Smetana J., Salavec M., Bostikova V., Chlibek R., Bostik P., Hanovcova I., Vackova M., Matulkova P., Splino M.: Herpes zoster in the Czech Republic - Epidemiology and Clinical Manifestations Herpes zoster (shingles) is a viral infection of the skin that manifests itself as painful, unilateral vesicular rash. The causative agent is varicella-zoster virus (VZV). Primary infection with VZV causes chickenpox, a common childhood infection, and then the virus lies dormant in the sensory neural ganglia, reactivating to cause shingles. The most important complications are neurological disorders (in particular postherpetic neuralgia) and eye disorders. First-line therapy are antiviral agents. A single vaccine has been registered to date. Herpes zoster occurs sporadically in the Czech Republic and its incidence is long-term stable. In 1990-2008 the average annual incidence was 6,306 cases (61.3 cases/100 000 population), with the lowest number of 5,511 cases (53.5/100 000) reported in 1991 and the highest number of 6,894 cases (67.6/100 000) reported in 2002. The incidence rate in females (69.9/100 000) was 1.4 times as high as in males (49.5/100 000). From the age perspective, the elderly are at a considerably higher risk of developing shingles. In 2008, the incidence rate was the highest in the age group 70 years (155.0/100 000). Nevertheless, the beginning of the upward trend is seen in the age group 45-49 years. Herpes zoster does not show any seasonal trend.