Epidemio-clinical study of Herpes Zoster in Erbil City

  • Khalis Bilal Mohammed Ali M.B.Ch.B.M.Sc. Lecturer, College of Nursing, Hawler Medical University
Keywords: Epidemio-clinical, Herpes Zoster, Erbil city


Background and objectives: Herpes zoster is a viral disease characterized by a painful skin rash with blisters in a limited area on one side of the body, often in a stripe. This study highlightes the epidemiological and clinical pattern of the disease in Erbil city.

Methods: A descriptive study conducted on patients with herpes zoster throughout July 2004 to July 2008, a specially designed questionnaire was prepared for this purpose obtaining age, sex, dermatome distribution, the presenting symptoms and date of infection.

Results: Out of 525 patients, 323 (61.5%) were male and 202 (38.5%) were female, with male to female ratio 1.59:1. The age of the patients ranged from 3-85 years, with (Mean ± SD = 43.12 ± 20.16). The highest percentage was among 40-49 years of age (17.14%), the frequency was increasing with progress of age, both sides of the body were affected equally, thoracic dermatomes (41.14%) were more affected than the other dermatomes. The pain was the commonest prodromal and presenting symptom, and the vesicles were the commonest type of skin lesions. No seasonal variation was noticed in the frequency of the disease.

Conclusion: The study concluded that epidemiological and clinical pattern of the disease in Erbil city is more or less similar to that found in other populations.


1. Johnson RW, Dworkin RH. Clinical review: Treatment of herpes zoster and postherpetic neuralgia.BMJ 2003;326 (7392):748.

2. Kennedy PG. Varicella-zoster virus latency in human ganglia. Rev. Med. Virol 2002;12 (5):327–34.

3. Peterslund NA. Herpesvirus infection: an overview of the clinical manifestations. Scand J Infect Dis Suppl 1991; 80:15–20.

4. Gilden DH, Cohrs RJ, Mahalingam R. Clinical and molecular pathogenesis of varicella virus infection. Viral Immunol 2003;16(3):243–58.

5. Dworkin RH, Johnson RW, Breuer J.Recommendations for the management of herpes zoster. Clin. Infect. Dis 2007;44 Suppl 1: S1–26. available from doi:10.1086/510206. PMID 17143845. http://www.journals.uchicago.edu/doi/full/10.1086/510206. accessed at 15.7.09.

6. Donahue JG, Choo PW, Manson JE, Platt R. The incidence of herpes zoster. Arch. Intern. Med 1995;155 (15):1605–9.

7. Araújo LQ, Macintyre CR, Vujacich C. Epidemiology and burden of herpes zoster and post-herpetic neuralgia in Australia, Asia and South America. Herpes 2007;14 (Suppl 2): 40A–4A. PMID 17939895. available from http://www.ihmf.org/journal/download/5%20-%20Herpes%2014.2%20suppl%20Araujo.pdf. Accessed at 15.7.09.

8. Cunningham AL, Breuer J, Dwyer DE, Gronow DW, Helme RD, Litt JC, Levin MJ, Macintyre CR. The prevention and management of herpes zoster. Med. J. Aust. 2008;188 (3): 171–6.

9. Hope-Simpson RE. The nature of herpes zoster: along term study and new hypothesis. Proc R Soc Med 1965; 58:9-20.

10. Thomas SL, Hall AJ. What does epidemiology tell us about risk factors for herpes zoster?. Lancet Infect Dis 2004;4 (1):26–33.

11. Hicks LD, Cook-Norris RH, Mendoza N, Madkan V, Arora A, Tyring SK. Family history as a risk factor for herpes zoster: a case-control study. Arch Dermatol 2008;144 (5):603–8. available at doi:10.1001/archderm.144.5.603. http://www.bmj.com/cgi/content/full/326/7392/748. Accessed at 21.7.09.

12. Freidman-Kien AE, Lafleur FL, Gendler E. Herpes zoster: a possible early clinical sign for development of acquired immunodefficiency syndrome in high risk individuals. J Am Acad Dermatol 1986;14:1023-8.

13. Alakloby OM, Aljabre SH, Randhawa MA, Alzahrani AJ, AlWunais KM, Bukhari IA. Herpes zoster in eastern saudi arabia: clinical presentation and management. J Drugs Dermatol 2008; 7(5): 457-62

14. Dubey AK, Jaisankar TJ, Thappa DM. Clinical and morphological characteristics of herpes zoster in South India. Indian J Dermatol 2005; 50(4):203-7
15. Ertunc V, Dane S, Colak A, Karakuzul A, Mete E, Senol M. Relation of age , sex, distribution and associated diseases with herpes zoster. J of Turgut Ozel Medical Center 1997; 4(1):29-32.
16. Goh CL, Khoo L. A retrospective study of the clinical presentation and outcome of herpes zoster in a tertiary dermatology outpatient referral clinic. Int J Dermatol 1997; 36:667-72
17. Rogers RS, Tindall JP. Herpes zoster in children. Arch Derm.1972; 106:204-7.

18. Miller AE. Selective decline in cellular immune response to varicella zoster in the elderly. Neurology 1980; 30:582.

19. Ruckdeschel JC, SchimpffSC, Smyth AC. Herpes zoster and impaired cell-mediated immunity to the varicella zoster virus in patients with Hodgkin's disease. Am J Med 1977; 62:77.

20. Sorenson OS, Haahr S, Moller-Larsen A. Cell mediated and humoral immunity to herpes virus during and after herpes zoster infections. Infect Immun 1980; 29:369.

21. Laxmisha C, Thappa DM, Jaisanker TJ. The spectrum of varicella zoster virus infection, a hospital based clinic in south India. Indian JDermatol 2004; 49(1):28-31.

22. Schimpff S, Serpick A, Stoler B, Rumack B, Mellin H, Joseph JM, Block J. Varicella-zoster infection in patients with cancer, Ann Int Med 1972;76:241-54.

23. Goffinet DR, Glatstein EJ, Merigan TC. Herpes zoster varicella infections and lymphoma. Ann Int Med 1972; 76:235.

24. Mazur MH, Raphael D. Herpes zoster at the NIH: a 20 year experience. Am J Med 1978; 65:738.

25. Rusthoven JJ, Ahlgren P, Elhakim T, Pinfold P, Reid J, Stewart L, Feld R. Varicella-zoster infection in adults cancer patients. Arch Intern Med 1988; 148:1561-6.

26. Ragozzino MW, Melton LJ, Kurland LT, Chu CP, Perry HO. Population-based study of herpes zoster and its sequelae. Medicine 1982; 5:310.
27. Guess HA, Broughton DD, Melton LJ, Kurland LT. Epidemiology of herpes zoster in children and adolescents: A population-based study. Pediatrics 1985; 4:512.
How to Cite
Mohammed Ali, K. (2018). Epidemio-clinical study of Herpes Zoster in Erbil City. Zanco Journal of Medical Sciences (Zanco J Med Sci), 14(1), 85 - 90. Retrieved from https://zjms.hmu.edu.krd/index.php/zjms/article/view/541
Original Articles