Article Text

Download PDFPDF
Declining incidence of chickenpox in the absence of universal childhood immunisation
  1. G L Lowe,
  2. R L Salmon,
  3. D Rh Thomas,
  4. M R Evans
  1. National Public Health Service Communicable Disease Surveillance Centre, Abton House, Cardiff CF14 3QX, UK
  1. Correspondence to:
    G L Lowe
    National Public Health Service Communicable Disease Surveillance Centre, Abton House, Cardiff CF14 3QX, UK; Gwen.lowe{at}


Objective: To examine the epidemiology of chickenpox in Wales from 1986 to 2001.

Design: Descriptive analysis of chickenpox consultations reported by the Welsh general practice sentinel surveillance scheme for infectious diseases, compared with annual shingles consultation rates from the same scheme to exclude reporting fatigue and data from a general practice morbidity database to validate results.

Setting: A total of 226 884 patients registered with one of 30 volunteer general practices participating in the sentinel surveillance scheme.

Main outcome measures: Age standardised and age specific incidence of chickenpox.

Results: Crude and age standardised consultation rates for chickenpox declined from 1986 to 2001, with loss of epidemic cycling. Rates remained stable in 0–4 year olds but declined in all older age groups, particularly those aged 5–14 years. Shingles consultation rates remained constant over the same period. Data from the morbidity database displayed similar trends.

Conclusion: General practitioner consultation rates for chickenpox are declining in Wales except in pre-school children. These findings are unlikely to be a reporting artefact but may be explained either by an overall decline in transmission or increased social mixing in those under 5 years old, through formal child care and earlier school entry, and associated increasing rates of mild or subclinical infection in this age group. Further investigation, particularly by serological surveillance, is necessary before universal varicella immunisation can be considered in the UK.

  • CDSC, Communicable Disease Surveillance Centre
  • GP, general practitioner
  • GPMD, general practice morbidity database
  • age distribution
  • chickenpox
  • chickenpox vaccine
  • incidence
  • pre-school child
  • varicella
  • Wales

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.