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General practice Terapia 2023, 4 ( 423 ) :  20  -  29

Threat of herpes zoster and its complications in Poland against the possibility of prevention by vaccination

Summary: Shingles is the result of the reactivation of latent VZV (varicella-zoster virus) infection. People over 50 years of age are most often affected (effect of physiological aging of the immune system). In the younger, the condition is a decrease in cellular immunity (disease- or drug-induced). Postherpetic neuralgia (PHN) is the most common complication of shingles. The pain can last for years and significantly interfere with everyday life. The risk of PHN ranges from 5% to above 30%. Other complications include encephalitis, meningitis, involvement of other parts of the nervous system, eye disease, disseminated shingles, and sometimes life-threatening bacterial superinfections. In the first month after the disease, the risk of stroke increases significantly. In 2015, 2019, 2020 and 2021, 2704, 2369, 1325 and 1508 patients were hospitalized due to shingles, respectively. Lower frequencies in 2020 and 2021 should be associated with the COVID-19 pandemic. Hospitalization rate 85 years of age amounted to 67/100,000. Higher incidence of hospitalization above 60 years of age may suggest a more severe course of herpes zoster above 60 years of age. Men were hospitalized more often than women. The length of hospitalization oscillated from 6.8 days to 7.4 days and was independent of gender. 56% of hospitalizations are uncomplicated shingles and 24% are complicated. 2% of complications were meningitis and encephalitis, and 8% were disseminated herpes zoster. Due to the current coding method, the percentage of PHN could not be determined. The significant burden of shingles on the healthcare system shown by us indicates that an effective and safe subunit vaccine available and registered in Poland, which can be used in immunosuppressed patients aged 18+ and people aged 50+, would be beneficial both from the perspective of individuals and the whole society.
Keywords: shingles, epidemiology, morbidity, hospitalization, complications, vaccinations

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