Herpes zoster in Germany: Quantifying the burden of disease

BMC Infectious Diseases

Research Article

Thorsten Rieck¹  Gérard Krause²  Ole Wichmann³  Anette Siedler³  Bernhard Ultsch⁴  Thomas Reinhold⁵ 

[1] Charité - University Medical Center, 10117, Berlin, Germany;Surveillance Unit, Robert Koch Institute, 13086, Berlin, Germany;Department for Infectious Disease Epidemiology, Robert Koch Institute, 13086, Berlin, Germany;Immunization Unit, Robert Koch Institute, 13086, Berlin, Germany;Immunization Unit, Robert Koch Institute, 13086, Berlin, Germany;Charité - University Medical Center, 10117, Berlin, Germany;Institute for Social Medicine, Epidemiology and Health Economics, Charité - University Medical Center, 10117, Berlin, Germany;

关键词: Herpes Zoster;    Postherpetic Neuralgia;    Statutory Health Insurance;    Varicella Vaccination;    Robert Koch Institute;   

DOI  :  10.1186/1471-2334-11-173

 received in 2011-04-13, accepted in 2011-06-16,  发布年份 2011

来源: Springer

【 摘 要 】

BackgroundHerpes zoster (HZ) is caused by a reactivation of the varicella-zoster-virus (VZV) and mainly affects individuals aged ≥ 50 years. Vaccines have been licensed or are under development that can protect against HZ and its main complication postherpetic neuralgia (PHN). In Germany, the burden of disease caused by HZ is not well known. To support the decision making process related to a potential vaccination recommendation, we estimated annual HZ disease burden in people aged ≥ 50 years in Germany by utilizing various data sources.MethodsWe assessed for 2007 and 2008 HZ-outpatient incidence (number of cases per 1,000 person-years, PY) by utilizing the Association of Statutory Health Insurance Physicians (ASHIP) database, which contains nationwide routine outpatient data. For the same time period annual number of HZ-inpatients and HZ-associated deaths were identified by using the Federal Health Monitoring System (FHM). PHN-incidence and loss of quality-adjusted life years (QALYs) caused by HZ were calculated by multiplying number of identified HZ-patients with upper and lower limit estimates for proportion of HZ-cases developing PHN and HZ-related QALY, respectively.ResultsFor the study period we identified an annual average of 306,511 HZ-outpatients aged 50+, resulting in a HZ-incidence of 9.6/1,000 PY. A total 14,249 HZ-associated inpatients and 66 deaths were reported in both years on average. HZ-incidence increased by age from 6.21 in people 50-54 years to 13.19 per 1,000 PY in people aged ≥ 90 years. Females were significantly more frequently affected than males in terms of outpatient HZ-incidence (11.12 vs. 7.8 per 1,000 PY), inpatient HZ-incidence (0.51 vs. 0.38 per 1,000 PY) and mortality (0.29 vs. 0.10 per 100,000 PY). PHN-incidence was estimated to range between 0.43 and 1.33 per 1,000 PY. Based on these figures, there were between 3,065 to 24,094 QALYs lost due to HZ in persons aged ≥ 50 years in Germany per annum.ConclusionOur study provides important baseline estimates for HZ-related disease burden in Germany. HZ poses a considerable burden on the health care system in Germany both in terms of outpatient and inpatient services. Follow-up assessments of HZ disease burden are needed to monitor the impact of VZV-vaccinations in Germany.

【 授权许可】

CC BY   
© Ultsch et al; licensee BioMed Central Ltd. 2011