A clinico-epidemiological study of childhood herpes zoster

Herpes zoster (HZ) is a viral infection believed to be caused by the re activation of varicella zoster virus (VZV) or human herpes virus type 3 (HHV 3) that persists in the posterior nerve root ganglion. HZ is rarely reported in the pediatric age group with an intact immunity. Past infection with VZV and immunization with chickenpox vaccine are key markers in the onset of varicella zoster in children. Our aim was to study the clinicoepidemiological pattern of HZ infection in children aged less than 12 years and to start an early management to prevent long term complications. A prospective observational study over a total duration of 2 years was conducted in a tertiary hospital, and all children less than 12 years of age with diagnosed HZ were included in the study. A total of 39 children were diagnosed to have pediatric HZ infection during the study period. The children were followed up over 4 weeks post diagnosis and were treated with oral acyclovir therapy along with symptomatic management. All children had an uneventful benign course, and their siblings and close pediatric contacts were also screened for the development of HZ or chickenpox during the incubation period. All children were screened for an underlying immunodeficiency and two cases of HIV co infection were detected. HZ is a rare disease in childhood. Varicella in early childhood is a risk factor for HZ in both immunocompromised and immunocompetent children. The appearance of HZ in a young child does not always imply an underlying immunodeficiency or malignancy, but the children should be screened for immunodeficiency. In general, the prognosis is good in healthy children.