Zoster

Herpes zoster is the clinical syndrome that results from reactivation of latent varicella infection in sensory ganglia, with varicella-zoster virus identified as the causative agent ^[1][2]. The condition is synonymous with shingles in the provided sources ^[2]. The disease identity in surveillance terms is therefore best understood as a reactivation manifestation of VZV rather than a primary acute varicella infection ^[1][2].

The disease is classically characterized by a painful unilateral vesicular eruption ^[1]. One source adds that patients may have malaise, headache, low-grade fever, and abnormal skin sensations for two to three days before the rash appears, and that the rash is usually unilateral, confined to a single dermatome, and evolves from maculopapular lesions to clear vesicles that become cloudy and crust over in seven to 10 days ^[2]. Complications specifically named in the sources include herpes zoster ophthalmicus, Ramsay Hunt syndrome, acute retinal necrosis, and post-herpetic neuralgia ^[1]. Post-herpetic neuralgia is described as the most common complication in one source and as pain in a dermatomal distribution sustained for at least 90 days after acute herpes zoster ^[2].

The provided sources give one U.S.-based burden estimate of about 1 million cases annually and an individual lifetime risk of 30% ^[2]. They also identify decreased cell-mediated immunity as an important risk context, with such patients reported to be 20 to 100 times more likely to develop herpes zoster ^[2]. Beyond these figures, source-backed detail on geographic variation, outbreak behavior, animal or environmental reservoirs, or healthcare surveillance burden is not yet available in the supplied material ^[1][2].

The source material describes herpes zoster as a reactivation of latent varicella-zoster virus within sensory ganglia, indicating an endogenous reactivation process rather than a newly acquired exogenous infection in the usual disease course ^[1][2]. No source-backed detail is provided here on direct person-to-person transmission routes, infectious period, or environmental persistence ^[1][2].

The clearest source-backed risk group is persons with conditions that decrease cell-mediated immunity, who are reported to be 20 to 100 times more likely to develop herpes zoster ^[2]. The sources also imply greater concern for older adults through vaccine approval and recommendation statements for adults 50 years and older or 60 years and older, but they do not provide a full age-specific risk profile ^[2]. Beyond immunosuppression and age-related vaccine guidance, additional high-risk groups are not specifically detailed in the supplied sources ^[1][2].

The sources emphasize vaccination as the principal preventive measure, noting that recombinant zoster vaccine has high efficacy and that varicella-zoster vaccination decreases the incidence of herpes zoster ^[1][2]. One source reports an overall vaccine efficacy of 97.2% for recombinant zoster vaccine and states that the vaccine is approved for adults 50 years and older, while another notes a recommendation for adults 60 years and older except for certain immunosuppressed patients ^[1][2]. No source-backed detail is provided on non-vaccine preventive measures beyond the general statement that the disease is highly preventable ^[1].

In surveillance interpretation, zoster should be treated as a clinically recognizable reactivation syndrome with a characteristic unilateral dermatomal vesicular rash and pain, with post-herpetic neuralgia as the key longer-term complication ^[1][2]. The provided material indicates that diagnosis is primarily clinical and may be aided by laboratory investigations, but it does not supply surveillance case definitions or reporting thresholds ^[1]. Source-backed detail on incidence trends outside the cited U.S. estimate, laboratory confirmation requirements, or notification practices is not yet available ^[1][2].

1. 1 Lim DZJ et al. Herpes Zoster and Post-Herpetic Neuralgia-Diagnosis, Treatment, and Vaccination Strategies. Pathogens. 2024 Jul 17. PMID: 39057822. doi: 10.3390/pathogens13070596. PubMed: https://pubmed.ncbi.nlm.nih.gov/39057822/
2. 2 Saguil A et al. Herpes Zoster and Postherpetic Neuralgia: Prevention and Management. Am Fam Physician. 2017 Nov 15. PMID: 29431387. PubMed: https://pubmed.ncbi.nlm.nih.gov/29431387/
3. 3 Shah S et al. Herpes zoster vaccination and the risk of dementia: A systematic review and meta-analysis. Brain Behav. 2024 Feb. PMID: 38687552. doi: 10.1002/brb3.3415. PubMed: https://pubmed.ncbi.nlm.nih.gov/38687552/
4. 4 Zoster und Zoster-Impfung. Primary and Hospital Care: Allgemeine Innere Medizin. 2023. doi: 10.4414/phc-d.2023.1262330095. DOI: https://doi.org/10.4414/phc-d.2023.1262330095
5. 5 Zoster Ophthalmicus with Zoster Meningoencephalitis. Kansas Journal of Medicine. 2019. doi: 10.17161/kjm.v9i4.8631. DOI: https://doi.org/10.17161/kjm.v9i4.8631
6. 6 Zoster (Herpes zoster, Gürtelrose). Kontrazeption mit OC in 160 Problemsituationen. 2011. doi: 10.1515/9783110245660.235. DOI: https://doi.org/10.1515/9783110245660.235

ICD-10

B02

ICD-11

1E91

Total cases

162K

Peak month

2019-10

Coverage

1 reporting countries · 2000-01-01 → 2026-06-01