And indeed, if it is very frequent and has its share of complications, The zona is much less contagious than chickenpox, although it is the same virus, the variclla-zoster virus (VZV). Chickenpox is primary infection by VZV, and this very common disease affects 90 % of the European population before the age of 15.
In 2022, Justin Bieber was assigned by Lié Syndrome de Ramsay Hunt, linked to the zona
Why is we immune to chickenpox but not against the zona?
We only catch the chickenpox once. But the virus is never completely eliminated, as Dr. Stéphanie Jacquinet, epidemiologist specializing in infectious diseases for Sciensano, explains. “”He puts himself into a latency in sensitive nodes, near the spinal cord. As long as immunity against the virus remains high enough, it stays there, but as soon as there is a drop in immunity against the virus, it can reactivate“This drop in immunity is most often due to age: out of the 48,000 cases identified each year in Belgium, 70 % are over 50, according to the KCE.
While the chickenpox develops in a “harmonious” way, distributing small blisters – the vesicles – which will be ulcerated and then stroke over the whole body, the zona manifests itself in a unilateral way. “”It is limited to one or two dermatomas, the skin areas innervated by the sensitive nerve fibers of a single nerve root: for example the thorax, the cervical and the ophthalmic medium“, Specifies Dr. Jacquinet.
Note that for people who did not have chickenpox but have received a vaccine against the disease, the risk is not zero either: “It is always possible to do the zona, but the risk is lower and it will be a more attenuated ‘zona’“Dit la spécialiste de Sciensano.
What complications with the zona?
10 to 20 % of zona cases can present complications. “”The most frequent is post-herpetic neuralgiaexplains Dr. Stéphanie Jacquinet, at Sciensano. It is a pain that remains at least 30 days after the rash. ” The incidence of neuralgia increases with age. Pain can remain over time. “”Half of patients who suffer from it keep disabling pain practically every day.”
In immunocompromised people, there is a potential risk of “scattered zona”, according to Dr. Jacquinet. “”The patient can make pneumonia, hepatitis, encephalitis. The risk of mortality is 5 to 10 % in these cases.”
Why not systematically vaccinate?
In August 2022, the Higher Health Council (CSS) issued an opinion recommending vaccination against the zona virus (herpes zoster for immunocompetent adults over the age of 60 and for immunocompromised patients, including those under immunosuppressive treatment from the age of 16 … but he added that the cost effectiveness of the vaccine must be taken into account Vaccine, Shingrix® (GSK) arrived on the Belgian market, having proven itself of efficiency and safety … but a cost of € 170 per dose.
The KCE studied the question and gave its opinion in October 2022: the price is too high compared to the health benefits that can be expected from this vaccine. “”If the reimbursement was granted, this vaccination would cost the health care budget for around € 602 million in the first year, and then almost € 23 million per year. The question is whether such important expenses can be justified for a disease that remains relatively benign for most people, especially in this period of budgetary restrictions“concluded the Federal Center for Health Care Expertise.
According to the KCE, an average of 12 deaths can be allocated each year to the Zona and its complications. “”For comparison, the average annual number of deaths due to the flu was previously evaluated between 250 and 350 deaths, and those due to pneumococcus, at around 440“.
