Varicella-zoster virus infection (chickenpox and shingles)
Key Findings
The disease
The varicella-zoster virus (VZV) causes two distinct diseases: varicella (chickenpox) and herpes zoster (shingles). After having chickenpox, the virus stays in the nerve cells of the body and can later reactivate as shingles. Shingles is most common in elderly people.
Transmission
Chickenpox is very contagious. It can be spread by droplets coughed or sneezed into the air or by touching the skin of an infected person.
Signs and symptoms
Symptoms of chickenpox include:
- fever
- rash that starts as red spots, become blister like and then form scabs
- blisters in the mouth and throat.
Complications include pneumonia, encephalitis (brain infection) and sometimes death.
Symptoms of shingles include:
- a painful, blister-like rash that starts in a localised area on one side of the face or body
- scabs (within 7–10 days).
Shingles on the face can affect the eyes and cause loss of vision.
Vaccination recommendations and coverage
Chickenpox vaccine has been included in the National Immunisation Program since 2006. It is included in the measles, mumps and rubella combined vaccination (MMRV) that is recommended at 18 months of age.
Shingles vaccination is funded for adults aged 70–79 years.
Who is most affected?
- Chickenpox is most common in children.
- Shingles is most common in older adults.
How common is it?
Because there are not reliable figures on the actual numbers of chickenpox and shingles cases in Australia, we instead use hospitalisation data as a more accurate measure of severe disease.
Hospitalisations/deaths
Between 2016 and 2019, there were 2955 hospital admissions recorded for varicella; 107 (3.6%) of these were recorded as being in Aboriginal and/or Torres Strait Islander people. Hospitalisation rates were highest in Aboriginal and/or Torres Strait Islander children 0–4 years (5.7 per 100,000) and those over 50 years (5.9 per 100,000). A total of 55 deaths were recorded for varicella (20 as underlying cause, 35 as associated cause); none of these were recorded as being in Aboriginal and/or Torres Strait Islander people.
Of the 27,781 hospitalisations for herpes zoster, 521 (1.9%) were recorded as being in Aboriginal and/or Torres Strait Islander people. Rates increased with age and were highest in those aged 50 years and above; however, the rate among Aboriginal and/or Torres Strait Islander people in this age group was significantly (20%) lower than for other people aged 50 years and older. A total of 455 deaths were recorded between 2016 and 2019 with herpes zoster as the underlying (143) or associated (312) cause, of which 1–5 were recorded as being in Aboriginal and/or Torres Strait Islander people.
Links and resources
Rates of chickenpox hospitalisation for Aboriginal and/or Torres Strait Islander people have continued to drop since the vaccination program was introduced in 2005.