title: Does monastic life predispose to the risk of Saint Anthony's fire (herpes zoster)?
abstract: BACKGROUND
  The consequences of the epidemiology of varicella for zoster epidemiology are still debated. We therefore compared the frequency of herpes zoster in an adult population with virtually no varicella zoster virus (VZV) exposure with that in the general population (GP).
  
  
  METHODS
  We performed a national, multicenter, observational, exposed versus nonexposed, comparative study. The nonexposed population consisted of members of contemplative monastic orders (CMO) of the Roman Catholic Church living in 40 isolated monasteries in France. The exposed population consisted of a sample of the GP representative of the French population in terms of age group, sex, socio-occupational categories, and regions.
  
  
  RESULTS
  The primary analysis population comprised 920 members of CMO (41.5% nuns; mean age, 64.2 years) and 1533 members of the GP (51.9% women; mean age, 64.6 years). The reported frequency of zoster was 16.2% among CMO and 15.1% in the GP (P = .27, adjusted for sex and age). The reported mean age of onset of zoster was 54.8 and 48.6 years, respectively (P = .06).
  
  
  CONCLUSIONS
  This study failed to demonstrate an increased risk or earlier onset of zoster in members of CMO not exposed to VZV, compared with that in the GP. Although adults highly exposed to VZV could have a reduced risk of zoster, compared with the GP, our results suggest that the opposite is not true: adults not exposed to VZV are not at increased risk of zoster when compared with the GP, challenging the relevance of the assumptions and forecasts of current epidemiological models.
authors.affiliation: Department of Infectious and Tropical Diseases, Annecy General Hospital, Pringy, France. jgaillat@ch-annecy.fr
authors.forename: Jacques
authors.initials: J
authors.lastname: Gaillat
authors.forename: Vincent
authors.initials: V
authors.lastname: Gajdos
authors.forename: Odile
authors.initials: O
authors.lastname: Launay
authors.forename: Denis
authors.initials: D
authors.lastname: Malvy
authors.forename: Bruno
authors.initials: B
authors.lastname: Demoures
authors.forename: Lucie
authors.initials: L
authors.lastname: Lewden
authors.forename: Sybil
authors.initials: S
authors.lastname: Pinchinat
authors.forename: Tarik
authors.initials: T
authors.lastname: Derrough
authors.forename: Claudine
authors.initials: C
authors.lastname: Sana
authors.forename: Evelyne
authors.initials: E
authors.lastname: Caulin
authors.forename: Benoît
authors.initials: B
authors.lastname: Soubeyrand
mesh_terms: D000368:Aged; D002410:Catholicism; D003625:Data Collection; D005260:Female; D005602:France / Q000453:epidemiology; D006562:Herpes Zoster / Q000453:epidemiology*; D014645:Herpesvirus 3, Human; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D011795:Surveys and Questionnaires