title: Reducing the burden of Herpes Zoster in Italy.
abstract: Herpes Zoster (HZ) is a viral disease with painful neuro-dermatologic manifestations. Incidence increases with age. In Italy, the estimated incidence is 6.3 cases/1000 person/year; hospital admissions are less than 2%, 69% in patients aged over 65 years. The most frequent complication of HZ is Post-Herpetic Neuralgia (PHN) characterized by metameric pain, allodynia, and hyperalgesia. In Italy 20.6% and 9.2% of HZ patients experience PHN after 3 and 6 months, respectively. Available antiviral and analgesic treatments are relatively unsatisfactory in reducing pain and length of the disease. Prevention has recently become possible with the live attenuated vaccine Oka/Merck. Clinical studies show a reduction of 51% in the incidence of the disease, 61% of its burden and 67% of PHN in vaccinees. Protection seems to be long lasting and vaccine safety matches registration requirements. Available evidence suggests that the costs for QALY (less than € 20 000) and avoided cases is favorable. Due to the heavy burden of disease, it is time to offer this vaccination to elderly population.
authors.affiliation: a University of Ferrara; Ferrara, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Gabutti
authors.forename: Elisabetta
authors.initials: E
authors.lastname: Franco
authors.forename: Paolo
authors.initials: P
authors.lastname: Bonanni
authors.forename: Michele
authors.initials: M
authors.lastname: Conversano
authors.forename: Antonio
authors.initials: A
authors.lastname: Ferro
authors.forename: Marzia
authors.initials: M
authors.lastname: Lazzari
authors.forename: Stefania
authors.initials: S
authors.lastname: Maggi
authors.forename: Alessandro
authors.initials: A
authors.lastname: Rossi
authors.forename: Silvestro
authors.initials: S
authors.lastname: Scotti
authors.forename: Francesco
authors.initials: F
authors.lastname: Vitale
authors.forename: Antonio
authors.initials: A
authors.lastname: Volpi
authors.forename: Donato
authors.initials: D
authors.lastname: Greco
mesh_terms: D019433:Chickenpox Vaccine / Q000008:administration & dosage* / Q000191:economics / Q000276:immunology*; D003362:Cost-Benefit Analysis; D006562:Herpes Zoster / Q000150:complications / Q000453:epidemiology* / Q000517:prevention & control*; D006801:Humans; D015994:Incidence; D007558:Italy / Q000453:epidemiology; D051474:Neuralgia, Postherpetic / Q000453:epidemiology* / Q000517:prevention & control*
chemical_list: D019433:Chickenpox Vaccine
keywords: Herpes Zoster; burden; epidemiology; immunization; prevention