• Robert Johnson, Janet McElhaney, Biagio Pedalino, and Myron Levin.
• r.w.johnson@bris.ac.uk
• Int. J. Infect. Dis. 2007 Nov 1;11 Suppl 2:S43-8.

BackgroundReactivation of latent varicella-zoster virus in sensory neurons to cause herpes zoster (shingles) is common in adults 50 years of age and older; half of adults experience an episode by age 85 years. Herpes zoster is attributable to the progressive decline in the VZV-specific cell-mediated immunity that occurs with aging or other conditions that cause immune compromise. Herpes zoster and complications, such as postherpetic neuralgia (PHN), can have a substantial negative impact on quality of life.DiscussionThe incidence of herpes zoster and its associated morbidity is increasing worldwide as the population ages. Nevertheless, the severity and impact of this condition, and its painful sequelae, are often unrecognized. Many patients delay seeking medical attention, complicating both diagnosis and treatment. Prevention appears to be the best option. A new herpes zoster vaccine significantly reduced the burden of illness (61.1%), the incidence of PHN (66.5%), and the incidence of herpes zoster (51.3%) (p < 0.001). Vaccine tolerability was good, with minor local injection site reactions the most common adverse event.ConclusionsHerpes zoster and PHN represent a substantial burden in terms of suffering and associated costs. Immunization of older adults is a good option to prevent herpes zoster and PHN.

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