The epidemiology of varicella hospitalizations in the US Army

Varicella infections affect the U.S. Army, but the extent has not been quan tified recently. We obtained 1990 to 1997 hospitalization data from the U.S . Army Medical Command and calculated rates using data from the Army Medica l Surveillance Activity and the U.S. Army Training Command. There was a dec line in the number and incidence of varicella hospitalizations for U.S. Arm y active duty soldiers from 1990 to 1997. Varicella incidence rates for act ive duty soldiers are significantly higher for females, blacks, those young er than 20 years, and those whose home of record were tropical island regio ns. Army initial entry training hospitalizations constitute 11.8% of active duty Army hospitalizations and have also declined. Varicella continues to affect the training and health of the U.S. Army; however, the impact has di minished over the years. A feasible approach to limit varicella in the U.S. Army is to target trainees for screening or vaccination. Refinement of thi s strategy should be determined from a follow-up cost-effectiveness analysi s.