Epidemiology and Infection

Epidemiology of varicella zoster virus infection in Canada and the United Kingdom

M.  BRISSON  a1 a2 a3 c1, W. J.  EDMUNDS  a1 a2, B.  LAW  a4 a5, N. J.  GAY  a1, R.  WALLD  a5, M.  BROWNELL  a5, L. L.  ROOS  a5 and G.  DE SERRES  a3
a1 PHLS CDSC, 61 Colindale Avenue, London NW9 5EQ
a2 City University, London EC1V OHB
a3 Public Health Research Unit, CHUL Research Centre, Faculty of Medicine, Laval University, Quebec
a4 Department of Pediatrics and Child Health, University of Manitoba, Winnipeg
a5 Manitoba Centre for Health Policy and Evaluation and Department of Community Health Sciences, University of Manitoba, Winnipeg


Many countries are currently studying the possibility of mass vaccination against varicella. The objective of this study was to provide a comprehensive picture of the pre-vaccine epidemiology of the varicella zoster virus (VZV) to aid in the design of immunization programs and to adequately measure the impact of vaccination. Population-based data including physician visit claims, sentinel surveillance and hospitalization data from Canada and the United Kingdom were analysed. The key epidemiological characteristics of varicella and zoster (age specific consultation rates, seasonality, force of infection, hospitalization rates and inpatient days) were compared. Results show that the overall epidemiology of varicella and zoster is remarkably similar between the two countries. The major difference being that, contrary to Canada, the epidemiology of varicella seems to be changing in the United Kingdom with an important decrease in the average age at infection that coincides with a significant increase in children attending preschool. Furthermore, differences exist in the seasonality between the United Kingdom and Canada, which seem to be primarily due to the school calendar. These results illustrate that school and preschool contact patterns play an important role in the dynamics of varicella. Finally, our results provide baseline estimates of varicella and zoster incidence and morbidity for VZV vaccine effectiveness and cost-effectiveness studies.

(Accepted May 11 2001)

c1 Author for correspondence.


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