Pathophysiology: Little is known about the route and the source of transmission of the virus. VZV is certainly transmissible through the airborne route and does not require close personal contact. The skin lesions are certainly full of infectious virus particles whilst in contrast, it is almost impossible to isolate virus from the upper respiratory tract. It is possible that aerial transmission originates from symptomless oral lesions.
Disease statistics: The percentage of cases represented by persons ≥15 years of age progressively decreased, from 18% in the period 1991–1995 to 10.7% in the years 2001–2004. This seems to represent an inversion of the trend reported in a previous Italian study, in which the percentage of cases represented by persons ≥15 years of age progressively increased in the period 1961–1996 ; similar trends of increase have also been reported by other studies outside Italy.
Treatment: Several studies indicate that antiviral medications decrease the duration of symptoms and the likelihood of postherpetic neuralgia, especially when initiated within 2 days of the onset of rash. In typical cases that involve individuals who are otherwise healthy, oral acyclovir may be prescribed. An important study by Kubeyinje (1997) suggested that the use of acyclovir in healthy young adults with zoster is not clearly justified, especially in situations of limited economic resources.
Research: The epidemiology of Varicella Zoster Virus infection in Italy. Italy's 2005–2007 National Vaccination Plan  recommends vaccinating persons at high risk of complications, susceptible adolescents, healthcare workers, and the staff of day-care centres and schools with small children. Mass vaccination is only recommended in regions where a vaccination coverage of greater than 80% for MMR can be achieved.