Close

Exploring the seasonal drivers of varicella zoster transmission and reactivation.

Abstract

Varicella zoster virus (VZV) is a herpesvirus that causes chickenpox and shingles. The biological mechanisms underpinning the multi-decadal latency of VZV in the body and subsequent viral reactivation-which occurs in approximately 30% of individuals-are largely unknown. Because chickenpox and shingles are endemic worldwide, understanding the relationship between VZV transmission and reactivation is important for informing disease treatment and control. While chickenpox is a vaccine-preventable childhood disease with a rich legacy of research, shingles is not a notifiable disease in most countries. To date, population-level studies of shingles have had to rely on small-scale hospital or community-level datasets. Here, we examined chickenpox and shingles notifications from Thailand and found strong seasonal incidence in both diseases, with a 3-month lag between peak chickenpox transmission season and peak shingles reactivation. We tested and fit 14 mathematical models examining the biological driversof chickenpox and shingles over an 8-year period to estimate rates of VZV transmission, reactivation, and immunity boosting, wherein re-exposure to VZV boosts VZV-specific immunity to reinforce protection against shingles. The models suggested the seasonal cycles of chickenpox and shingles have different underlying mechanisms, with ultraviolet radiation (UV) being correlated with shingles reactivation.

MIDAS Network Members

Citation: