Trends in hospital admissions for Varicella and Zoster viruses in England, 2001/2002–2010/2011: time trend study

Abstract

SummaryObjectivesVaricella and Herpes Zoster are common infectious diseases. Various studies have estimated rates of infection for both manifestations of these infections; however rates of hospital admissions across the country have not previously been described. This paper presents data on hospital admissions in England for Varicella and Herpes Zoster from 2001/2002 to 2010/2011.DesignTime trends study of all hospital admissions for Varicella and Herpes Zoster from 2001/2002 to 2010/2011 in England.SettingHospital admissions across England from 2001/2002 to 2010/2011.ParticipantsWe included all patients admitted to hospital from 2001/2002 to 2010/2011 diagnosed with Varicella and Zoster according to the International Classification of Diseases version 10 (ICD-10).Main outcome measuresThe main outcome measures were admission rates by year and diagnosis and age-specific admission rates for Varicella and Zoster from 2001/2002 to 2010/2011.MethodsWe analysed data from Hospital Episode Statistics which include patient characteristics such as age which was used here in order to standardise rates to the relevant population. We also used mid-year population estimates from the Office for National Statistics for standardisation purposes. All analyses were conducted using Stata v12.0.ResultsThe hospital admission rate for Varicella cases has risen by 1.8% over the 10-year study period. While the overall admission rates for Herpes Zoster have decreased by 4% from 2001/2002 levels. The vast majority of Varicella and Zoster admissions were not associated with any complications.ConclusionThe introduction of Herpes Zoster vaccine is anticipated to decrease hospital admissions in older age groups further. A repeat of this study after a further period of time would help to evaluate the impact of the introduction of Herpes Zoster vaccine in England on hospital admissions.

The burden of hospitalisation for varicella and herpes zoster in England from 2004 to 2013

“…When using the same diagnostic fields for case ascertainment, the incidence of varicella and zoster admissions in our study was comparable to the incidence reported by these studies ( Table 6). The approximately stable incidence of VZV hospital admissions in time was in agreement with the study by Abdalrahman et al 24…”

“…The incidence of VZV admissions in England was previously reported for the period 1995/1996 23 and 2001/02e2010/11. 24 The first study (which also included Wales) used only the primary diagnosis for case ascertainment and reported lower incidences of hospital admissions for varicella (4.5 per 100,000) as well as for zoster (4.4 per 100,000). The second study included all diagnostic fields for case ascertainment and reported an annual incidence of 6.9 varicella admissions and 10.9 zoster admissions per 100,000.…”

Should the UK introduce a universal childhood varicella vaccination programme?

“…The incidence of paediatric varicella hospitalisations was estimated at 29.5 per 100 000 person-years—highest in children aged 0–4 years. This compares with a recent retrospective study in England that found rates of hospitalised varicella of 31.2 per 100 000 children aged 0–15 years in 2010/2011 10. The majority of hospitalisations occurred in otherwise healthy children, a feature that is consistent with countries such as the UK.…”

“…The authors acknowledge that, given the secular variation that occurs with varicella, assessment of burden based on a single year is a limitation. Between 2001/2002 and 2010/2011, varicella hospitalisations in England varied between 57.5 per 1 000 000 to 78 per 1 000 000 10. Any economic model should therefore allow for a variation of at least 33%.…”

Fifteen-minute consultation: Chickenpox vaccine—should parents immunise their children privately?

“…While the majority of complications are related to secondary bacterial skin infections, some of the rarer complications can be life-threatening and 2500 to 3000 children (less than 15 years) are admitted to hospitals in England every year 3. Even in uncomplicated disease, studies have shown up to 50% of children will see a healthcare professional during their illness representing a significant burden particularly to primary care 4.…”