Civen Rachel, Marin Mona, Zhang John, Abraham Amanuel, Harpaz Rafael, Mascola Laurene, Bialek Stephanie R
From the *Los Angeles County Department of Public Health, Los Angeles, California; and †Centers for Disease Control and Prevention, Atlanta, Georgia.
Pediatr Infect Dis J. 2016 Oct;35(10):1132-6. doi: 10.1097/INF.0000000000001249.
Changes in herpes zoster (HZ) epidemiology are expected with childhood varicella vaccination. We reported previously that during 2000 to 2006 HZ incidence decreased 55% in children <10 years of age, while among 10- to 19-year olds it increased by 63%. We update the analysis with 4 additional years of data.
Population-based active surveillance was conducted for HZ in Antelope Valley, California. Structured telephone interviews and medical chart reviews collected data on demographics, varicella vaccinations, disease histories and clinical information. We calculated HZ incidence for 2007 to 2010 and assessed trends since 2000.
Among children <10 years of age, HZ incidence continued the decreasing trend previously reported. During 2007 to 2010, the average incidence was 12.8 cases/100,000 children compared with 41.6 cases/100,000 children during 2000 to 2006, a 69% decline (P < 0.0001). For the 10- to 19-year olds, during 2007 to 2010 HZ incidence did not continue the increasing trend reported from 2000 to 2006; lower rates than in 2006 were observed in 3 of the 4 additional years evaluated. During 2007 to 2010 the average incidence was 78.2 cases/100,000 children compared with 68.0 cases/100,000 children during 2000 to 2006, a 13% increase (P = 0.123), with substantial fluctuation in annual rates throughout the 11 years of surveillance.
During the mature varicella vaccination program, declines in HZ incidence among children <10 years of age continued through 2010. Among the 10- to 19-year olds, the increase reported through 2006 did not continue further and lower rates than in 2006 were observed through 2010. Widespread use of varicella vaccine could reduce HZ incidence among vaccinated populations. Ongoing monitoring of HZ incidence is needed to detect and understand changes in HZ epidemiology in the varicella vaccine era.
儿童水痘疫苗接种后，带状疱疹（HZ）的流行病学预计会发生变化。我们之前报告过，在2000年至2006年期间，10岁以下儿童的HZ发病率下降了55%，而10至19岁儿童的发病率上升了63%。我们用另外4年的数据更新了分析。
在加利福尼亚州羚羊谷对HZ进行基于人群的主动监测。通过结构化电话访谈和病历审查收集人口统计学、水痘疫苗接种、疾病史和临床信息的数据。我们计算了2007年至2010年的HZ发病率，并评估了自2000年以来的趋势。
在10岁以下儿童中，HZ发病率延续了之前报告的下降趋势。在2007年至20年期间，平均发病率为12.8例/10万儿童，而2000年至2006年期间为41.6例/10万儿童，下降了69%（P<0.0001）。对于10至19岁儿童，在2007年至2010年期间，HZ发病率没有延续2000年至2006年报告的上升趋势；在另外评估的4年中的3年观察到发病率低于2006年。在2007年至2010年期间，平均发病率为78.2例/10万儿童，而2000年至2006年期间为68.0例/10万儿童，上升了13%（P=0.123），在整个11年的监测中，年发病率有大幅波动。
在水痘疫苗接种计划成熟期间，10岁以下儿童HZ发病率在2010年之前持续下降。在10至19岁儿童中，2006年之前报告的发病率上升没有进一步延续，并且在2010年观察到发病率低于2006年。水痘疫苗广泛使用可降低接种人群中的HZ发病率。需要持续监测HZ发病率，以发现和了解水痘疫苗时代HZ流行病学的变化。
