Dear Colleagues,

Infection by the human herpesvirus known as varicella-zoster virus (VZV) is responsible for varicella. Varicella, commonly referred to as chickenpox, typically manifests as a rash in young immunocompetent children. This pursues a generally mild clinical course; rare complications include bacterial superinfection of skin lesions, pneumonia, and central nervous system manifestations. In adults, varicella can result in significant morbidity and even death. Varicella in immunocompromised individuals, maternal varicella, and congenital varicella are associated with significant risk of mortality. The host immunity established following VZV infection is usually lifelong; however, it does not result is clearance of the virus. VZV, much like other human herpesviruses, establishes latency, a condition in which the virus achieves a non-replicative state, effectively hiding it from the host’s immune response. In the case of VZV, latency is established in the sensory ganglia. In the event of the host’s immune response waning, the dormant VZV can assume a replicative (lytic) state, allowing zoster or shingles to occur.  Shingles is a debilitating disease, particularly in the event of post-herpetic neuralgia.

In temperate climates such as the UK, many children have experienced varicella by the age of 10 years and by adulthood in excess of 90% of the population has evidence of prior VZV infection. In tropical zones, VZV infection tends to occur in individuals of older age groups. Effective vaccines are available to prevent varicella; however, uptake has been variable following concerns that varicella vaccination may result in increased cases of zoster later in life. Recently, zoster vaccines have also become available. In this Special Issue, varicella and zoster epidemiology will be addressed together with the benefits of vaccination, both in relation to differing geographical regions and in the face of new infectious challenges (SARS-CoV-2) and associations with neurological diseases.

Dr. Peter Maple
Guest Editor

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• varicella-zoster virus
• chickenpox
• shingles
• vaccination
• epidemiology
• geographical regions
• neurological diseases
• SARS-CoV-2