Medical Surveillance Monthly Report (MSMR). Volume 8, Number 6, August 2002
ARMED FORCES HEALTH SURVEILLANCE CENTER SILVER SPRING MD
Pagination or Media Count:
Primary infection with varicella-zoster virus VZV causes varicella chickenpox, a common disease of children. Following varicella, VZV persists in latent form in the ganglia of sensory nerves. Herpes zoster shingles is the clinical manifestation of localized reactivation of VZV in spinal or cranial nerves. The clinical course of herpes zoster is characterized by neuralgia and the eruption of vesicles in the skin over the paths of affected nerves. Symptoms can range from mild itching and discomfort to intense pain and generally last from two to four weeks. Post-herpetic neuralgia pain that persists after skin lesions have healed is a serious complication of herpes zoster that primarily affects elderly and immunocompromised patients. Depending on its anatomic location and severity, herpes zoster can be debilitating, especially to service members in field operational settings. Recent estimates of the overall incidence of herpes zoster range from 130 to 215 per 100,000 persons per year. 4,5 In general populations, risk factors for herpes zoster include increasing age, white race, and immunosuppression e.g., HIV-1 infection, certain cancers, immunosuppressive drugs. It is unclear whether risk is related to gender, and there is no clear evidence of seasonality of herpes zoster incidence. Although an estimated 300,000 to 500,000 cases of herpes zoster occur in the United States each year, there have been few population-based studies of its epidemiology and none, to our knowledge, focusing on members of the US Armed Forces or on other generally healthy young adults. For this report, we estimated incidence rates, demographic correlates of risk, and seasonal patterns of incidence of herpes zoster among active duty members of the US Armed Forces.