Public awareness and knowledge of herpes zoster: results of a global survey

BACKGROUND: Herpes zoster (HZ), the reactivation of varicella zoster virus, occurs in 1 in 5 people worldwide and may result in a variety of complications, including postherpetic neuralgia (PHN). Treatment of patients with HZ represents a considerable challenge, especially among the elderly who are prone to get a more severe form of the disease and its complications. Since May 2006, a vaccine was approved for the prevention of HZ or PHN among individuals aged 50 or 60 years and older.
OBJECTIVE: Since the success of any new vaccine initiative depends on public awareness of the disease, we conducted the HZ Global Awareness Survey to gauge existing levels of awareness and knowledge of HZ.
METHODS: The survey was conducted by telephone or face-to-face among 8,688 adults >OR=50 years of age in 22 countries between December 2006 and January 2007 and addressed awareness, knowledge, symptoms, and treatment of HZ.
RESULTS: Wide variation in HZ awareness was noted among countries. In some countries (New Zealand, Brazil, and Malaysia) nearly all individuals surveyed (97-100%) over the age of 50 years had heard of HZ. In contrast, less than 20% of individuals surveyed were aware of HZ in Turkey, India and Chile. The survey revealed almost universally poor knowledge of the causes and symptoms of HZ. Only 3% of respondents mentioned chicken pox as the cause of the disease. The majority of respondents were unaware of their risk of HZ, with 71% considering themselves unlikely or very unlikely to develop HZ. The survey also revealed that those respondents with prior HZ experience were much more likely to consider pain as the worst symptom of the disease than those without prior HZ experience. The misconception of HZ-related morbidity among individuals with no first-hand experience of the disease highlights the global educational need to raise awareness of the seriousness of HZ and its potential long-term complications.
CONCLUSIONS: This survey suggests a population-wide effort to improve global awareness of HZ would be required for a successful vaccine initiative. Further studies would be required to understand regional differences in the understanding of HZ.