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Herpes zoster in children and adolescents

PETURSSON, GUNNAR MD; HELGASON, SIGURDUR MD; GUDMUNDSSON, SIGURDUR MD, PHD; SIGURDSSON, JOHANN A. MD, PHD

The Pediatric Infectious Disease Journal: October 1998 - Volume 17 - Issue 10 - p 905-908
Original Studies

Objectives. To follow the clinical course of herpes zoster and to determine the incidence, frequency of complications and association with malignancy in children and adolescents.

Design. Prospective cohort study in a primary health care setting in Iceland. The main outcome measures were age and sex distribution of patients and discomfort or pain 1, 3 and 12 months after the rash and general health before and 3 to 6 years after the zoster episode.

Results. During observation of the target population for a period of 75 750 person years, 121 episodes of acute zoster developed (incidence 1.6/1000/year) in 118 patients. End points were gained for all 118 patients after 554 person years of follow-up. Systemic acyclovir was never used. No patient developed postherpetic neuralgia, moderate or severe pain or any pain lasting longer than 1 month from start of the rash (95% confidence interval, 0 to 0.03). Potential immunomodulating conditions were diagnosed in 3 patients (2.5%) within 3 months of contracting zoster. Only 5 (4%) had a history of severe diseases.

Conclusions. The probability of postherpetic neuralgia in children and adolescents is extremely low. Zoster is seldom associated with undiagnosed malignancy in the primary care setting.

From the Department of Family Medicine, University of Iceland (GP, JAS), the Health Care Center of Arbaer (SH) and the Department of Internal Medicine, National University Hospital (SG), Reykjavik, Iceland.

Accepted for publication July 8, 1998.

Address for reprints: Sigurdur Helgason, M.D., Health Care Center of Arbaer, Hraunbaer 102, IS-110 Reykjavik, Iceland. Fax 354 567 11 83; E-mail sh@centrum.is.

© Williams & Wilkins 1998. All Rights Reserved.