Use of hospitalization and pharmaceutical prescribing data to compare the prevaccination burden of varicella and herpes zoster in Australia

Abstract

The aims of the study were to compare the burden of varicella and herpes zoster in Australia. No national surveillance exists for varicella or herpes zoster. We used hospital morbidity data from 1993-9 and pharmaceutical prescribing data from 1995-9. In the financial year 1998/99, there were 4718 hospitalizations for zoster compared to 1991 for varicella. For varicella the mean age of patients was 15 years compared to 69 years for zoster. The mean length of stay in hospital was 4.2 days for varicella and 12.7 days for zoster. Varicella accounted for 8396 (3726 with principal diagnosis varicella) bed days compared to 26 266 (5382 with principal diagnosis of zoster) for zoster. The in-hospital case-fatality rate was 0.4% for varicella and 1% for zoster. In 1999, 59 200 community-based cases of zoster were treated with antivirals. We estimate that 157 266 cases of zoster occurred in the community in 1999, a rate of 830 per 100 000 population. Herpes zoster has a higher burden of disease than varicella, and must be a component of disease surveillance in order to determine the full impact of vaccination on the epidemiology of varicella zoster virus (VZV).

Varicella infection – Evidence for peak activity in summer months

“…These findings are consistent with other Australian analyses of national hospitalisation data. 18 Our estimate of the overall rate of varicella-related hospitalisations, 2.7 per 10,000 hospitalisations, was also consistent with international literature in pre-vaccination era populations e although these studies have tended to focus on paediatric populations. 19,20 Diagnoses of varicella infection made up a greater proportion of locum consultations relative to the VAED data.…”

Varicella Vaccination in Australia and New Zealand

“…Overall, the disease burden due to HZ is higher than that due to varicella, with average annual hospitalization rates of 24/100,000 population, or 10/100,000 population for HZ as the principal diagnosis [5]. The mortality due to HZ is 2-3 times higher than that due to varicella [3,5]. It has been estimated that 1157,000 cases of HZ occurred in the Australian community in 1999, at a rate of 830/100,000 population [3].…”

“…The mortality due to HZ is 2-3 times higher than that due to varicella [3,5]. It has been estimated that 1157,000 cases of HZ occurred in the Australian community in 1999, at a rate of 830/100,000 population [3]. New Zealand.…”

Varicella vaccination in Europe: are we ready for a universal childhood programme?

“…Two studies have shown similar or only marginally higher hospitalisation rates for zoster [45,64]. It can be speculated that coincidental zoster may occur, especially among elderly hospitalised adults with long hospital stays, some of who will die from other causes [45].…”