Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2015 Apr 30;10(4):e0125025.
doi: 10.1371/journal.pone.0125025. eCollection 2015.

Increasing trends of herpes zoster in Australia

Raina MacIntyre  1 , Alicia Stein  2 , Christopher Harrison  3 , Helena Britt  3 , Abela Mahimbo  4 , Anthony Cunningham  5
Affiliations

Increasing trends of herpes zoster in Australia

Raina MacIntyre et al. PLoS One. .

Erratum in

  • Correction: increasing trends of herpes zoster in Australia.
    MacIntyre CR, Stein A, Harrison C, Britt H, Mahimbo A, Cunningham A. MacIntyre CR, et al. PLoS One. 2015 Jun 3;10(6):e0129872. doi: 10.1371/journal.pone.0129872. eCollection 2015. PLoS One. 2015. PMID: 26038831 Free PMC article. No abstract available.

Abstract

Background: Increasing trends in incidence of herpes zoster (HZ) have been reported in Australia and internationally. This may reflect the impact of childhood VZV vaccination programs introduced universally in Australia in late 2005. The objective of this study was to evaluate changes in incidence of HZ and PHN in Australia over time, and associated healthcare resource utilisation.

Methods: Australian data on general practice (GP) encounters for HZ, specific antiviral prescribing data from the pharmaceutical benefits scheme, emergency department presentations from the states of NSW and Victoria and national hospitalisation data for HZ were analysed for time trends using regression models. Two time periods (2000-2006 and 2006-2013) were compared which correspond broadly with the pre- and post- universal VZV vaccination period.

Results: All data sources showed increasing rates of HZ with age and over time. The GP database showed a significant annual increase in encounters for HZ of 2.5 per 100,000 between 1998 and 2013, and the rates of prescriptions for HZ increased by 4.2% per year between 2002 and 2012. In the 60+ population HZ incidence was estimated to increase from 11.9 to 15.4 per 1,000 persons using GP data or from 12.8 to 14.2 per 1,000 persons using prescription data (p<0.05, between the two periods). Hospitalisation data did not show the same increasing trend over time, except for the age group ≥80 years. Most emergency visits for HZ were not admitted, and showed significant increases over time.

Discussion: The burden of HZ in Australia is substantial, and continues to increase over time. This increase is seen both pre- and post-universal VZV vaccination in 2005, and is most prominent in the older population. The substantial burden of HZ, along with ageing of the Australian population and the importance of healthy ageing, warrants consideration of HZ vaccination for the elderly.

PubMed Disclaimer

Conflict of interest statement

Competing Interests: Raina MacIntyre has received funding for investigator-driven research from Merck, GSK and bioCSL. Alicia Stein is an employee of bioCSL, which distributes the zoster vaccine (ZOSTAVAX) in Australia, and holds shares in the parent company, CSL Limited. Anthony Cunningham consults for and has received honoraria from GSK, Merck and bioCSL in relation to Herpes zoster vaccines. Dr Helena Britt is Chief Investigator of, and Christopher Harrison is a senior analyst working on the BEACH program, data from which was used in this paper. The program is funded by an Australian Government Competitive Grant, and by multiple commercial organizations who have formal ‘arms length’ Research Agreements with the University of Sydney for this project. One of these organizations is bioCSL. Abela Mahimbo: None to declare. This does not alter the authors’ adherence to PLOS ONE policies on sharing data and materials.

Figures

Fig 1
Fig 1. Age dependent incidence of herpes zoster and PHN over two consecutive time periods.
Fig 2
Fig 2. Trend in antiviral prescription rates over time in the Australian population.
Fig 3
Fig 3. Estimated age specific hospitalisation rates for herpes zoster over two time periods.
Fig 4
Fig 4. Trend in hospitalisation rates over time in the Australian population.
Fig 5
Fig 5. Trends in emergency department presentations for herpes zoster over time in NSW and Victoria.
See this image and copyright information in PMC

References

    1. Cunningham AL, Breuer J, Dwyer DE, Gronow DW, Helme RD, Litt JC, et al. (2008) The prevention and management of herpes zoster. Medical Journal of Australia 188: 171–176. - PubMed
    1. Stein AN, Britt H, Harrison C, Conway EL, Cunningham A, MacIntyre CR (2009) Herpes zoster burden of illness and health care resource utilisation in the Australian population aged 50 years and older. Vaccine 27: 520–529. 10.1016/j.vaccine.2008.11.012 - DOI - PubMed
    1. Yawn BP, Gilden D (2013) The global epidemiology of herpes zoster. Neurology 81: 928–930. 10.1212/WNL.0b013e3182a3516e - DOI - PMC - PubMed
    1. Schmader KE (2002) Epidemiology and impact on quality of life of postherpetic neuralgia and painful diabetic neuropathy. The Clinical journal of pain 18: 350–354. - PubMed
    1. Harpaz R, Ortega-Sanchez I, Seward J (2008) Advisory Committee on Immunization Practices (ACIP) Centers for Disease Control and Prevention (CDC). Prevention of herpes zoster: Recommendations of the advisory committee on immunization practices (ACIP). MMWR Recomm Rep 57: 30. - PubMed

Publication types

Substances