ABSTRACT
The incidence of herpes zoster in the elderly (50 years and older) 2004 in Germany was determined by retrospectively analysing representative treatment data of the statutory health insurance sample of AOK Hesse/KV Hesse. The overall observed incidence rate of herpes zoster was 9.4 cases per 1,000 person-years (PY). 10.1% of herpes-zoster-patients suffered at least 1 month from pain, the so called postherpetic neuralgia (PHN1), 6.9% had at least 3 months pain (PHN3). Incidence rate of herpes zoster rose markedly with age: from 6.8 per 1,000 PY in 50 to 54 year-olds to 12.4 PY in persons 80 years and older. Incidence rate in the immunocompromised was higher (11.6 per 1,000 PY) than in the immunocompetent (9.1 per 1,000 PY). According to a standardized extrapolation of the sample to the German population, about 300,000 persons 50 years and older suffered from acute herpes zoster on the year 2004 in Germany.
Subject(s)
Herpes Zoster/epidemiology , Aged , Aged, 80 and over , Cross-Sectional Studies , Female , Germany , Humans , Incidence , Male , Middle Aged , Neuralgia, Postherpetic/epidemiology , Retrospective StudiesABSTRACT
The primary infection with varicella-zoster virus (VZV) is manifest clinically as varicella. It is a common very contagious disease, normally appearing in childhood. VZV is a ubiquitous virus with a high prevalence. Clinically it is characterized by pleomorphic skin lesions. Normally antiviral therapy is necessary only in severe cases, in adults or in immunosuppressed patients. Herpes zoster, also caused by (VZV), is a neurodermal disease representing the endogenous relapse of the primary varicella infection. Herpes zoster is characterized by lesions concentrated in the innervation region of a cranial or spinal nerve. One of the most feared manifestations of herpes zoster is pain. Several antiviral drugs are approved and many studies have shown that antiviral therapy, started early in the course of disease, can significantly reduce risk and duration of postherpetic neuralgia in elderly patients. Therefore, antiviral therapy in combination with an adequate pain management should be given to all elderly patients as soon as herpes zoster is diagnosed.
Subject(s)
Chickenpox Vaccine/therapeutic use , Chickenpox/diagnosis , Chickenpox/drug therapy , Herpes Zoster/diagnosis , Herpes Zoster/drug therapy , Neuralgia/prevention & control , Skin Diseases, Viral/diagnosis , Skin Diseases, Viral/drug therapy , Chickenpox/transmission , Herpes Zoster/transmission , Humans , Neuralgia/etiology , Practice Guidelines as Topic , Practice Patterns, Physicians' , Skin Diseases, Viral/transmission , Treatment OutcomeABSTRACT
BACKGROUND: Herpes zoster is a common disease caused by the varicella-zoster virus. The use of virostatic agents as early as possible is necessary in shortening zoster-associated pain. OBJECTIVES: Rapid diagnosis is necessary for the optimal efficacy of antiviral therapy. The diagnosis in the early stage of infection is often difficult. METHODS: In the present study skin biopsies of patients with herpes zoster and unclear skin changes were analysed by detecting viral DNA using the polymerase chain reaction (PCR) in order to amplify open reading frames (ORF) 14, 29 and 63. RESULTS: Varicella-zoster virus DNA could be detected with PCR of all three ORF not only from blisters but also from erythematous skin. CONCLUSIONS: PCR is the method of choice for the viral diagnosis in herpes zoster before blister eruption.
Subject(s)
DNA, Viral/analysis , Herpes Zoster/diagnosis , Polymerase Chain Reaction , Aged , Herpes Zoster/pathology , HumansABSTRACT
The dermatology clinic in Krefeld has treated a wide range of patients since its founding in 1845. Nowadays the spectrum consists of allergology, occupational dermatology, phototherapy, dermatosurgery, phlebology and proctology as well as special clinics for andrology, sexually transmitted diseases and patients with HIV-infection.
Subject(s)
Dermatology/history , Hospitals, Special/history , Germany , History, 19th Century , History, 20th Century , HumansABSTRACT
Ticks (Ixodes ricinus) are found all over the world, with special preference of a few epidemic areas. They do not only invade their hosts one by one, but often in large groups.