2023-11-06 12:11:12
Several studies in the US point out this trend. “There is no single cause,” they point out from the Seimc and they include “the reactivation of the chickenpox virus” in a cocktail of factors. Data indicate an increase in cases of shingles in those under 50 years of age.
Suffering the painful discomfort of ‘shingles’ or shingles should not be attributed only to the elderly. Some studies in the US already point to increases in cases in young adults, between 30 and 40, “although we have to verify that this is the case. We cannot be blunt only with the collection of data from the clinic. They must be analyzed from an epidemiological point of view,” explains Josefa Masa Calles, from the Epidemiology Service of Vaccine-Preventable Diseases of the National Epidemiology Center (CIBERESP) of the Carlos III Health Institute (ISCIII).
While Masa Calles tries to clarify the situation, data from different studies begin to put on the table an uptick in cases of “an infection caused by the varicella-zoster virus, of the Herpesviridae family, which is the same agent that causes chickenpox.” “explains María del Mar Tomás Carmona, spokesperson for the Spanish Society of Infectious Diseases and Clinical Microbiology (Seimc).
In the US, the CDC reflects the trend of increasing cases in age groups under 50 years of age. It should be noted that, in Spain, more than 90% of adults have had chickenpox in childhood and, therefore, can develop shingles. “Vaccination against chickenpox, systematically and under Health coverage, arrived well into the 21st century (2005-2008). In them, the development of herpes zoster is more complicated; that possibility would only be possible if the vaccine had left a festering virus that would show its face some time later,” says Masa Calles.
A work published by the NIH points out the change in trend. “During the study period, rates had the greatest increase in the group of patients under 30 years of age, followed by the cohort between 30 and 60 years of age, and both groups represented a greater proportion of the total patients with herpes zoster in 2021 compared to 2018.” The data, placed ‘in quarantine’ while they are reviewed since the researchers warn that it is a preprint, are the clue “on which we have to work now,” Masa Calles insists.
From the Seimc, the spokesperson recalls that it is not an infectious contagious infection but “due to the reactivation of the virus that remains confined.” [dormido o latente] in the sensory ganglia of the dorsal roots after primary infection. Reactivation generally occurs decades after suffering from chickenpox.”
Why are there more cases?
In the absence of definitive records with an epidemiological perspective, as warned by the ISCIII expert, who hopes to have them in 2024, we must focus on the cocktail detailed by Tomás Carmona. “There is no single associated cause,” she points out bluntly. Among the reasons he lists are Covid infections and reinfections, climate change, lifestyle habits (stress) and increased circulation of the chickenpox virus. “All this affects our immune state and its reaction.”
“Since the arrival of SARS-CoV-2 we have seen how the entire virus ecosystem has been altered,” argues the Seimc spokesperson. To do this, she remembers the “unusual appearance of the flu in summer, the alteration of the B strain on the A; the disappearance of RSV for almost a year…”.
Regarding the heading of environmental impact, “it should be mentioned that studies are beginning to be carried out on how higher temperatures and higher humidity levels, along with certain seasonal changes, are also favoring it,” explains the Seimc spokesperson.
Regarding lifestyles, Tomás Carmona does not hesitate to point out stress. “It is also highly associated with anxiety and is behind the production of the reactivation of the latent virus.”
A work published in Clinical Infectious Disease points out that “the incidence of herpes zoster has increased more than four times in the last six decades. “This increase is unlikely to be due to the introduction of chickenpox vaccination, antiviral therapy, or the change in the prevalence of immunocompromised individuals.”
While all these points of view “we can analyze them in a more calm way”, because “it takes time to analyze what has happened these five years [con una pandemia de por medio]”, emphasizes the ISCIII expert, patients suffer from indescribable pain and skin discomfort.
How does the outbreak progress?
About 10-15% of those infected suffer pain for at least 90 days (postherpetic neuralgia, PHN). Additionally, less frequently, it can cause permanent neurological damage, such as cranial nerve palsies and hemiparesis or visual impairment secondary to herpes zoster ophthalmicus. “You can only do symptomatic treatment,” explains Tomás Carmona. “Although, to avoid new outbreaks, you can opt for vaccination against shingles.”
From the ISCIII, the latest data available on the impact of herpes zoster corresponds to 2018. Thus, the Epidemiological Report on the situation of Herpes Zoster in Spain, 1998-2018 Results of the National Epidemiological Surveillance Network indicates that the incidence rate It is greater in women than in men at any age. Although, the trend is increasing with age and accelerates from the 50-54 year old group: it goes from 235.7 cases per 100,000 inhabitants between 45-49 years old to 333.5, which represents an increase in 41%. Although the increase in the rate slows down from 75-79 years of age, it then reaches a maximum in the 80-84 year-old group (877.1 cases per 100,000).
This is one of the reasons why “vaccination is recommended in these age groups,” says Masa Calles. “And not only because of the impact of the infection itself, but rather because of all the comorbidities and complications that it entails in this age group,” says Tomás Carmona. Pilar Perez
#Cases #herpes #zoster #increase #people #years #age #Health #Medicine