Measuring the pain and severity associated with the prodromal phase of Herpes Zoster in Canada: A prospective community-based study

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Measuring the pain and severity associated with the prodromal phase of Herpes Zoster in Canada: A prospective community-based study

Presenter: Mark Brisson. Merck Frosst Canada Ltd, Kirkland, Quebec, Canada.

Aim: Describe the frequency, severity and duration of prodromal pain in herpes zoster and identify associated risk factors.

Methods: From October 2005 to June 2006, 284 patients (ł50 years of age) presenting with a herpes zoster rash were recruited at 90 clinics across Canada. Morbidity associated with the prodromal phase was measured using the Initial Zoster Impact Questionnaire (IZIQ).

Results: 274 patients answered the IZIQ, 60% of whom were female. The mean age of patients was 66 years (SD=11). Prodromal pain was reported in 68% of cases. Of these, 39% reported having more than 18 h of pain per day. On average, prodromal pain appeared 4.4 days (SD=3.6) before rash onset. Average and worst pain during the prodrome were five (SD=2.8) and six (SD=2.9) out of 10, respectively (10 is worst imaginable pain). Age and gender did not significantly affect the occurrence of prodromal pain. Patients with prodromal pain were more likely to experience pain (98% vs. 83%, P<0.001) and suffered greater average pain (5.5 vs. 4.7, P<0.05) after the onset of herpes zoster rash than those who did not report prodromal pain.

Conclusion: This study suggests that the pain during the prodromal phase of HZ is significant, and that the presence of prodromal pain is a risk factor for greater pain after the onset of herpes zoster rash. The patients in this study will be followed up for 6 months to determine whether the presence of prodromal pain is a risk factor for postherpetic neuralgia and duration and severity of herpes zoster associated pain.


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