Chickenpox epidemiology and demographics: Difference between revisions

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==Overview==
The [[incidence]] of [[chickenpox]] varies among various age groups. [[Varicella]] commonly affects children less than 10 years of age with the highest [[incidence]] among children 1-4 years of age. The [[incidence]] of [[chickenpox]] for children between 0 to 4 years of age is 5234 per 100,000 individuals. Between the years 1990-1994, the [[case fatality rate]] of [[chickenpox]] in the US/UK was 2-3 per 100,000 individuals. In developed countries, [[chickenpox]] causes around 3 deaths per 100,000 individuals.
==Epidemiology==
===Incidence===


==Epidemiology and Demographics==
The [[incidence]] of [[chickenpox]] varies among various age groups. The [[incidence]] rates per 100,000 persons in each age group were as follow:
Primary [[varicella]] is an [[endemic]] [[disease]]. Cases of varicella are seen throughout the year but, like other viruses spread by the [[respiratory]] route eg. [[measles]] and [[rubella]], they are seen more commonly in the winter and early spring. This is unlike that for [[enteroviruses]] and lends some support to the view that varicella is spread mainly by the respiratory route. [[Herpes zoster]], in contrast, occurs sporadically and evenly throughout the year.
*For age groups 0 to 4 years 5234 per 100,000 individuals
*For age groups 5 to 9 years 4132 per 100,000 individuals
*For age groups 10 to 14 years 1404 per 100,000 individuals
*For age groups 15 to 19 years 610 per 100,000 individuals
*For age groups >20 years 175 per 100,000 individuals
The rates of [[incidence]] of [[chickenpox]] declines for older age groups.<ref name="pmid7658062">{{cite journal |vauthors=Choo PW, Donahue JG, Manson JE, Platt R |title=The epidemiology of varicella and its complications |journal=J. Infect. Dis. |volume=172 |issue=3 |pages=706–12 |year=1995 |pmid=7658062 |doi= |url=}}</ref>
[[Image:Chickenpox Graph 1.jpg|center|thumb|500px|Source: https://www.cdc.gov/]]
 
===Case Fatality Rate===
Between the years 1990-1994, case fatality rate in the US/UK is 2-3 per 100,000.
*The [[case fatality rate]] among children was 1 per 100,000.
*In 2008 the [[case fatality rate]] in Brazil estimated [[case fatality rate]] is 4 per 100,000. <ref name="urlwww.who.int">{{cite web |url=http://www.who.int/immunization/sage/meetings/2014/april/2_SAGE_April_VZV_Seward_Varicella.pdf |title=www.who.int |format= |work= |accessdate=}}</ref>
*In 2000 the [[case fatality rate]] in Guinea Bissau was approximately 129 per 100,000 cases, 50 times higher than US/UK.
*In 1970, the [[case fatality rate]] in India among adults was 52 per 100,000 cases, 20 times higher than US/UK.
*Worldwide, the [[case fatality rate]] among adults was 20-25 per 100,000. <ref name="urlwww.who.int">{{cite web |url=http://www.who.int/immunization/sage/meetings/2014/april/2_SAGE_April_VZV_Seward_Varicella.pdf |title=www.who.int |format= |work= |accessdate=}}</ref>
[[Image:VZV - Case Fatality Rate.jpg|center|500px|source: WHO.int]]
 
==Demographics==


===Age===
===Age===
*The [[prevalence]] of chicken pox decreases with age.
*Varicella commonly affects children less than 10 years of age with the highest [[incidence]] among children 1-4 years of age.
[[Image:VZV_-_Age 2.jpg|center|600px|source: WHO.int]]
[[Image:Chickenpox Graph 3.jpg|center|600px|source: WHO.int]]


Varicella is one of the classic diseases of childhood, with the highest prevalence occurring in the 4 - 10 years old age group. Like rubella, infection is uncommon in preschool children. Varicella is highly communicable, with an attack rate of 90% in close contacts. Most people become infected before adulthood but 10% of young adults remain susceptible. However, this pattern of [[infection]] is not universal, eg. in rural India, varicella is predominantly a disease of adults, the mean age of infection being 23.4 years. It was suggested that this could be due to interference by other respiratory [[viruses]] that the children are exposed to at an early age.<ref name="EpidemiologyURL">{{cite web
===Gender===
|url=http://virology-online.com/viruses/VZV3.htm
|title=Epidemiology of Varicella Zoster Virus Infection, Epidemiology of VZV Infection, Epidemiology of Chicken Pox, Epidemiology of Shingles
|format=
|work=
|accessdate=2008-04-22
}}</ref>


Historically, varicella has been a disease predominantly affecting preschool and school-aged children. Although mostly noted in preschool and primary levels, the said disease has also been noticed among adults, with the pocks being darker and the [[scars]] more prominent than their younger counterparts.<ref name="EpidemiologyURL"/>
*The [[prevalence]] and [[incidence]] of chickenpox generally do not vary by gender.
*Chickenpox is more prevalent in females between the ages of 15 - 24 as compared to males.<ref name="pmid14979582">{{cite journal |vauthors=Fleming DM, Cross KW, Cobb WA, Chapman RS |title=Gender difference in the incidence of shingles |journal=Epidemiol. Infect. |volume=132 |issue=1 |pages=1–5 |year=2004 |pmid=14979582 |pmc=2870070 |doi= |url=}}</ref>


In the U.S., 55 percent of chickenpox deaths are in the over-20 age group, even though they are a tiny fraction of the cases.
===Race===
*There is no racial predilection for chickenpox.


===Prevalence===
===Developed Countries===
The [[epidemiology]] and [[demographics]] of chickenpox in developed countries are as follows:<ref name="urlwww.who.int">{{cite web |url=http://www.who.int/immunization/sage/meetings/2014/april/2_SAGE_April_VZV_Seward_Varicella.pdf |title=www.who.int |format= |work= |accessdate=}}</ref>


Since the chickenpox vaccine was developed in 1995, the major data of chickenpox in the environment is before 1995. In the prevaccine era, varicella was endemic in the United States, and virtually all persons acquired [[varicella]] by adulthood. As a result, the number of cases occurring annually was estimated to approximate the birth cohort, or approximately 4 million per year. Varicella was removed from the list of nationally notifiable conditions in 1981, but some states continued to report cases to CDC. The majority of cases (approximately 85%) occurred among children younger than 15 years of age. The highest age-specific incidence of varicella was among children 1–4 years of age, who accounted for 39% of all cases. This age distribution was probably a result of earlier exposure to VZV in preschool and child care settings. Children 5–9 years of age accounted for 38% of cases. Adults 20 years of age and older accounted for only 7% of cases (National Health Interview Survey data, 1990–1994).
*[[Incidence]]
**1500 – 1600 per 100,000 persons per year
*[[Case fatality rate|Case-fatality rate]]
**3 deaths per 100,000 cases


Data from three active varicella surveillance areas indicate that the incidence of varicella, as well as varicella-related hospitalizations, has decreased significantly since licensure of vaccine in 1995. In 2004, varicella vaccination coverage among children 19–35 months in two of the active surveillance areas was estimated to be 89% and 90%. Compared with 1995, varicella cases declined 83%–93% by 2004. Cases declined most among children aged 1–4 and 5–9 years, but a decline occurred in all age groups including infants and adults, indicating reduced transmission of the virus in 308 Varicella 21 these groups. The reduction of varicella cases is the result of the increasing use of varicella vaccine. Varicella vaccine coverage among 19–35-month-old children was estimated by the National Immunization Survey to be 90% in 2007.
==Gallery==
 
Despite high one-dose vaccination coverage and success of the vaccination program in reducing varicella morbidity and mortality, varicella surveillance indicates that the number of reported varicella cases appears to have plateaued. An increasing proportion of cases represent breakthrough [[infection]] (chickenpox occurring in a previously vaccinated person). In 2001–2005, outbreaks were reported in schools with high varicella vaccination coverage (96%–100%). These outbreaks had many similarities: all occurred in elementary schools; vaccine effectiveness was within the expected range (72%–85%); the highest attack rates occurred among the younger students; each outbreak lasted about 2 months; and persons with [[breakthrough infection]] transmitted the virus although the breakthrough disease was mild. Overall attack rates among vaccinated children were 11%–17%, with attack rates in some classrooms as high as 40%. These data indicate that even in settings where almost everyone was vaccinated and vaccine performed as expected, varicella outbreaks could not be prevented with the current one-dose vaccination policy. These observations led to the recommendation in 2006 for a second routine dose of varicella vaccine.


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Image:Chickenpox Graph 2.jpg
Image:Chickenpox Graph 2.jpg
Image:Chickenpox Graph 3.jpg
Image:Chickenpox Graph 3.jpg
Image:VZV_-_Case Fatality Rate.jpg
Image:VZV_-_Age 2.jpg
Image: Chickenpox40.jpeg| Varicella cases and states reporting, United States, 1972-1996. <SMALL><SMALL>''[http://phil.cdc.gov/phil/home.asp From Public Health Image Library (PHIL).] ''<ref name=PHIL> {{Cite web | title = Public Health Image Library (PHIL) | url = http://phil.cdc.gov/phil/home.asp}}</ref></SMALL></SMALL>
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Latest revision as of 20:53, 29 July 2020


Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Aravind Reddy Kothagadi M.B.B.S[2]

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Overview

The incidence of chickenpox varies among various age groups. Varicella commonly affects children less than 10 years of age with the highest incidence among children 1-4 years of age. The incidence of chickenpox for children between 0 to 4 years of age is 5234 per 100,000 individuals. Between the years 1990-1994, the case fatality rate of chickenpox in the US/UK was 2-3 per 100,000 individuals. In developed countries, chickenpox causes around 3 deaths per 100,000 individuals.

Epidemiology

Incidence

The incidence of chickenpox varies among various age groups. The incidence rates per 100,000 persons in each age group were as follow:

  • For age groups 0 to 4 years 5234 per 100,000 individuals
  • For age groups 5 to 9 years 4132 per 100,000 individuals
  • For age groups 10 to 14 years 1404 per 100,000 individuals
  • For age groups 15 to 19 years 610 per 100,000 individuals
  • For age groups >20 years 175 per 100,000 individuals

The rates of incidence of chickenpox declines for older age groups.[1]

Source: https://www.cdc.gov/

Case Fatality Rate

Between the years 1990-1994, case fatality rate in the US/UK is 2-3 per 100,000.

source: WHO.int
source: WHO.int

Demographics

Age

  • The prevalence of chicken pox decreases with age.
  • Varicella commonly affects children less than 10 years of age with the highest incidence among children 1-4 years of age.
source: WHO.int
source: WHO.int
source: WHO.int
source: WHO.int

Gender

  • The prevalence and incidence of chickenpox generally do not vary by gender.
  • Chickenpox is more prevalent in females between the ages of 15 - 24 as compared to males.[3]

Race

  • There is no racial predilection for chickenpox.

Developed Countries

The epidemiology and demographics of chickenpox in developed countries are as follows:[2]

Gallery

References

  1. ↑ Choo PW, Donahue JG, Manson JE, Platt R (1995). "The epidemiology of varicella and its complications". J. Infect. Dis. 172 (3): 706–12. PMID 7658062.
  2. ↑ 2.0 2.1 2.2 "www.who.int" (PDF).
  3. ↑ Fleming DM, Cross KW, Cobb WA, Chapman RS (2004). "Gender difference in the incidence of shingles". Epidemiol. Infect. 132 (1): 1–5. PMC 2870070. PMID 14979582.
  4. ↑ "Public Health Image Library (PHIL)".


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