European Journal of Epidemiology

, Volume 19, Issue 12, pp 1113–1118 | Cite as

The consistency of shingles and its significance for health monitoring

  • Douglas M. Fleming
  • Aad Bartelds
  • Rachel S. Chapman
  • Kenneth W. Cross
Infectious Diseases

Abstract

Accurate estimation of monitored populations is essential for epidemiological study. Many countries do not have systems of patient registration and routine disease surveillance is thereby hindered. We studied the incidence of shingles over time and investigated the hypothesis that the incidence is consistent and could be used as a proxy for estimating the monitored population. Annual incidence rates of shingles reported in the Weekly Returns Service (WRS) since 1970 and in the Dutch Sentinel Network (DSN) over the period 1998–2001 were studied. Gender specific annual rates (1998–2001) were compared after standardising for age. The population in the DSN was estimated by applying the WRS incidence rates to the numbers of DSN incident cases. The incidence of shingles was annually and seasonally consistent. Incidence in males was similar in both networks and in females approximately 18% greater in the WRS: in age groups 15–64 years, incidence was similar in both networks, but in children 0–14 years and in persons 65 years and over, it was higher in the WRS. The total populations in the DSN estimated from average age/gender specific rates in the WRS were within 12% of the observed in each of the 4 years surveyed. The incidence of shingles in the two countries was sufficiently close to estimate the surveyed population aged 15–64 years from knowledge of incident cases in the community. Routine monitoring of shingles in sentinel practice networks is commended as a method of assuring recording quality and as a means of estimating the survey population where the registered population is not known.

Keywords

Epidemiology Sentinel practices Shingles Surveillance 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Fleming, DM, Cross, KW 1999Comparison and harmonisation of denominator data for primary health care research in countries of the European CommunitySchlaud, M eds. Biomedical health researchIOS PressAmsterdam119120Google Scholar
  2. Hope-Simpson, RE. 1965The nature of HZ: A long term study and a new hypothesisProc R Soc Med58912PubMedGoogle Scholar
  3. Fleming DM, Norbury CA, Crombie DL. Annual and seasonal variation in the incidence of common diseases. Br J Gen Pract 1991; 53.Google Scholar
  4. Wilson, JB 1986Thirty one years of herpes zoster in a rural practice.Br Med J29313491351Google Scholar
  5. Donahue, JG, Choo, PW, Manson, JE, Platt, R 1995The incidence of herpes zosterArch Intern Med15516031609CrossRefGoogle Scholar
  6. Meister, W, Neiss, A, Gross, G,  et al. 1998Demography, symptomatology, and course of disease in ambulatory zoster patients.A physician-based survey in GermanyIntervirology41272277CrossRefPubMedGoogle Scholar
  7. di Luzio Paparatti, U, Arpinelli, F, Visona, G. 1999Herpes zoster and its complications in Italy: An observational surveyJ Infect38116120PubMedGoogle Scholar
  8. Chidiac, C, Bruxelle, J, Daures, JP,  et al. 2001Characteristics of patients with herpes zoster on presentation to practitioners in FranceClin Infect Dis336269CrossRefPubMedGoogle Scholar
  9. Brisson, M, Edmunds, WJ, Law, B,  et al. 2001Epidemiology of varicella zoster virus infection in Canada and the United KingdomEpidemiol Infect127305314PubMedCrossRefGoogle Scholar
  10. Nagasako, EM, Johnson, RW, Griffin, DR, Elpern, DJ, Dworkin, RH 2003Geographic and racial aspects of herpes zoster.J Med Virol70S20S23PubMedGoogle Scholar
  11. Liesegang, TJ 1999Varicella viral diseaseMayo Clin Proc74983998PubMedCrossRefGoogle Scholar
  12. Gershon, AA, Steinberg, SP, Gelb, L. 1984Clinical reinfection with varicella-zoster virusJ Infect Dis149137142PubMedGoogle Scholar
  13. Junker, AK, Angus, E, Thomas, EE 1991Recurrent varicella-zoster virus infections in apparently immunocompetent childrenPediatr Infect Dis J10569575PubMedCrossRefGoogle Scholar
  14. Terada, K, Kawano, S, Shimada, Y, Yagi, Y, Kataoka, N 1996Recurrent chickenpox after natural reinfectionPediatr Infect Dis J15179181PubMedGoogle Scholar
  15. Martin, KA, Junker, AK, Thomas, EE, Van Allen, MI, Friedman, JM 1994Occurrence of chickenpox during pregnancy in women seropositive for varicella-zoster virusJ Infect Dis170991995PubMedGoogle Scholar
  16. Gershon AA, Takashashi W. In: Plotkin SA, Orenstein WA (eds), Vaccines. Philadelphia: WB Saunders Co, 1999; 477.Google Scholar
  17. Thiry N, Beutels P, Shkedy Z, Vranckx R, Vandermeulen C, Wielen Damme PV. The seroepidemiology of primary varicella-zoster virus infection in Flanders (Belgium). Eur J Pediatr. 2002; 161: 588–593. Epub 2002 Sep 24.Google Scholar
  18. Kilgore, PE, Kruszon-Moran, D, Seward, JF,  et al. 2003Varicella in Americans from NHANES III: implications for control through routine immunizationJ Med Virol70S111S118PubMedGoogle Scholar
  19. Fleming, DM. 1999Weekly returns service of the Royal College of General PractitionersCommun Dis Public Health296100PubMedGoogle Scholar
  20. Bartelds AIM, Fracheboud J, van der Zee J. The Dutch sentinel practice network; relevance for public health policy. Netherlands Institute of Primary Health Care Utrecht, The Netherlands.Google Scholar
  21. Eurostat. Demographic Statistics 1999. Office for Official Publications of The European Community, Luxembourg.Google Scholar
  22. Fleming DM, Cross KW, Cobb WA, Chapman RS. Gender difference in the incidence of shingles Epidemiol Infect 2003; 132; 1–5.Google Scholar
  23. Fleming, DM, Schellevis, FG, Falcao, I, Alonso, TV, Padilla, LP 2001The incidence of chickenpox in the community.Eur J Epidemiol1710231027CrossRefPubMedGoogle Scholar
  24. Scottish CMR project ‘Practice Team Information’ http://www.show.scot.nhs.uk/isd/cmr/.Google Scholar
  25. Schmader, K, George, LK, Burchett, BM, Pieper, CF, Hamilton, JS 1996Racial differences in the occurrences of herpes zosterJ Infect Dis174329341Google Scholar
  26. Simpson S. 1991 population estimates for areas smaller than districts. Population Trends Winter 1997 Office for National Statistics, London.Google Scholar

Copyright information

© Kluwer Academic Publishers 2004

Authors and Affiliations

  • Douglas M. Fleming
    • 1
  • Aad Bartelds
    • 2
  • Rachel S. Chapman
    • 1
  • Kenneth W. Cross
    • 1
  1. 1.Birmingham Research Unit of the Royal College of General PractitionersHarborne, BirminghamUK
  2. 2.NIVELUtrechtThe Netherlands

Personalised recommendations