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: Data of hospitalizations for varicella and herpes zoster in Spain during the 1999-2000 period were obtained from the national surveillance system for hospital data. A total of 3083 hospitalizations for varicella and 6324 for herpes zoster were identified, representing an annual incidence of 4.1 and 8.4 per 100,000 persons per year, respectively. Almost half of patients hospitalized for varicella were children under 5 years of age.
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: Varicella vaccines available in Spain were marketed in 1998 and 2003 for non-routine use. Since 2006 some regions decided to include varicella vaccination in their regional routine vaccination programmes at 15-18 months of age. Other regions chose the strategy of vaccinating susceptible adolescents. This study shows the trends in severe varicella zoster virus infections through the analysis of the hospital discharges related to varicella and herpes zoster in the general population from 2005 to 2010 in Spain.