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Incidence and hospitalization rates of varicella and herpes zoster before varicella vaccine introduction: a baseline assessment of the shifting epidemiology of varicella disease

COPLAN, PAUL SCD; BLACK, STEVEN MD; ROJAS, CARLOS MD, PhD; SHINEFIELD, HENRY MD; RAY, PAULA MS; LEWIS, EDWIN MS; GUESS, HARRY MD, PhD

Pediatric Infectious Disease Journal:
Original Studies
Abstract

Background. A 15-year postmarketing evaluation of the impact of varicella vaccine on the age distribution of varicella disease is being conducted at Kaiser Permanente Medical Care Program, Northern California (KPMCP). We report on a baseline assessment of the age-specific incidence and hospitalization rates of varicella and herpes zoster that was conducted before vaccine introduction.

Methods. To assess the annual incidence of varicella, a telephone survey was conducted in a random sample of ∼8000 youths 5 to 19 years of age. The annual incidence of hospitalizations for varicella and herpes zoster in 1994 was assessed with the use of the computerized database at KPMCP.

Results. Varicella annual incidence was 10.3% in 5- to 9-year-olds, 1.9% in 10- to 14-year-olds and 1.2% in the 15- to 19-year age groups, respectively. Hospitalization rates among the entire KPMCP membership were 2.6 and 2.1 per 100 000 person years for varicella and zoster, respectively. Varicella incidence in the 15- to 19-year age group was higher among African-Americans than among Caucasians.

Conclusions. Varicella rates were similar in the 5- to 9- and 10- to 14-year age groups to rates from other published studies conducted in 1972 to 1978, 1980 to 1988 and 1990 to 1992; however, the rate in 15- to 19-year-olds was 2 to 4 times higher than published rates in the same age category.

Author Information

From Merck Research Laboratories, Blue Bell, PA (PC, HG); Kaiser Permanente Division of Research, Oakland, CA (SB, HS, PR, EL); and The University of North Carolina, Chapel Hill, NC (CR).

Accepted for publication Feb. 12, 2001.

Address for reprints: Paul Coplan, Sc.D., Epidemiology Department, Merck Research Laboratories, BL-7, 10 Sentry Parkway, Blue Bell, PA 19422. Fax 610-397-2992; E-mail paul_coplan@merck.com.

© 2001 Lippincott Williams & Wilkins, Inc.