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      A population-based study of the incidence and complication rates of herpes zoster before zoster vaccine introduction.

      Mayo Clinic Proceedings
      Adult, Age Distribution, Age Factors, Aged, Aged, 80 and over, Bell Palsy, virology, Female, Herpes Zoster, complications, epidemiology, Herpes Zoster Oticus, etiology, Herpes Zoster Vaccine, Hospitalization, statistics & numerical data, Humans, Immunocompetence, Immunocompromised Host, Incidence, Male, Middle Aged, Minnesota, Neuralgia, Postherpetic, Oculomotor Nerve Diseases, Population Surveillance, Recurrence, Retrospective Studies, Superinfection

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          Abstract

          To establish accurate, up-to-date, baseline epidemiological data for herpes zoster (HZ) before the introduction of the recently licensed HZ vaccine. Using data from January 1, 1996, to October 15, 2005, we conducted a population-based study of adult residents (Greater than or equal to 22 years) of Olmsted County, MN, to determine (by medical record review) the incidence of HZ and the rate of HZ-related complications. Incidence rates were determined by age and sex and adjusted to the US population. A total of 1669 adult residents with a confirmed diagnosis of HZ were identified between January 1, 1996, and December 31, 2001. Most (92%) of these patients were immunocompetent and 60% were women. When adjusted to the US adult population, the incidence of HZ was 3.6 per 1000 person-years (95% confidence interval, 3.4-3.7), with a temporal increase from 3.2 to 4.1 per 1000 person-years from 1996 to 2001. The incidence of HZ and the rate of HZ-associated complications increased with age, with 68% of cases occurring in those aged 50 years and older. Postherpetic neuralgia occurred in 18% of adult patients with HZ and in 33% of those aged 79 years and older. Overall, 10% of all patients with HZ experienced 1 or more nonpain complications. Our population-based data suggest that HZ primarily affects immunocompetent adults older than 50 years; 1 in 4 experiences some type of HZ-related complication.

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