzerland, vaccination against varicella is not recommended in the basic immunisation schedule. However, for individuals aged 11-40 years who do not have a reliable varicella history the Swiss Federal Office of Public Health recommends either (i) a vaccination or (ii) a serology test and vaccination of those with a negative result. In the Travel Clinic of the University of Zurich, the second strategy is followed. In this study we retrospectively assessed the overall percentage of individuals with varicella-specific antibodies despite a negative history and we examined the influence of age, number of siblings, order of siblings, age difference to siblings and nationality on varicella seropositivity. Between December 2008 and August 2015, the sera of 1757 individuals with a negative varicella history were tested for varicella antibodies. A total of 1593 individuals (91%) had a positive result. We found an increasing trend for varicella seropositivity with increasing age. Those aged less than 40 years were significantly more often seronegative (9.5%) than those aged 40 years and above (6.0%, p = 0.049). Seropositivity was associated with nationality. The percentage of seropositives increased with the number of siblings. Our results indicate that, despite the significant varicella seropositivity differences between those aged below and above, the age of 40 may not be an ideal threshold for performing a varicella serology in individuals with a negative or unknown varicella history. In the age groups above 40, testing for varicella antibodies may be especially reasonable in individuals with no or a small number of siblings and in those of specific nationalities.
Highlights
Varicella is the primary infection caused by the highly contagious varicella zoster virus (VZV)
In this study we retrospectively assessed the overall percentage of individuals with varicella-specific antibodies despite a negative history and we examined the influence of age, number of siblings, order of siblings, age difference to siblings and nationality on varicella seropositivity
According to previous studies conducted in Switzerland between 1994 and 2005, VZV seroprevalence in adolescents and young adults ranges between 94% and 97% [1,2,3,4,5]
Summary
Varicella is the primary infection caused by the highly contagious varicella zoster virus (VZV). Seroprevalences show regional differences, studies from other Western European countries report comparable VZV prevalences [6,7,8]. If varicella infection is contracted in adulthood, the risk of complications such as pneumonia, encephalitis or meningitis is higher than in children [11]; in Switzerland, the frequency of hospitalisations for adults is 16 times higher and mortality is increased 40 times [12]. The Swiss Federal Office of Public Health recommends the following approach in individuals aged 11 to
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