Assessment of the Seroprevalence of Varicella zoster Virus in Young Adults Aged 15 – 35 Years Old in Mashhad, Iran

Abstract

Background: Varicella zoster virus (VZV) is highly contagious and can lead to two distinct diseases. Initially, it causes chickenpox, a primary infection common among children worldwide, characterized by itchy, red blisters that cover the body. After this initial outbreak, the virus can lie dormant in nerve tissues and may reactivate later in life as herpes zoster, commonly known as shingles, which presents as a painful rash. While chickenpox is generally mild and resolves on its own, it can cause severe complications, especially in vulnerable groups such as immunocompromised individuals or adults. These complications can range from bacterial superinfections and pneumonia to encephalitis. In rare cases, it may lead to life-threatening conditions like necrotizing fasciitis or toxic shock syndrome, highlighting the potential severity of what is often considered a childhood illness. Objectives: One of the main risk factors for varicella-zoster infection is the absence of immunity. Individuals who have not been vaccinated against or previously infected with the VZV are at risk of contracting chickenpox when exposed. Additionally, close contact with infected individuals increases the likelihood of transmission. People with chronic conditions or those undergoing immunosuppressive therapy are particularly vulnerable to severe complications from varicella-zoster infections. Therefore, this study was conducted to assess the seroepidemiology of antibodies against varicella zoster in the young adult population in Mashhad. Methods: This cross-sectional study was conducted in 2018 on men and women aged 15 to 35 years in Mashhad, northeast Iran. Random cluster sampling was utilized. Individuals undergoing treatment for rare diseases were excluded from the study. The enzyme-linked immunoassay (ELISA) technique was employed to assess the presence of IgG antibodies against varicella zoster in 724 serum samples. Data analysis was performed using SPSS 20, and the significance level was set at 0.05. Results: Overall, among the 724 participants aged 15 - 35 years old in Mashhad, the frequency of anti-varicella IgG seropositivity was 85.9%. Our results indicated significant associations between age (P = 0.001) and occupational status (P = 0.02) with varicella-zoster seroprevalence. Conclusions: We observed a high frequency of anti-varicella zoster IgG seroprevalence among young adults in Mashhad. Infants, pregnant women, and individuals with weakened immune systems are more likely to develop severe forms of chickenpox or experience complications from shingles, including pneumonia and encephalitis. Given the severe health problems caused by the varicella virus and its high prevalence in Mashhad, we recommend incorporating the varicella vaccine into the public vaccination program. Additionally, further examination of the burden of herpes zoster, including its impact on quality of life and healthcare utilization, can guide interventions to mitigate the consequences of this condition.