Epidemiology

Varicella-zoster virus (VZV) is found worldwide and is very contagious.[1]​ The virus is more prevalent in temperate climates, and outbreaks are more common in late winter and spring.[2] Serosurveys in the US before vaccination was introduced have shown that more than 90% of individuals had VZV antibodies in adolescence and nearly 100% by adulthood.[3]​ The greatest incidence of varicella is in children 1 to 9 years of age, but in tropical climates, particularly in rural areas with smaller population densities, the disease is often acquired in adulthood.[1][4]​​​[5]

Estimated hospital admission rates for varicella in developed countries range from 2 to 6 per 100,000 people and appear to be higher in African-American people and non-white Hispanic people.[6][Figure caption and citation for the preceding image starts]: African patient with varicellaImage provided by the CDC and the Public Health Image Library [Citation ends].com.bmj.content.model.Caption@2c01c75d

​Immunocompromised patients are at greater risk of complications and mortality. The mortality rate due to varicella is low. In 2012-2016, the annual average age-adjusted mortality rate for varicella was 0.03 per million population, which is a reduction of 94% compared with prevaccine period, and a 47% reduction compared with the period 2005-2007.[7]

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