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. 2023 Jan;12(1):131-141.
doi: 10.1007/s40121-022-00692-y. Epub 2022 Nov 8.

Epidemiology of Herpes Zoster in Adults in Mexico: A Retrospective Database Analysis

Adriana Guzman-Holst  1 , Maria Yolanda Cervantes-Apolinar  2 , Juan Carlos Tinoco Favila  3 , Gloria Huerta-Garcia  4
Affiliations

Epidemiology of Herpes Zoster in Adults in Mexico: A Retrospective Database Analysis

Adriana Guzman-Holst et al. Infect Dis Ther. 2023 Jan.

Abstract

Introduction: The risk of herpes zoster (HZ) increases with age. In countries with an ageing population such as Mexico, a rise in the risk of HZ and complications is expected. The goal of this study was to provide an updated estimate of the potential burden of HZ and associated complications in Mexico.

Methods: A retrospective database study was performed using data from the national surveillance database of the Ministry of Health (Secretaría de Salubridad y Asistencia/Dirección General de Información en Salud). HZ cases and associated complications were identified via the International Classification of Diseases 10th Revision codes. Emergency room (ER) visits, hospitalizations, and deaths were extracted and analyzed by age group and year. The observation period was between 2011 and 2020 for ER visits and hospitalizations and between 2011 and 2019 for deaths. Cumulative incidence per 1000 people and case fatality rate were estimated.

Results: During the observation period, 53,030 ER visits, 4172 hospitalizations, and 263 deaths due to HZ were reported nationwide. The cumulative incidence of HZ based on ER visits was 1.04 per 1000 people aged ≥ 50 years but increased in older age groups (1.47 per 1000 people aged ≥ 65 years). The most common complications were neuralgia (10.9%), ocular disease (7.0%), meningoencephalitis (2.9%), and disseminated disease (3.1%). Patients ≥ 65 years accounted for 37% of hospitalizations and 81% of deaths.

Conclusion: In Mexico, HZ and its complications impose a considerable burden on the population and the healthcare system. Prospective surveillance studies are required to obtain an accurate picture of the current epidemiology of HZ in Mexico and to estimate the benefits of future vaccination strategies against HZ.

Keywords: Dynamic cubes; Healthcare resource use; Herpes zoster incidence; Mexico; Older adults; Retrospective database study.

Plain language summary

Herpes zoster (HZ), also called shingles, is a disease typically characterized by a painful skin rash. It affects mostly older adults and immunocompromised populations. Approximately 30% of patients have complications such as prolonged, severe pain; eye disease; or disease affecting parts of the body other than the skin. In this study, we analyzed national passive surveillance data for HZ disease and related complications in Mexico. Over the last 10 years (2011–2020), more than 50,000 cases and 4000 hospitalizations have been observed. In those, 263 people died, and most of the deaths (81%) occurred in people aged 65 years or older. Since the proportion of older people in the Mexican population will increase over the next decades, herpes zoster will probably become more frequent and complicated. Vaccination against HZ could help protect the older population against this serious disease.

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Figures

Fig. 1
Fig. 1
Number of HZ cases by age group and by year. HZ herpes zoster, y years. Patients for whom age was not available were not included in this figure (n = 47)
Fig. 2
Fig. 2
HZ cases by region (2011–2020). HZ herpes zoster. Map adapted from https://d-maps.com/pays.php?num_pay=288&lang=en with permission
Fig. 3
Fig. 3
Number of HZ-related hospitalizations by age group and by year. HZ herpes zoster, y years
Fig. 4
Fig. 4
Distribution of diagnosis for a HZ-related hospitalizations (2011–2020) and b deaths (2011–2019). The nomenclature of complications corresponds to ICD-10 codes. HZ herpes zoster, ICD-10 International Classification of Diseases 10th Revision
See this image and copyright information in PMC

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