Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on medication adherence

LIVE: Thursday 27th June 2024, 18:00-19:30 (CEST)
Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.
ADVANCED SEARCH
Log in
Top
BMC Infectious Diseases
Published in: BMC Infectious Diseases 1/2013

Open Access 01-12-2013 | Research article

Similar herpes zoster incidence across Europe: results from a systematic literature review

Authors: Sybil Pinchinat, Ana M Cebrián-Cuenca, Hélène Bricout, Robert W Johnson

Published in: BMC Infectious Diseases | Issue 1/2013

Login to get access

Abstract

Background

Herpes zoster (HZ) is caused by reactivation of the varicella-zoster virus (VZV) and mainly affects individuals aged ≥50 years. The forthcoming European launch of a vaccine against HZ (Zostavax®) prompts the need for a better understanding of the epidemiology of HZ in Europe. Therefore the aim of this systematic review was to summarize the available data on HZ incidence in Europe and to describe age-specific incidence.

Methods

The Medline database of the National Library of Medicine was used to conduct a comprehensive literature search of population-based studies of HZ incidence published between 1960 and 2010 carried out in the 27 member countries of the European Union, Iceland, Norway and Switzerland. The identified articles were reviewed and scored according to a reading grid including various quality criteria, and HZ incidence data were extracted and presented by country.

Results

The search identified 21 studies, and revealed a similar annual HZ incidence throughout Europe, varying by country from 2.0 to 4.6/1 000 person-years with no clearly observed geographic trend. Despite the fact that age groups differed from one study to another, age-specific HZ incidence rates seemed to hold steady during the review period, at around 1/1 000 children <10 years, around 2/1 000 adults aged <40 years, and around 1–4/1 000 adults aged 40–50 years. They then increased rapidly after age 50 years to around 7–8/1 000, up to 10/1 000 after 80 years of age. Our review confirms that in Europe HZ incidence increases with age, and quite drastically after 50 years of age. In all of the 21 studies included in the present review, incidence rates were higher among women than men, and this difference increased with age. This review also highlights the need to identify standardized surveillance methods to improve the comparability of data within European Union Member States and to monitor the impact of VZV immunization on the epidemiology of HZ.

Conclusions

Available data in Europe have shortcomings which make an accurate assessment of HZ incidence and change over time impossible. However, data are indicative that HZ incidence is comparable, and increases with age in the same proportion across Europe.
Appendix
Available only for authorised users
Literature
1.
Thiry N, Beutels P, Shkedy Z, Vranckx R, Vandermeulen C, Van Der Wielen M, Van Damme P: The seroepidemiology of primary varicella-zoster virus infection in Flanders (Belgium). Eur J Pediatr. 2002, 161: 588-593. 10.1007/s00431-002-1053-2.CrossRefPubMed
2.
British Society for the Study of Infection: Guidelines for the management of shingles: report of a working group of the British Society for the Study Infection. J Infect. 1995, 30: 193-200.CrossRef
3.
Gross G, Schöfer H, Wassilew SW, Friese K, Timm A, Guthoff R, Pau HW, Malin JP, Wutzler P, Doerr HW: Herpes zoster guideline of the German Dermatology Society (DDG). J Clin Virol. 2003, 26: 277-289. 10.1016/S1386-6532(03)00005-2.CrossRefPubMed
4.
Lee VK, Simpkins L: Herpes Zoster and Postherpetic Neuralgia in the Elderly. Geriatr Nurs. 2000, 21: 132-136. 10.1067/mgn.2000.108260.CrossRefPubMed
5.
Edmunds WJ, Brisson M, Rose JD: The epidemiology of herpes zoster and potential cost-effectiveness of vaccination in England and Wales. Vaccine. 2001, 19: 3076-3090. 10.1016/S0264-410X(01)00044-5.CrossRefPubMed
6.
7.
Yawn BP, Saddier P, Wollan PC, Sauver JL, Kurland MJ, SY LS: A Population-Based Study of the Incidence and Complication Rates of Herpes Zoster Before Zoster Vaccine Introduction. Mayo Clin Proc. 2007, 82: 1341-1349. 10.4065/82.11.1341.CrossRefPubMed
8.
Sengupta N, Breuer J: A Global Perspective of the Epidemiology and Burden of Varicella-Zoster Virus. Curr Ped Rev. 2009, 5: 207-228. 10.2174/157339609791317315.CrossRef
9.
Hannouche D, Alfandari S, Bouhour D, Fouchard N, Geffray L, Quinet B: Prise en charge des infections à VZV. Med Mal Infect. 1998, 28: 1-8. Article in FrenchCrossRef
10.
Johnson RW, Wasner G, Saddier P, Baron R: Postherpetic neuralgia: epidemiology, pathophysiology and management. Expert Rev Neurother. 2007, 7: 1581-1595. 10.1586/14737175.7.11.1581.CrossRefPubMed
11.
Scott FT, Leedham-Green ME, Barrett-Muir WY, Hawrami K, Gallagher WJ, Johnson R, Breuer J: A Study of Shingles and the Development of Postherpetic Neuralgia in East London. J Medl Virol. 2003, 70: S24-S30. 10.1002/jmv.10316.CrossRef
12.
Scott FT, Johnson RW, Leedham-Green ME, Davies E, Edmunds WJ, Breuer J: The burden of Herpes Zoster: A prospective population based study. Vaccine. 2006, 24: 1308-1314. 10.1016/j.vaccine.2005.09.026.CrossRefPubMed
13.
Moher D, Liberati A, Tetzlaff J, Altman DG: Reprint–preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Phys Ther. 2009, 89: 873-880.PubMed
14.
Meister W, Neiss A, Gross G, Doerr HW, Höbel W, Malin JP, Von Essen J, Reimann BY, Witke C, Wutzler P: Demography, Symptomatology, and Course of Disease in Ambulatory Zoster Patients. Intervirol. 1998, 41: 272-277. 10.1159/000024949.CrossRef
15.
Chidiac C, Bruxelle J, Daurès J-P, Hoang-Xuan T, Morel P, Leplège A, El Hasnaoui A, De Labaryere C: Characteristics of Patients with Herpes Zoster on Presentation to Practitioners in France. Clin Infect Dis. 2001, 33: 62-69. 10.1086/320884.CrossRefPubMed
16.
di Luzio PU, Arpinelli F, Visonà G: Herpes Zoster and its Complications in Italy: An Observational Survey. J Infect. 1999, 38: 116-120. 10.1016/S0163-4453(99)90079-8.CrossRef
17.
Gabutti G, Serenelli C, Sarno O, Marconi S, Corazza M, Virgili A: Epidemiologic features of patients affected by herpes zoster: database analysis of the Ferrara University Dermatology Unit, Italy. Méd Maladies Infect. 2010, 40: 268-272. 10.1016/j.medmal.2009.09.005.CrossRef
18.
Parlato A, Spica VR, Ciccozzi M, Farchi F, Gallè F, Di Onofrio V, Franco E, Liguori G: Compliance with herpes zoster vaccination in young and adult individuals in two regions of Italy. BMC Public Health. 2010, 10: 1-5. 10.1186/1471-2458-10-1.CrossRef
19.
Pérez-Faérinos N, Ordobas M, Garcia-Fernandez C, Garcia-Comas L, Canellas S, Rodero I, Gutiérrez-Rodriguez A, Garcia-Gutiérrez J, Ramirez R: Varicella and Herpes Zoster in Madrid, based on the Sentinel General Practitioner Network: 1997–2004. BMC Infect Dis. 2007, 7: 1-5. 10.1186/1471-2334-7-1.CrossRef
20.
Truyers C, Bartholomeeusen S, Buntinx F, De Loof J: Incidentie van herpes zoster. Huisarts Onderzoek. 2005, 34: 260-262. Article in Flemish
21.
Réseau Sentinelles Coordination nationale: Bilan annuel du réseau Sentinelles Janvier-Décembre 2009. Rapport d’activité. 2009, Paris:
22.
Gonzalez Chiappe S, Sarazin M, Turbelin C, Lasserre A, Pelat C, Bonmarin I, Chosidow O, Blanchon T, Hanslik T: Herpes zoster: Burden of disease in France. Vaccine. 2010, 28: 7933-7938. 10.1016/j.vaccine.2010.09.074.CrossRefPubMed
23.
Mick G, Gallais JL, Simon F, Pinchinat S, Bloch K, Beillat M, Serradell L, Derrough T: Burden of Herpes Zoster and postherpetic neuralgia: incidence, proportion, and associated costs in the French population aged 50 or over. Rev Epidemiol Sante Publique. 2010, 58: 393-401. 10.1016/j.respe.2010.06.166. Article in FrenchCrossRefPubMed
24.
Czernichow S, Dupuy A, Flahault A, Chosidow O: Zona: enquête d’incidence chez les médecins généralistes du réseau “Sentinelles”. Ann Dermatol Venereol. 2001, 128: 497-501. Article in FrenchPubMed
25.
Schiffner-Rohe VJ, Jow S, Lilie HM, Köster I, Schubert I: Herpes Zoster in Germany. A retrospective analyse of SHL data. MMW Fortschr Med. 2010, 151 (4): 193-197. Article in GermanPubMed
26.
Paul E, Thiel T: Epidemiology of varicella zoster infection. Results of a prospective study in the Ansbach area. Hautarzt. 1996, 47: 604-609. 10.1007/s001050050476. Article in GermanCrossRefPubMed
27.
Helgason S, Sigurdsson JA, Gudmundsson S: The Clinical Course of Herpes Zoster: a Prospective Study in Primary Care. Eur J Gen Pract. 1996, 2: 12-16. 10.3109/13814789609161651.CrossRef
28.
Petursson G, Helgason S, Gudmundsson S, Sigurdsson JA: Herpes zoster in children and adolescents. Pediatr Infect Dis J. 1998, 17: 905-908. 10.1097/00006454-199810000-00011.CrossRefPubMed
29.
Emberti Gialloreti L, Merito M, Pezzotti P, Naldi L, Gatti A, Beillat M, Serradell L, Di Marzo R, Volpi A: Epidemiology and economic burden of herpes zoster and post-herpetic neuralgia in Italy: A retrospective, population-based study. BMC Infect Dis. 2010, 10: 1-11. 10.1186/1471-2334-10-1.CrossRef
30.
Di Legami V, Gianino MM, Ciofi Degli Atti M, Massari M, Migliardi A, Scalia Tomba G, Zotti C: Epidemiology and costs of herpes zoster: Background data to estimate the impact of vaccination. Vaccine. 2007, 25: 7598-7604. 10.1016/j.vaccine.2007.07.049.CrossRefPubMed
31.
Opstelten W, Van Essen GA, Schellevis FG, Verheij TJM, Moons KGM: Gender as an Independent Risk Factor for Herpes Zoster: A Population-Based Prospective Study. Ann Epidemiol. 2006, 16: 692-695. 10.1016/j.annepidem.2005.12.002.CrossRefPubMed
32.
de Melker H, Berbers G, Hahné S, Rümke H, van den Hof S, de Wit A, Boot H: The epidemiology of varicella and herpes zoster in The Netherlands: implications for varicella zoster virus vaccination. Vaccine. 2006, 24: 3946-3952. 10.1016/j.vaccine.2006.02.017.CrossRefPubMed
33.
Opstelten W, Mauritz JW, De Wit NJ, Van Wijck AJM, Stalman WAB, Van Essen GA: Herpes zoster and postherpetic neuralgia: incidence and risk indicators using a general practice research database. Fam Pract. 2002, 19: 471-475. 10.1093/fampra/19.5.471.CrossRefPubMed
34.
Cebrian-Cuenca AM, Diez-Domingo J, Puig-Barbera J, Navarro-Perez J, Sanmartin-Rodriguez M: Epidemiology of Herpes Zoster Infection among Patients Treated in Primary Care Centres in the Valencian Community (Spain). BMC Fam Pract. 2010, 11: 1-23. 10.1186/1471-2296-11-1.CrossRef
35.
Garcia Cenoz M, Castilla J, Montes Y, Moran J, Salaberri A, Elia F, Floristan Y, Rodrigo I, Irisarri F, Arriazu M, Zabala A, Barricarte A: Varicella and herpes zoster incidence prior to the introduction of systematic child vaccination in Navarre, 2005–2006. An Sist Sanit Navar. 2011, 30: 71-80.
36.
Richard J-L, Zimmermann H: Herpès zoster 1998 – 2001. 2001, : Sentinella-Jahresbericht, 6. Article in French
37.
Gauthier A, Breuer J, Carrington D, Martin M, Rémy V: Epidemiology and cost of herpes zoster and post-herpetic neuralgia in the United Kingdom. Epidemiol Infect. 2009, 137: 38-47. 10.1017/S0950268808000678.CrossRefPubMed
38.
39.
Fleming DM, Cross KW, Cobb WA, Chapman RS: Gender difference in the incidence of shingles. Epidemiol Infect. 2003, 132: 1-5.CrossRef
40.
Brisson M, Edmunds WJ: Epidemiology of Varicella-Zoster Virus in England and Wales. J Med Virol. 2003, 70: S9-S14. 10.1002/jmv.10313.CrossRefPubMed
41.
Glynn C, Crockford G, Gavaghan D, Cardno P, Price D, Miller J: Epidemiology of shingles. J Roy Soc Med. 1990, 83: 617-619.PubMedPubMedCentral
42.
43.
Volpi A, Gross G, Hercogova J, Johnson RW: Current Management of Herpes Zoster: The European View. Am J Clin Dermatol. 2005, 6: 317-325. 10.2165/00128071-200506050-00005.CrossRefPubMed
44.
Donahue JG, Choo PW, Manson JE, Platt R: The Incidence of Herpes Zoster. Arch Intern Med. 1995, 155: 1605-1609. 10.1001/archinte.1995.00430150071008.CrossRefPubMed
45.
Ragozzino MW, Melton LJ, Kurland LT, Chu CP, Perry HO: Population-based study of herpes zoster and its sequelae. Medicine. 1982, 61: 310-316.CrossRefPubMed
46.
Gaillat J, Gajdos V, Launay O, Malvy D, Demoures B, Lewden L, Pinchinat S, Derrough T, Sana C, Caulin E, Soubeyrand B: Does monastic life predispose to the risk of Saint Anthony’s fire (herpes zoster)?. Clin Infect Dis. 2011, 53: 405-410. 10.1093/cid/cir436.CrossRefPubMed
47.
48.
Terada K, Yoshihiro K, Kawano S, Morita T: Incidence of herpes zoster in pediatricians and family practitioners. Estimation of efficacy of varicella vaccine for protection against herpes zoster in the elderly. Kawasaki Med J. 1994, 20: 99-102.
49.
Brisson M, Gay NJ, Edmunds WJ, Andrews NJ: Exposure to varicella boosts immunity to herpes-zoster: implications for mass vaccination against chickenpox. Vaccine. 2002, 20: 2500-2507. 10.1016/S0264-410X(02)00180-9.CrossRefPubMed
50.
Thomas SL, Wheeler JG, Hall AJ: Contacts with varicella or with children and protection against herpers zoster in adults:a case-control study. Lancet. 2002, 360: 678-682. 10.1016/S0140-6736(02)09837-9.CrossRefPubMed
51.
Salleras M, Dominguez A, Soldevila N, Prat A, Garrido P, Torner N, Borras E, Salleras L: Contacts with children and young people and adult risk of suffering herpes zoster. Vaccine. 2011, 29: 7602-7605. 10.1016/j.vaccine.2011.08.023.CrossRefPubMed
52.
Garnett GP, Grenfell BT: The epidemiology of varicella-zoster virus infections: the influence of varicella on the prevalence of herpes zoster. Epidemiol Infect. 1992, 108: 513-528. 10.1017/S0950268800050019.CrossRefPubMedPubMedCentral
53.
Yawn BP, Wollan P, St Sauver J: Comparing shingles incidence and complication rates from medical record review and administrative database estimates: how close are they?. Am J Epidemiol. 2011, 174: 1054-1061. 10.1093/aje/kwr206.CrossRefPubMedPubMedCentral
54.
Thomas SL, Hall AJ: What does epidemiology tell us about risk factors for herpes zoster?. Lancet Infect Dis. 2004, 1: 26-33.CrossRef
55.
Pinot de Moira A, Nardone A: Varicella zoster virus vaccination policies and surveillance strategies in Europe. Euro Surveill. 2005, 10: 43-45.PubMed
56.
Report Venice II: Varicella and herpes Zoster surveillance and vaccination recommandations 2010–11. 2010, Stockholm: ECDC
57.
Report Statens Serum Institut: Surveillance of Varicella and Herpes Zoster in Europe. 2010, Copenhagen:
58.
Jumaan AO, Yu O, Jackson LA, Bohlke K, Galil K, Seward JF: Incidence of herpes-zoster, before and after varicella vaccination associated decreases in the incidence of varicella, 1992–2002. J Infect Dis. 2005, 191: 2002-2007. 10.1086/430325.CrossRefPubMed
59.
Alain S, Paccalin M, Larnaudie S, Perreaux F, Launay O: Impact of routine pediatric varicella vaccination on the epidemiology of herpes zoster. Med Mal Infect. 2009, 39: 698-706. 10.1016/j.medmal.2009.04.009. Article in FrenchCrossRefPubMed
60.
Yih WK, Brooks DR, Lett SM, Jumaan AO, Zhang Z, Clements KM, Seward JF: The incidence of varicella and herpes zoster in Massachusetts as measured by the Behavioral Risk Factor Surveillance System (BRFSS) during a period of increasing varicella vaccine coverage, 1998–2003. BMC Public Health. 2005, 5 (68): 1-9.
61.
Eurostat: Active ageing and solidarity between generations. A statistical portrait of the European Union 2012. 2012, Luxembourg: Luxembourg, 2012
62.
Jumaan A, Schmid DS, Gargiullo P, Seward J: Letter to the Editor. Vaccine. 2004, 22: 3228-3231. 10.1016/j.vaccine.2004.03.064.CrossRefPubMed
63.
Joesoef MR: Potential coding error of herpes zoster (HZ) vaccination and HZ diagnosis in administrative data. Vaccine. 2011, 29: 2008-2009. 10.1016/j.vaccine.2010.12.093.CrossRefPubMed
64.
Brisson M, Edmunds WJ, Law B, Gay NJ, Wall R, Brownell M, Roos L, De Serres G: Epidemiology of varicella zoster virus infection in Canada and the United Kingdom. Epidemiol Infect. 2001, 127: 305-314.CrossRefPubMedPubMedCentral
Metadata
Title
Similar herpes zoster incidence across Europe: results from a systematic literature review
Authors
Sybil Pinchinat
Ana M Cebrián-Cuenca
Hélène Bricout
Robert W Johnson
Publication date
01-12-2013
Publisher
BioMed Central
Published in
BMC Infectious Diseases / Issue 1/2013
Electronic ISSN: 1471-2334
DOI
https://doi.org/10.1186/1471-2334-13-170

Other articles of this Issue 1/2013

BMC Infectious Diseases 1/2013 Go to the issue

Case report

Colonic involvement in disseminated histoplasmosis of an immunocompetent adult: case report and literature review

Case report

Osteitis in the dens of axis caused by Treponema pallidum

Research article

Drug use evaluation of cefepime in the first affiliated hospital of Bengbu medical college: a retrospective and prospective analysis

Research article

Population-level effects of clinical immunity to malaria

Research article

Disease burden of herpes zoster in Sweden - predominance in the elderly and in women - a register based study

Research article

Retrospective analysis of antimicrobial resistance and bacterial spectrum of infection in Gabon, Central Africa
Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Reserve your place

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin
Prof. Florian Limbourg
Prof. Anoop Chauhan
Developed by: Springer Medicine
Obesity Clinical Trial Summary

At a glance: The STEP trials

Read more

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Pediatric Cardiology Video

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

Cardiopulmonary Comorbidity Video

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Valvular Heart Disease Video

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Heart Failure Video

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.

ACC 2024 Congress Coverage

Year in Review: Heart failure and cardiomyopathies

Heart Failure Video

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.

Watch now

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

16-04-2024 Type 2 Diabetes News

Incentivised to exercise

11-04-2024 Lifestyle Modifications News

New intervention for STEMI-related cardiogenic shock

10-04-2024 Myocardial Infarction News

» View more highlights on the ACC 2024 congress hub page

Image Credits