Herpes Zoster-Related Deaths in the United States: Validity of Death Certificates and Mortality Rates, 1979-2007

Mahamud, Abdirahman; Marin, Mona; Nickell, Steven P.; Shoemaker, Trevor; Zhang, Junyi; Bialek, Stephanie R.

doi:10.1093/cid/cis575

Cited by 20 publications

(14 citation statements)

References 18 publications

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“…There were 63 studies on the incidence of HZ from 22 countries3 4 6 12–71; 25 studies on trends of HZ from 7 countries3 12 15–19 23–25 27 28 49 53 65 68 72–80; 60 studies on PHN from 19 countries3 4 6 12 18 33–36 38 40 42 43 46 54 56 60–63 69 81–118; 9 studies on HZ recurrence from 5 countries4 12 13 57 60 119–122; 12 studies on HZO from 5 countries12 35 43 61 123–130; 28 studies on hospitalisation rates from 14 countries24 26 27 30 37 41 44 46 48 52 55 56 58 62–64 72 73 76 77 131–137 and 10 studies on mortality rates from 10 countries 26 30 37 41 44 48 58 62 134 138…”

Section: Resultsmentioning

confidence: 99%

Systematic review of incidence and complications of herpes zoster: towards a global perspective

2014

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ObjectiveThe objective of this study was to characterise the incidence rates of herpes zoster (HZ), also known as shingles, and risk of complications across the world.DesignWe systematically reviewed studies examining the incidence rates of HZ, temporal trends of HZ, the risk of complications including postherpetic neuralgia (PHN) and HZ-associated hospitalisation and mortality rates in the general population. The literature search was conducted using PubMed, EMBASE and the WHO library up to December 2013.ResultsWe included 130 studies conducted in 26 countries. The incidence rate of HZ ranged between 3 and 5/1000 person-years in North America, Europe and Asia-Pacific, based on studies using prospective surveillance, electronic medical record data or administrative data with medical record review. A temporal increase in the incidence of HZ was reported in the past several decades across seven countries, often occurring before the introduction of varicella vaccination programmes. The risk of developing PHN varied from 5% to more than 30%, depending on the type of study design, age distribution of study populations and definition. More than 30% of patients with PHN experienced persistent pain for more than 1 year. The risk of recurrence of HZ ranged from 1% to 6%, with long-term follow-up studies showing higher risk (5–6%). Hospitalisation rates ranged from 2 to 25/100 000 person-years, with higher rates among elderly populations.ConclusionsHZ is a significant global health burden that is expected to increase as the population ages. Future research with rigorous methods is important.

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Section: Resultsmentioning

confidence: 99%

Systematic review of incidence and complications of herpes zoster: towards a global perspective

2014

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“…3,[11][12] Thus, death certification accuracy is key in ensuring that governmental prioritization of public health priorities and allocation of health funding for a multitude of conditions such as coronary heart disease, dementia, and various infections-to name a few-is appropriate. [13][14][15][16] Autopsy remains the standard against which clinician death certification accuracy is assessed. 3,[1][2][3][4][5][6][7][8][9][10][11][12][17][18] Despite many diagnostic medical advances, recent studies still report autopsy to reveal major missed diagnoses in roughly 17.7%-29% of cases.…”

Section: Discussionmentioning

confidence: 99%

Death Certification: Errors and Interventions

2019

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Death certificates are legal documents containing critical information. Despite the importance of accurate certification, errors remain common. Estimates of error prevalence vary between studies, and error classification systems are often unclear. Relatively few studies have assessed the frequency at which death certification errors occur in US hospitals, and even fewer have attempted a standardized classification of errors based on their severity. In the current study, our objective was to evaluate the frequency of death certification errors at an academic center, implement a standardized method of categorizing error severity, and analyze sources of error to better identify ways to improve death certification accuracy. Design: We retrospectively reviewed the accuracy of cause and manner of death certification at our regional academic institution for 179 cases in which autopsy was performed between 2013-2016. We compared non-pathologist physician completed death certificates with the cause and manner of death ultimately determined at autopsy. Methods: Errors were classified via a 5-point scale of increasing error severity. Grades I-IIc were considered minor errors, while III-V were considered severe. Sources of error were analyzed. Results: In the majority of cases (85%), death certificates contained ≥ one error, with multiple errors (51%) being more common than single (33%). The most frequent error type was Grade 1 (53%), followed by Grade III (30%), and Grade IIb (18%). The more severe Grade IV errors were seen in 23% of cases; no Grade V errors were found. No amendments were made to any death certificates following finalization of autopsy results during the study period. Conclusion: This study reaffirms the importance of autopsy and autopsy pathologists in ensuring accurate and complete death certification. It also suggests that death certification errors may be more frequent than previously reported. We propose a method by which death certification errors can be classified in terms of increasing severity. By understanding the types of errors occurring on death certificates, academic institutions can work to improve certification accuracy. Better clinician education, coordination with autopsy pathologists, and implementation of a systematic approach to ensuring concordance of death certificates with autopsy results is recommended.

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“…Deaths due to HZ are infrequent but most often occur in older adults and in persons who are immunosuppressed [96]. Analysis of data from North America, Europe, and the Asia-Pacific found HZ mortality rates between 0.02 and 0.47 per 100,000 person-years [94].…”

Section: Hospitalization and Mortalitymentioning

confidence: 99%

Development of adjuvanted recombinant zoster vaccine and its implications for shingles prevention

Lecrenier

Beukelaers

Colindres

et al. 2018

Expert Review of Vaccines

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GSK has developed a two-dose adjuvanted recombinant zoster vaccine (Shingrix, RZV) to protect people aged ≥50 years (50+) against herpes zoster (HZ) and its complications. RZV showed >90% efficacy against HZ, sustained over 4 years of follow-up, in all studied age groups. Areas covered: This article reviews the scientific rationale underlying the design of RZV; the clinical evidence demonstrating immunogenicity, safety, and efficacy in persons 50+; and the public health implications and cost-effectiveness. Expert commentary: A decline in varicella zoster virus (VZV) immunity is associated with increased risk of HZ in adults 50+ and immunocompromised individuals. RZV was designed to restore levels of anti-VZV cellular and humoral immunity to prevent VZV reactivation. RZV includes the recombinant gE glycoprotein antigen, and Adjuvant System AS01 which promotes cellular and antibody responses. In two Phase III studies in subjects aged 50+ and 70+ years, RZV efficacy against HZ compared to placebo was >90% and ≥89% against post-herpetic neuralgia (PHN). RZV is expected to dramatically impact HZ morbidity including its complications, and associated health-care costs. In the US population aged 50+ years, vaccination with RZV can be cost-effective compared to no vaccination and cost-saving compared to the currently available live-attenuated HZ vaccine (Zostavax, Merck).

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Herpes Zoster-Related Deaths in the United States: Validity of Death Certificates and Mortality Rates, 1979-2007

Abstract: National death certificate data greatly overestimate deaths in which HZ is the underlying or contributing cause of death. The HZ vaccination program could prevent some HZ-related deaths, but the impact will be difficult to assess using national mortality data.

Cited by 20 publications

References 18 publications

Systematic review of incidence and complications of herpes zoster: towards a global perspective

Systematic review of incidence and complications of herpes zoster: towards a global perspective

Death Certification: Errors and Interventions

Development of adjuvanted recombinant zoster vaccine and its implications for shingles prevention

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