Epidemiology of Herpes Zoster in Adults in Mexico: A Retrospective Database Analysis

Plain Language Summary Herpes zoster (HZ), also called shingles, is a disease typically characterized by a painful skin rash. It affects mostly older adults and immunocompromised populations. Approximately 30% of patients have complications such as prolonged, severe pain; eye disease; or disease affecting parts of the body other than the skin. In this study, we analyzed national passive surveillance data for HZ disease and related complications in Mexico. Over the last 10 years (2011-2020), more than 50,000 cases and 4000 hospitalizations have been observed. In those, 263 people died, and most of the deaths (81%) occurred in people aged 65 years or older. Since the proportion of older people in the Mexican population will increase over the next decades, herpes zoster will probably become more frequent and complicated. Vaccination against HZ could help protect the older population against this serious disease. Introduction The risk of herpes zoster (HZ) increases with age. In countries with an ageing population such as Mexico, a rise in the risk of HZ and complications is expected. The goal of this study was to provide an updated estimate of the potential burden of HZ and associated complications in Mexico. Methods A retrospective database study was performed using data from the national surveillance database of the Ministry of Health (Secretaria de Salubridad y Asistencia/Direccion General de Informacion en Salud). HZ cases and associated complications were identified via the International Classification of Diseases 10th Revision codes. Emergency room (ER) visits, hospitalizations, and deaths were extracted and analyzed by age group and year. The observation period was between 2011 and 2020 for ER visits and hospitalizations and between 2011 and 2019 for deaths. Cumulative incidence per 1000 people and case fatality rate were estimated. Results During the observation period, 53,030 ER visits, 4172 hospitalizations, and 263 deaths due to HZ were reported nationwide. The cumulative incidence of HZ based on ER visits was 1.04 per 1000 people aged >= 50 years but increased in older age groups (1.47 per 1000 people aged >= 65 years). The most common complications were neuralgia (10.9%), ocular disease (7.0%), meningoencephalitis (2.9%), and disseminated disease (3.1%). Patients >= 65 years accounted for 37% of hospitalizations and 81% of deaths. Conclusion In Mexico, HZ and its complications impose a considerable burden on the population and the healthcare system. Prospective surveillance studies are required to obtain an accurate picture of the current epidemiology of HZ in Mexico and to estimate the benefits of future vaccination strategies against HZ.

Automated summary

This study analyzed national surveillance data to examine the burden of herpes zoster (HZ) and its complications in Mexico. Over the past 10 years, there have been over 50,000 HZ cases and 4,000 hospitalizations reported. 263 deaths were also recorded, with the majority occurring in individuals aged 65 years or older. Given the expected increase in the proportion of older people in the Mexican population, the incidence of HZ is likely to rise, highlighting the importance of vaccination to protect the elderly population against this serious disease.