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: From 1997 to 2006, a total of 48,388 patients with herpes zoster, ranging from a 3-month-old girl to a 102-year-old woman, were monitored at the 46 dermatology clinics in the Miyazaki Prefecture, which has a population of about 1.2 million. The mean herpes zoster incidence was 4.15/1,000 person-years, ranging from 1.96 to 7.84/1,000 person-years among different age groups, and the herpes zoster incidence was significantly higher in females (4.58) than in males (3.67).
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: Epidemiology of herpes zoster and its relationship to varicella in Japan: A 10-year survey of 48,388 herpes zoster cases in Miyazaki prefecture.