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

Published online by Cambridge University Press:  26 November 2001

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

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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.

Type
Research Article
Copyright
2001 Cambridge University Press