Herpes zoster risk factors: Difference between revisions
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==Overview== | ==Overview== | ||
Shingels are developed in patients who were previously infected with [[VZV]] (through natural infection that caused [[varicella]] or [[varicella vaccine|varicella vaccination]]).All older adults in the United States are at risk for herpes zoster as approximately 99.5% of people born in the United States who are 40 years of age and older have had varicella. Common risk factors include increasing age, [[immunosupression ]]and stress. | |||
== Risk Factors == | == Risk Factors == | ||
*Shingels are developed in patients who were previously infected with [[VZV]] (through natural infection that caused [[varicella]] or [[varicella vaccination]]).<ref name=Shingels> CDC http://www.cdc.gov/shingles/hcp/clinical-overview.html (August 2016) Accessed on October 24,2016</ref> | *Shingels are developed in patients who were previously infected with [[VZV]] (through natural infection that caused [[varicella]] or [[varicella vaccine|varicella vaccination]]).<ref name=Shingels> CDC http://www.cdc.gov/shingles/hcp/clinical-overview.html (August 2016) Accessed on October 24,2016</ref> | ||
*All older adults in the United States are at risk for herpes zoster as approximately 99.5% of people born in the United States who are 40 years of age and older have had varicella. | *All older adults in the United States are at risk for herpes zoster as approximately 99.5% of people born in the United States who are 40 years of age and older have had varicella.<ref name="pmid12744889">{{cite journal| author=Chapman RS, Cross KW, Fleming DM| title=The incidence of shingles and its implications for vaccination policy. | journal=Vaccine | year= 2003 | volume= 21 | issue= 19-20 | pages= 2541-7 | pmid=12744889 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12744889 }} </ref> | ||
Risk factors include: | Risk factors include: | ||
*Previous varicella virus infection | |||
'''Adults''' | |||
*Decline in cell mediated immunity<ref name="pmid16378799">{{cite journal| author=Wung PK, Holbrook JT, Hoffman GS, Tibbs AK, Specks U, Min YI et al.| title=Herpes zoster in immunocompromised patients: incidence, timing, and risk factors. | journal=Am J Med | year= 2005 | volume= 118 | issue= 12 | pages= 1416 | pmid=16378799 | doi=10.1016/j.amjmed.2005.06.012 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16378799 }} </ref> | *Previous [[chicken pox|varicella virus infection]] ( [[varicella vaccine|Varicella vaccination]] or [[varicella]] ) | ||
*Decline in [[cell mediated immunity]]<ref name="pmid16378799">{{cite journal| author=Wung PK, Holbrook JT, Hoffman GS, Tibbs AK, Specks U, Min YI et al.| title=Herpes zoster in immunocompromised patients: incidence, timing, and risk factors. | journal=Am J Med | year= 2005 | volume= 118 | issue= 12 | pages= 1416 | pmid=16378799 | doi=10.1016/j.amjmed.2005.06.012 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16378799 }} </ref> | |||
:*Increasing age >50 yrs<ref name="pmid3033012">{{cite journal| author=Hayward AR, Herberger M| title=Lymphocyte responses to varicella zoster virus in the elderly. | journal=J Clin Immunol | year= 1987 | volume= 7 | issue= 2 | pages= 174-8 | pmid=3033012 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=3033012 }} </ref><ref name="pmid15930418">{{cite journal| author=Oxman MN, Levin MJ, Johnson GR, Schmader KE, Straus SE, Gelb LD et al.| title=A vaccine to prevent herpes zoster and postherpetic neuralgia in older adults. | journal=N Engl J Med | year= 2005 | volume= 352 | issue= 22 | pages= 2271-84 | pmid=15930418 | doi=10.1056/NEJMoa051016 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15930418 }} [https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16262218 Review in: ACP J Club. 2005 Nov-Dec;143(3):61] </ref> | :*Increasing age >50 yrs<ref name="pmid3033012">{{cite journal| author=Hayward AR, Herberger M| title=Lymphocyte responses to varicella zoster virus in the elderly. | journal=J Clin Immunol | year= 1987 | volume= 7 | issue= 2 | pages= 174-8 | pmid=3033012 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=3033012 }} </ref><ref name="pmid15930418">{{cite journal| author=Oxman MN, Levin MJ, Johnson GR, Schmader KE, Straus SE, Gelb LD et al.| title=A vaccine to prevent herpes zoster and postherpetic neuralgia in older adults. | journal=N Engl J Med | year= 2005 | volume= 352 | issue= 22 | pages= 2271-84 | pmid=15930418 | doi=10.1056/NEJMoa051016 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15930418 }} [https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16262218 Review in: ACP J Club. 2005 Nov-Dec;143(3):61] </ref> | ||
:*Immunosupression<ref name="pmid20563710">{{cite journal| author=Abendroth A, Kinchington PR, Slobedman B| title=Varicella zoster virus immune evasion strategies. | journal=Curr Top Microbiol Immunol | year= 2010 | volume= 342 | issue= | pages= 155-71 | pmid=20563710 | doi=10.1007/82_2010_41 | pmc=3936337 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20563710 }} </ref> | :*[[Immunosupression]]<ref name="pmid20563710">{{cite journal| author=Abendroth A, Kinchington PR, Slobedman B| title=Varicella zoster virus immune evasion strategies. | journal=Curr Top Microbiol Immunol | year= 2010 | volume= 342 | issue= | pages= 155-71 | pmid=20563710 | doi=10.1007/82_2010_41 | pmc=3936337 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20563710 }} </ref><ref name="pmid14267505">{{cite journal| author=HOPE-SIMPSON RE| title=THE NATURE OF HERPES ZOSTER: A LONG-TERM STUDY AND A NEW HYPOTHESIS. | journal=Proc R Soc Med | year= 1965 | volume= 58 | issue= | pages= 9-20 | pmid=14267505 | doi= | pmc=1898279 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=14267505 }} </ref> | ||
:**Malignancy, especially leukemia and lymphoma | :**[[Malignancy]], especially [[leukemia]] and [[lymphoma]] | ||
:**HIV<ref name="pmid8728488">{{cite journal| author=Chronister CL| title=Review of external ocular disease associated with aids and HIV infection. | journal=Optom Vis Sci | year= 1996 | volume= 73 | issue= 4 | pages= 225-30 | pmid=8728488 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8728488 }} </ref> | :**[[HIV]] (relative risk of herpes zoster is 15 times greater in men with HIV than a non HIV patients)<ref name="pmid1308664">{{cite journal| author=Buchbinder SP, Katz MH, Hessol NA, Liu JY, O'Malley PM, Underwood R et al.| title=Herpes zoster and human immunodeficiency virus infection. | journal=J Infect Dis | year= 1992 | volume= 166 | issue= 5 | pages= 1153-6 | pmid=1308664 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=1308664 }} </ref><ref name="pmid8728488">{{cite journal| author=Chronister CL| title=Review of external ocular disease associated with aids and HIV infection. | journal=Optom Vis Sci | year= 1996 | volume= 73 | issue= 4 | pages= 225-30 | pmid=8728488 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8728488 }} </ref><ref name="pmid2686873">{{cite journal| author=Cohen PR, Grossman ME| title=Clinical features of human immunodeficiency virus-associated disseminated herpes zoster virus infection--a review of the literature. | journal=Clin Exp Dermatol | year= 1989 | volume= 14 | issue= 4 | pages= 273-6 | pmid=2686873 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=2686873 }} </ref> | ||
:**Organ transplant (bone marrow or solid organ transplant) | :**[[Organ transplant]] (bone marrow or solid organ transplant)<ref name="pmid14267505">{{cite journal| author=HOPE-SIMPSON RE| title=THE NATURE OF HERPES ZOSTER: A LONG-TERM STUDY AND A NEW HYPOTHESIS. | journal=Proc R Soc Med | year= 1965 | volume= 58 | issue= | pages= 9-20 | pmid=14267505 | doi= | pmc=1898279 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=14267505 }} </ref> | ||
:**Medications ( steroids, chemotherapy or transplant related immunosupression medications)<ref name="pmid12654381">{{cite journal| author=Benz MS, Glaser JS, Davis JL| title=Progressive outer retinal necrosis in immunocompetent patients treated initially for optic neuropathy with systemic corticosteroids. | journal=Am J Ophthalmol | year= 2003 | volume= 135 | issue= 4 | pages= 551-3 | pmid=12654381 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12654381 }} </ref><ref name="pmid19350185">{{cite journal| author=Fernandes NF, Malliah R, Stitik TP, Rozdeba P, Lambert WC, Schwartz RA| title=Herpes zoster following intra-articular corticosteroid injection. | journal=Acta Dermatovenerol Alp Pannonica Adriat | year= 2009 | volume= 18 | issue= 1 | pages= 28-30 | pmid=19350185 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19350185 }} </ref> | :**Medications ( [[steroids]], [[chemotherapy]] or transplant related immunosupression medications like [[Bicalutamide]], [[crofelemer]], [[Febuxostat]], [[Ruxolitinib]], [[Tacrolimus]], [[Tiagabine]], [[Tocilizumab]])<ref name="pmid12654381">{{cite journal| author=Benz MS, Glaser JS, Davis JL| title=Progressive outer retinal necrosis in immunocompetent patients treated initially for optic neuropathy with systemic corticosteroids. | journal=Am J Ophthalmol | year= 2003 | volume= 135 | issue= 4 | pages= 551-3 | pmid=12654381 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12654381 }} </ref><ref name="pmid19350185">{{cite journal| author=Fernandes NF, Malliah R, Stitik TP, Rozdeba P, Lambert WC, Schwartz RA| title=Herpes zoster following intra-articular corticosteroid injection. | journal=Acta Dermatovenerol Alp Pannonica Adriat | year= 2009 | volume= 18 | issue= 1 | pages= 28-30 | pmid=19350185 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19350185 }} </ref> | ||
*Stress | *Stress | ||
Other potential risk factors include: | |||
*Women > men<ref name="pmid18528318">{{cite journal| author=Harpaz R, Ortega-Sanchez IR, Seward JF, Advisory Committee on Immunization Practices (ACIP) Centers for Disease Control and Prevention (CDC)| title=Prevention of herpes zoster: recommendations of the Advisory Committee on Immunization Practices (ACIP). | journal=MMWR Recomm Rep | year= 2008 | volume= 57 | issue= RR-5 | pages= 1-30; quiz CE2-4 | pmid=18528318 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18528318 }} </ref><ref name="pmid14720565">{{cite journal| author=Thomas SL, Hall AJ| title=What does epidemiology tell us about risk factors for herpes zoster? | journal=Lancet Infect Dis | year= 2004 | volume= 4 | issue= 1 | pages= 26-33 | pmid=14720565 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=14720565 }} </ref> | *Women > men<ref name="pmid18528318">{{cite journal| author=Harpaz R, Ortega-Sanchez IR, Seward JF, Advisory Committee on Immunization Practices (ACIP) Centers for Disease Control and Prevention (CDC)| title=Prevention of herpes zoster: recommendations of the Advisory Committee on Immunization Practices (ACIP). | journal=MMWR Recomm Rep | year= 2008 | volume= 57 | issue= RR-5 | pages= 1-30; quiz CE2-4 | pmid=18528318 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18528318 }} </ref><ref name="pmid14720565">{{cite journal| author=Thomas SL, Hall AJ| title=What does epidemiology tell us about risk factors for herpes zoster? | journal=Lancet Infect Dis | year= 2004 | volume= 4 | issue= 1 | pages= 26-33 | pmid=14720565 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=14720565 }} </ref> | ||
*Whites > African Americans (by at least 50%) <ref name="pmid21224457">{{cite journal| author=Tseng HF, Smith N, Harpaz R, Bialek SR, Sy LS, Jacobsen SJ| title=Herpes zoster vaccine in older adults and the risk of subsequent herpes zoster disease. | journal=JAMA | year= 2011 | volume= 305 | issue= 2 | pages= 160-6 | pmid=21224457 | doi=10.1001/jama.2010.1983 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21224457 }} </ref>. | *Whites > African Americans (by at least 50%) <ref name="pmid21224457">{{cite journal| author=Tseng HF, Smith N, Harpaz R, Bialek SR, Sy LS, Jacobsen SJ| title=Herpes zoster vaccine in older adults and the risk of subsequent herpes zoster disease. | journal=JAMA | year= 2011 | volume= 305 | issue= 2 | pages= 160-6 | pmid=21224457 | doi=10.1001/jama.2010.1983 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21224457 }} </ref>. | ||
'''Children''' | |||
Age <10 years<ref name="pmid3863086">{{cite journal| author=Guess HA, Broughton DD, Melton LJ, Kurland LT| title=Epidemiology of herpes zoster in children and adolescents: a population-based study. | journal=Pediatrics | year= 1985 | volume= 76 | issue= 4 | pages= 512-7 | pmid=3863086 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=3863086 }} </ref> | |||
*Herpes zoster is unusual in this age group except if [[varicella]] acquired during the first year of life and [[VZV]] infection [[in utero]]. | |||
Age >10 years<ref name="pmid15816149">{{cite journal| author=Mullooly JP, Riedlinger K, Chun C, Weinmann S, Houston H| title=Incidence of herpes zoster, 1997-2002. | journal=Epidemiol Infect | year= 2005 | volume= 133 | issue= 2 | pages= 245-53 | pmid=15816149 | doi= | pmc=2870243 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15816149 }} </ref> | |||
*[[Immunosupression]] | |||
:*[[Malignancy]] | |||
:*[[Immunosupressive drugs]] ([[steroids]], [[chemotherapy]] or transplant related immunosupression medications) | |||
:*[[HIV]] | |||
:*[[Organ transplant]] ([[bone marrow]] or solid organ transplant) | |||
==References== | ==References== | ||
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; L. Katie Morrison, MD;Associate Editor(s)-in-Chief: Cafer Zorkun, M.D., Ph.D. [2]; Yamuna Kondapally, M.B.B.S[3]
Overview
Shingels are developed in patients who were previously infected with VZV (through natural infection that caused varicella or varicella vaccination).All older adults in the United States are at risk for herpes zoster as approximately 99.5% of people born in the United States who are 40 years of age and older have had varicella. Common risk factors include increasing age, immunosupression and stress.
Risk Factors
- Shingels are developed in patients who were previously infected with VZV (through natural infection that caused varicella or varicella vaccination).[1]
- All older adults in the United States are at risk for herpes zoster as approximately 99.5% of people born in the United States who are 40 years of age and older have had varicella.[2]
Risk factors include:
Adults
- Previous varicella virus infection ( Varicella vaccination or varicella )
- Decline in cell mediated immunity[3]
- Increasing age >50 yrs[4][5]
- Immunosupression[6][7]
- Malignancy, especially leukemia and lymphoma
- HIV (relative risk of herpes zoster is 15 times greater in men with HIV than a non HIV patients)[8][9][10]
- Organ transplant (bone marrow or solid organ transplant)[7]
- Medications ( steroids, chemotherapy or transplant related immunosupression medications like Bicalutamide, crofelemer, Febuxostat, Ruxolitinib, Tacrolimus, Tiagabine, Tocilizumab)[11][12]
- Stress
Other potential risk factors include:
Children
Age <10 years[16]
- Herpes zoster is unusual in this age group except if varicella acquired during the first year of life and VZV infection in utero.
Age >10 years[17]
- Malignancy
- Immunosupressive drugs (steroids, chemotherapy or transplant related immunosupression medications)
- HIV
- Organ transplant (bone marrow or solid organ transplant)
References
- ↑ CDC http://www.cdc.gov/shingles/hcp/clinical-overview.html (August 2016) Accessed on October 24,2016
- ↑ Chapman RS, Cross KW, Fleming DM (2003). "The incidence of shingles and its implications for vaccination policy". Vaccine. 21 (19–20): 2541–7. PMID 12744889.
- ↑ Wung PK, Holbrook JT, Hoffman GS, Tibbs AK, Specks U, Min YI; et al. (2005). "Herpes zoster in immunocompromised patients: incidence, timing, and risk factors". Am J Med. 118 (12): 1416. doi:10.1016/j.amjmed.2005.06.012. PMID 16378799.
- ↑ Hayward AR, Herberger M (1987). "Lymphocyte responses to varicella zoster virus in the elderly". J Clin Immunol. 7 (2): 174–8. PMID 3033012.
- ↑ Oxman MN, Levin MJ, Johnson GR, Schmader KE, Straus SE, Gelb LD; et al. (2005). "A vaccine to prevent herpes zoster and postherpetic neuralgia in older adults". N Engl J Med. 352 (22): 2271–84. doi:10.1056/NEJMoa051016. PMID 15930418. Review in: ACP J Club. 2005 Nov-Dec;143(3):61
- ↑ Abendroth A, Kinchington PR, Slobedman B (2010). "Varicella zoster virus immune evasion strategies". Curr Top Microbiol Immunol. 342: 155–71. doi:10.1007/82_2010_41. PMC 3936337. PMID 20563710.
- ↑ 7.0 7.1 HOPE-SIMPSON RE (1965). "THE NATURE OF HERPES ZOSTER: A LONG-TERM STUDY AND A NEW HYPOTHESIS". Proc R Soc Med. 58: 9–20. PMC 1898279. PMID 14267505.
- ↑ Buchbinder SP, Katz MH, Hessol NA, Liu JY, O'Malley PM, Underwood R; et al. (1992). "Herpes zoster and human immunodeficiency virus infection". J Infect Dis. 166 (5): 1153–6. PMID 1308664.
- ↑ Chronister CL (1996). "Review of external ocular disease associated with aids and HIV infection". Optom Vis Sci. 73 (4): 225–30. PMID 8728488.
- ↑ Cohen PR, Grossman ME (1989). "Clinical features of human immunodeficiency virus-associated disseminated herpes zoster virus infection--a review of the literature". Clin Exp Dermatol. 14 (4): 273–6. PMID 2686873.
- ↑ Benz MS, Glaser JS, Davis JL (2003). "Progressive outer retinal necrosis in immunocompetent patients treated initially for optic neuropathy with systemic corticosteroids". Am J Ophthalmol. 135 (4): 551–3. PMID 12654381.
- ↑ Fernandes NF, Malliah R, Stitik TP, Rozdeba P, Lambert WC, Schwartz RA (2009). "Herpes zoster following intra-articular corticosteroid injection". Acta Dermatovenerol Alp Pannonica Adriat. 18 (1): 28–30. PMID 19350185.
- ↑ Harpaz R, Ortega-Sanchez IR, Seward JF, Advisory Committee on Immunization Practices (ACIP) Centers for Disease Control and Prevention (CDC) (2008). "Prevention of herpes zoster: recommendations of the Advisory Committee on Immunization Practices (ACIP)". MMWR Recomm Rep. 57 (RR-5): 1–30, quiz CE2-4. PMID 18528318.
- ↑ Thomas SL, Hall AJ (2004). "What does epidemiology tell us about risk factors for herpes zoster?". Lancet Infect Dis. 4 (1): 26–33. PMID 14720565.
- ↑ Tseng HF, Smith N, Harpaz R, Bialek SR, Sy LS, Jacobsen SJ (2011). "Herpes zoster vaccine in older adults and the risk of subsequent herpes zoster disease". JAMA. 305 (2): 160–6. doi:10.1001/jama.2010.1983. PMID 21224457.
- ↑ Guess HA, Broughton DD, Melton LJ, Kurland LT (1985). "Epidemiology of herpes zoster in children and adolescents: a population-based study". Pediatrics. 76 (4): 512–7. PMID 3863086.
- ↑ Mullooly JP, Riedlinger K, Chun C, Weinmann S, Houston H (2005). "Incidence of herpes zoster, 1997-2002". Epidemiol Infect. 133 (2): 245–53. PMC 2870243. PMID 15816149.