In Caribbean island populations, varicella-zoster virus (VZV) infection is reported regularly among adolescents and adults. Among them, disease more often runs a severe course, causing a substantial burden in these populations. This seroepidemiological study aimed to obtain insight into VZV susceptibility and its determinants in island populations of Caribbean Netherlands (CN).
Participants from Bonaire, St. Eustatius and Saba (n = 1,829, aged 0-90 years) donated a blood sample and completed a questionnaire. VZV-specific IgG antibodies were determined using a bead-based multiplex-immunoassay. Risk factors were analyzed using a logistic regression model.
Overall seroprevalence in CN was 78%, being lowest on St. Eustatius (73%) and highest on Bonaire and Saba (79%). Seropositivity increased gradually with age, with 60% and 80% at ages 10 and 30 years, respectively, and ranging between 80-90% thereafter. Higher odds for VZV-seronegativity were seen among persons who were born in CN or resided there since early childhood, and among single-person households.
VZV susceptibility is relatively high among adolescents and adults in CN. In order to reduce the burden of VZV-related disease in these populations, routine varicella vaccination is recommended. As data are scarce, our findings can serve as a blueprint for the epidemiology in tropical regions.

Copyright © 2020. Published by Elsevier Ltd.

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