title: Incidence of herpes zoster and its complications in Germany, 2005-2009.
abstract: OBJECTIVE
  After introduction of a herpes zoster (HZ) vaccine in Germany in 2013, a potential recommendation by the German Standing Vaccination Committee is still pending. This study estimated data on the disease burden of HZ in Germany to extend the data basis for the decision process.
  
  
  METHODS
  A retrospective cohort study on data from 7 million statutory health insurance members from 2005 to 2009 was conducted. HZ cases were identified using ICD-10-codes. IRs of HZ and complications were estimated overall, by age, sex and immune status. The proportion of postherpetic neuralgia (PHN), hospitalizations, the diagnosing physician specialty and systemic antiviral therapy were assessed.
  
  
  RESULTS
  Annual standardized IRs ranged between 5.3 and 5.5 per 1000 person-years (PY) between 2006 and 2009 with higher IRs in females. In 2009, 72.4% of HZ patients were without complications, while 15.5% suffered from nervous system involvement. The age-related increase was higher for HZ complications than for uncomplicated HZ. Immunocompromised patients suffered slightly more complications than immunocompetent patients. The PHN proportion increased to 15% in 2009 with a steady age-related increase. About 3% of HZ cases were hospitalized.
  
  
  CONCLUSIONS
  Age-related increases of HZ complications and PHN suggest that particularly older patients might benefit from HZ vaccination.
authors.affiliation: Leibniz Institute for Prevention Research and Epidemiology - BIPS, Achterstraße 30, 28359 Bremen, Germany. Electronic address: hille@bips.uni-bremen.de.
authors.forename: Kathrin
authors.initials: K
authors.lastname: Hillebrand
authors.affiliation: Sanofi Pasteur MSD, Epidemiology Unit, 162, Avenue Jean Jaures, CS50712, 69367 Lyon Cedex 07, France. Electronic address: HBricout@spmsd.com.
authors.forename: Hélène
authors.initials: H
authors.lastname: Bricout
authors.affiliation: Sanofi Pasteur MSD GmbH, Paul-Ehrlich-Straße 1, 69181 Leimen, Germany. Electronic address: renate.schulze-rath@bayer.com.
authors.forename: Renate
authors.initials: R
authors.lastname: Schulze-Rath
authors.affiliation: Leibniz Institute for Prevention Research and Epidemiology - BIPS, Achterstraße 30, 28359 Bremen, Germany. Electronic address: schink@bips.uni-bremen.de.
authors.forename: Tania
authors.initials: T
authors.lastname: Schink
authors.affiliation: Leibniz Institute for Prevention Research and Epidemiology - BIPS, Achterstraße 30, 28359 Bremen, Germany; Department of Public Health/Health Sciences, University of Bremen, Bremen, Germany. Electronic address: garbe@bips.uni-bremen.de.
authors.forename: Edeltraut
authors.initials: E
authors.lastname: Garbe
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D005260:Female; D005858:Germany / Q000453:epidemiology; D006562:Herpes Zoster / Q000150:complications* / Q000453:epidemiology*; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D007223:Infant; D008297:Male; D008875:Middle Aged; D051474:Neuralgia, Postherpetic; D012189:Retrospective Studies; D055815:Young Adult
keywords: Epidemiology; Herpes zoster; Incidence rate; Varicella zoster virus; Zoster complications