Objective: To analyze the differences between adults and children in the epidemic characteristics and clinical manifestations of chickenpox and provide a reference for the prevention strategy adjustment of chickenpox. Methods: The incidence data of chickenpox surveillance in Shandong Province from January 2019 to December 2021 were collected. Descriptive epidemiological methods were used to analyze the distribution of cases, and the chi-square test was used to compare the differences in epidemiological characteristics and clinical manifestations of varicella cases between adults and children. Results: A total of 66 182 cases of chickenpox were reported from 2019 to 2021, including 24 085 cases of adults chickenpox, the male to female sex ratio was 1∶1 (12 032∶12 053), basically the same for men and women, and 42 097 cases of children chickenpox, with a gender ratio of 1.4∶1, the male to female ratio was 1.4∶1 (24 699∶17 398). Fever in chickenpox cases was mainly low and moderate, but the proportion of moderate fever with temperature between 38.1 and 39.0 ℃ in children cases (35.0%,14 744/42 097) was significantly higher than that in adults (32.0%,7 696/24 085). The number of herpes in chickenpox cases was mainly less than 50, but the proportion of severe cases with 100-200 herpes in children was higher than that in adults. The incidence rate of complications was 1.4% (333/24 085) in adults chickenpox, the incidence rate of complications was 1.7% (731/42 097) in children chickenpox. The incidence of encephalitis and pneumonia in children was higher than in adults, and the difference was statistically significant (P<0.05). The proportion of chickenpox cases was mainly outpatient, but the hospitalization rate of children cases was 14.4% (6 049/42 097), higher than that of adults, which was 10.7% (2 585/24 085). Conclusions: There were differences between adult chickenpox and child chickenpox in terms of epidemic and clinical manifestations; the symptoms of child chickenpox were more serious than adult chickenpox. However, the adult chickenpox population is generally susceptible and lacks immune strategy protection, which calls for more attention.
Child ; Humans ; Adult ; Male ; Female ; Infant ; Chickenpox/prevention & control* ; Hospitalization ; Incidence ; Pneumonia/epidemiology* ; Epidemics ; Fever/epidemiology* ; Chickenpox Vaccine

The reported incidence of varicella in Beijing from 2019 to 2021 were 63.8/100 000, 32.2/100 000 and 38.6/100 000, respectively. There were two VZV epidemics in Beijing each year, one peaked in May and the other in November. However, the first VZV epidemic almost disappeared in 2020. Among the cases involved in the varicella outbreaks in school, the proportion of the students with no history of vaccine immunization, 1 dose of immunization and 2 doses of immunization were 33.12%, 44.79% and 22.08%, respectively. The major body of VZV breakthrough cases was children aged 6-14 years (523/755, 69.27%). The proportion of moderate- or severe-rash were 55.32%, 39.06%, 29.96% in the three groups of cases with no immunization history, 1 dose of immunization and 2 doses of immunization, respectively (P<0.001). A total of 1 089 varicella samples were collected, and 837 (76.86%) were confirmed to be PCR-positive for VZV and were identified as VZV wild strains. 311 VZV strains were sequenced successfully, and 307 strains were clade 2 (98.72%), 1 clade 3 (0.32%) and 3 Clade 5 (0.96%). Compared with the representative strains, the nucleotide similarities of ORF22 fragments were between 99.4% and 100%, and amino acid similarities were between 99.4% and 100%.
Beijing/epidemiology* ; Chickenpox/epidemiology* ; Chickenpox Vaccine ; Child ; Herpesvirus 3, Human/genetics* ; Humans ; Schools ; Vaccination

OBJECTIVE: To investigate the level of IgG antibody to varicella in the healthy population aged 1-19 years in Harbin, China. METHODS: Random sampling was performed to select 1 203 healthy individuals aged 1-19 years in Harbin. According to age, they were divided into ≥1 years group (n=240), ≥4 years group (n=396), ≥7 years group (n=364) and 14-19 years group (n=203). Enzyme-linked immunosorbent assay was used to measure the concentration of varicella-zoster virus (VZV)-IgG antibody in serum, and a concentration of VZV-IgG antibody of ≥100 mIU/mL was considered positive, suggesting that the subject had the ability to resist VZV infection. RESULTS: The overall positive rate of VZV-IgG antibody was 71.49% (860/1 203), and the concentration of VZV-IgG antibody was 447±17 mIU/mL. The concentration of VZV-IgG antibody tended to increase with age (P<0.05). The positive rate of VZV-IgG antibody in the urban population was significantly higher than that in the rural population (P<0.05). There was significant difference in the positive rate of VZV-IgG antibody between the populations with different doses of varicella vaccination (P<0.05), and the population with 2 doses of vaccination had the highest positive rate of VZV-IgG antibody. There was a significant difference in the concentration of VZV-IgG antibody between the populations with different medical histories (P<0.05), and the population with a past history of varicella had the highest concentration. CONCLUSIONS Among the healthy population aged 1-19 years in Harbin, there is a significant difference in the level of VZV-IgG antibody between the urban and rural populations, as well as between different age groups. Varicella vaccination should be strengthened in areas with a low vaccination rate and the population aged <14 years.
Adolescent ; Adult ; Antibodies, Viral ; Chickenpox ; epidemiology ; Child ; Child, Preschool ; China ; epidemiology ; Herpesvirus 3, Human ; Humans ; Immunoglobulin G ; Infant ; Seroepidemiologic Studies ; Young Adult

OBJECTIVES: Although the nationwide inoculation rate of varicella vaccine was approximately 95% in Korean children recently, the number of notified varicella cases is unexpectedly continuously increasing till now. To suggest some hypotheses regarding this discrepancy, an age-period-cohort (APC) analysis as a descriptive epidemiology study was conducted for children residing in Jeju-do, Korea. METHODS: The raw data were obtained from the nationwide database for insurance claim of healthcare fee provided by the National Health Insurance Service, Korea. The selection criteria were children aged 2–13 years who visited any healthcare center due to varicella from 2005 to 2016 while residing in Jeju-do. After calculating the birth cohort-specific crude incidence rates by age and year, the intrinsic estimator method was used to perform the APC analysis. RESULTS: As the annual crude incidence rates decreased with increasing age between 2005 and 2016, the age and period effects also decreased. The intrinsic estimator coefficients suggesting the cohort effect shifted from positive to negative in 2011, the starting year of free varicella vaccine program in Jeju-do. CONCLUSIONS: The results suggested that inoculated varicella vaccines have preventive effects. However, further studies to evaluate waning immunity would be needed.
Chickenpox Vaccine ; Chickenpox* ; Child* ; Cohort Effect ; Delivery of Health Care ; Epidemiology ; Fees and Charges ; Humans ; Immunization Programs ; Immunization Schedule ; Incidence* ; Insurance ; Jeju-do* ; Korea* ; Measles-Mumps-Rubella Vaccine ; Methods ; National Health Programs ; Parturition ; Patient Selection ; Vaccines

OBJECTIVES: Although the nationwide inoculation rate of varicella vaccine was approximately 95% in Korean children recently, the number of notified varicella cases is unexpectedly continuously increasing till now. To suggest some hypotheses regarding this discrepancy, an age-period-cohort (APC) analysis as a descriptive epidemiology study was conducted for children residing in Jeju-do, Korea.METHODS: The raw data were obtained from the nationwide database for insurance claim of healthcare fee provided by the National Health Insurance Service, Korea. The selection criteria were children aged 2–13 years who visited any healthcare center due to varicella from 2005 to 2016 while residing in Jeju-do. After calculating the birth cohort-specific crude incidence rates by age and year, the intrinsic estimator method was used to perform the APC analysis.RESULTS: As the annual crude incidence rates decreased with increasing age between 2005 and 2016, the age and period effects also decreased. The intrinsic estimator coefficients suggesting the cohort effect shifted from positive to negative in 2011, the starting year of free varicella vaccine program in Jeju-do.CONCLUSIONS: The results suggested that inoculated varicella vaccines have preventive effects. However, further studies to evaluate waning immunity would be needed.
Chickenpox Vaccine ; Chickenpox ; Child ; Cohort Effect ; Delivery of Health Care ; Epidemiology ; Fees and Charges ; Humans ; Immunization Programs ; Immunization Schedule ; Incidence ; Insurance ; Jeju-do ; Korea ; Measles-Mumps-Rubella Vaccine ; Methods ; National Health Programs ; Parturition ; Patient Selection ; Vaccines

Herpes zoster (HZ) is the result of reactivation and multiplication of latent varicella zoster virus that persisted in latent form within the sensory ganglia following an earlier attack of varicella. It occurs most frequently in older adults and immunosuppressed individuals. Classically, the rash presents as painful, erythematous, maculopapular, and vesicular lesions that typically involve single dermatome, and usually do not cross the midline. The diagnosis is mainly made clinically, except in patients with atypical manifestations in which laboratory virologic testing is required. HZ has been associated with several complications, of which postherpetic neuralgia is the most common and debilitating. The treatment of HZ includes the use of antiviral agents, analgesics for control of acute zoster pain, good skin care for healing, and prevention of secondary bacterial infection. Antiviral agents should be started within 72 hours of onset to reduce the severity of the infection, the duration of the eruptive phase, and the intensity of acute pain. The options for treating postherpetic neuralgia include lidocaine patch, high dose capsaicin patch, gabapentin, pregabalin, opioids, and tricyclic antidepressants. A live attenuated zoster vaccine reduces the incidence of by one-half and the incidence of postherpetic neuralgia by two-thirds. We herein review the recent data on the epidemiology, pathophysiology, diagnosis and management of HZ including HZ vaccine.
Acute Pain ; Adult ; Analgesics ; Analgesics, Opioid ; Antidepressive Agents, Tricyclic ; Antiviral Agents ; Bacterial Infections ; Capsaicin ; Chickenpox ; Diagnosis ; Epidemiology ; Exanthema ; Ganglia, Sensory ; Herpes Zoster Vaccine ; Herpes Zoster ; Herpesvirus 3, Human ; Humans ; Incidence ; Lidocaine ; Neuralgia, Postherpetic ; Pregabalin ; Skin Care

BACKGROUND: Pediatric infectious skin diseases are different from their counterparts in adults, since the sources of infection and disease progressions are distinct. To our knowledge, there have been no reports of epidemiologic studies of pediatric infectious skin diseases in Korea. OBJECTIVE: The purpose of this study was to evaluate the distribution of pediatric infectious skin diseases in the Ansan and Southwestern area of Gyeonggi-do, and to compare the results with previous reports about general pediatric dermatoses. METHODS: The authors retrospectively evaluated 4,366 cases of pediatric infectious skin diseases from July 2003 to June 2013 in the Department of Dermatology at Korea University Ansan Hospital. The monthly, seasonal, and annual incidences, as well as the ages and genders of the patients were evaluated. RESULTS: The study included 2004 (45.0%) girls and 2362 (55.0%) boys. The most frequent age of infection was 4 to 6 years old (range 0~15 years), and the peak incidences occurred in July, August, and January. The most common infectious dermatoses were viral (76.0%), bacterial (11.5%), fungal (8.3%), and parasitic (4.0%). The 10 most common pediatric infectious skin diseases were viral wart (45.8%), molluscum contagiosum (20.9%), impetigo (10.3%), tinea (7.1%), scabies (3.8%), herpes zoster (2.5%), varicella (1.6%), herpes simplex (1.5%), eczema herpeticum (1.1%), and cellulitis (0.9%). CONCLUSION: Compared to previously published reports, the distribution of pediatric infectious skin diseases has changed and was different from general pediatric dermatoses.
Adult ; Cellulitis ; Chickenpox ; Dermatology ; Disease Progression ; Epidemiologic Studies* ; Epidemiology ; Female ; Gyeonggi-do* ; Herpes Simplex ; Herpes Zoster ; Humans ; Impetigo ; Incidence ; Kaposi Varicelliform Eruption ; Korea ; Molluscum Contagiosum ; Retrospective Studies ; Scabies ; Seasons ; Skin Diseases ; Skin Diseases, Infectious* ; Tinea ; Warts

BACKGROUND: Herpes Zoster is a disease that occurs after the virus is reactivated due to infection of the varicella virus in childhood. Risk factors are advanced age, malignant neoplasm, organ transplantation, immunosuppressive agents taking are known. The purpose of this study was to investigate the relationship between the seasonal effect and other risk factors on the incidence of herpes zoster. METHODS: The medical records of 1,105 patients admitted to the outpatient diagnosed with herpes zoster were retrospectively examined. The patients' sex, age, dermatome, onset, underlying disease, residential areas were collected. RESULTS: The incidence of women outnumbered men and increased for those above the age of 50. The number of occurrences of herpes zoster patients was higher in the spring and summer than in winter. Unlike men, women had the most frequent outbreaks in March. The most common occurrence of dermatome is in the thoracic region. The number of occurrence was similar on the left as the right. CONCLUSIONS: In this study, herpes zoster occurs more often in women than in men and more frequently occurs in women in the spring and summer.
Chickenpox ; Chungcheongnam-do ; Disease Outbreaks ; Epidemiologic Studies* ; Epidemiology ; Female ; Herpes Zoster* ; Humans ; Immunosuppressive Agents ; Incidence* ; Male ; Medical Records ; Organ Transplantation ; Outpatients ; Retrospective Studies ; Risk Factors ; Seasons ; Transplants

This study was designed to assess the immune status of the Korean population against varicella-zoster virus (VZV) through a seroepidemiologic study. Residual blood samples were collected from diagnostic laboratories throughout Korea. Samples were collected in October 2009 to March 2010 from persons 0-79 yr of age and were tested by ELISA (Enzygnost(R); Dade Behring, Schwalbach, Germany). Total seroprevalence in subjects 1-79 yr of age was 89.6%. Seroprevalence increased as age increased from 67.3% in subjects 1-4 yr of age to 94.2% in subjects 10-14 yr of age and in subjects over 20 yr of age seroprevalence ranged from 98.0% to 100%. In children under 1 yr of age, passive immunity waned after birth with none of the subjects having antibodies from 7 months of age and over. Among subjects 1-79 yr of age, susceptible subjects to VZV were mainly under 20 yr of age. These results provide information in understanding the dynamics of varicella disease in Korea, which is important in building up strategies for disease control.
Adolescent ; Adult ; Aged ; Antibodies, Viral/analysis ; Chickenpox/*epidemiology ; Child ; Child, Preschool ; Enzyme-Linked Immunosorbent Assay ; Female ; Herpes Zoster/*epidemiology ; Herpesvirus 3, Human/immunology/*isolation & purification ; Humans ; Infant ; Male ; Middle Aged ; Republic of Korea/epidemiology ; Seroepidemiologic Studies ; Young Adult

OBJECTIVEforecast the epidemic trend and to evaluate the effect of outbreak control measures by investigation of a varicella outbreak event with a discrete time delay SEIR model.

METHODSA discrete time delay model was formulated by discretization method based on a continuous SEIR model with the consideration of the time delay effect on latent period and communicable period. The epidemic trend forecast was carried out based on the number of expected cases. The theoretical effect evaluation was assessed by comparing the results from different emergency control measures.

RESULTSWithout any control measures, the theoretical attack rate was 30.16% (504/1671). The course of the epidemic lasted for 4 months and the peak epidemic time was 78 days after the onset of the first case. 'Generation' phenomenon had been observed in the course of the epidemic with the interval of two weeks. The actual number of cases was decreased by 89.48% (451/504) compared with the number of expected cases under no control measure scenario. With the rigorous quarantine measure for all cases on their onset day, when the measure was conducted on 0, 14, 28, 42 days after the onset of the first case, the total numbers of expected cases were 22, 59, 127 and 220 respectively. With the quarantine measure conducted on 14 days after the onset of the first case, when the proportion of quarantine was 30%, 50%, 70%, 90%, the total number of expected cases were 485, 457, 386 and 169, respectively. With the emergent vaccination for all persons, when the measure was conducted on 0, 14, 28, 42 days after the onset of the first case, the total numbers of expected cases were 7, 26, 81 and 202 respectively. With the emergent vaccination conducted on 14 days after the onset of the first case, when the immunization coverage rate was 30%, 50%, 70%, 90%, the total numbers of expected cases were 354, 246, 127 and 40, respectively.

CONCLUSIONThe number of expected cases can be regarded as the reference to evaluate the effect of control measures. The simulation results suggest that it will get more benefits to conduct control measures earlier in varicella outbreak events, and the effect of emergent vaccination is better than that of quarantine measure under the same conditions.

Chickenpox ; epidemiology ; prevention & control ; Communicable Disease Control ; methods ; Disease Outbreaks ; prevention & control ; Humans ; Incidence ; Models, Theoretical