Genital herpes in Canada: Deciphering the hidden epidemic

Can J Infect Dis Med Microbiol. 2012 Spring;23(1):e6-9. doi: 10.1155/2012/386329.

Abstract

Introduction: Genital herpes (GH) is the most common cause of genital ulceration, but is not reportable in Canada. Research in the United States has found that less than 10% of seropositive persons reported a diagnosis of GH. The present article investigates the rates of diagnosed cases of GH in Canada from 2002 to 2007.

Methods: Primary case diagnosis data on GH for the period between 2002 and 2007 were obtained from the Canadian Disease and Therapeutic Index, a proprietary database maintained by Intercontinental Medical Statistics (IMS) Health Canada. Of the 45,000 to 49,000 office-based physicians in Canada, IMS Health collected diagnosis-specific prescription diaries from a sample of 652, stratified according to geographic region and representing all major specialties, during this period.

Results: Between 2002 and 2007, there were approximately 84,398 to 122,456 medically attended GH cases annually in Canada. Approximately 74% to 93% of these diagnosed cases made one physician visit per year. The annual rate of medically attended GH cases ranged from 261.2 per 100,000 population to 386.6 per 100,000 population.

Discussion: The present report is the first time that administrative data have been used to estimate the annual rate of medically attended GH cases in Canada. The data include both incident and prevalent cases and are likely an underestimate of the actual number of cases because they only represent diagnosed cases presenting for medical care. Further seroepidemiological and clinical research studies would be helpful to assess the burden of infection and to plan appropriate diagnostic, treatment and preventive counselling services.

Introduction: Genital herpes (GH) is the most common cause of genital ulceration, but is not reportable in Canada. Research in the United States has found that less than 10% of seropositive persons reported a diagnosis of GH. The present article investigates the rates of diagnosed cases of GH in Canada from 2002 to 2007.

Methods: Primary case diagnosis data on GH for the period between 2002 and 2007 were obtained from the Canadian Disease and Therapeutic Index, a proprietary database maintained by Intercontinental Medical Statistics (IMS) Health Canada. Of the 45,000 to 49,000 office-based physicians in Canada, IMS Health collected diagnosis-specific prescription diaries from a sample of 652, stratified according to geographic region and representing all major specialties, during this period.

Results: Between 2002 and 2007, there were approximately 84,398 to 122,456 medically attended GH cases annually in Canada. Approximately 74% to 93% of these diagnosed cases made one physician visit per year. The annual rate of medically attended GH cases ranged from 261.2 per 100,000 population to 386.6 per 100,000 population.

Discussion: The present report is the first time that administrative data have been used to estimate the annual rate of medically attended GH cases in Canada. The data include both incident and prevalent cases and are likely an underestimate of the actual number of cases because they only represent diagnosed cases presenting for medical care. Further seroepidemiological and clinical research studies would be helpful to assess the burden of infection and to plan appropriate diagnostic, treatment and preventive counselling services.

Introduction: L’herpès génital (HG) est la principale cause d’ulcération génitale, mais il n’est pas à déclaration obligatoire au Canada. D’après des recherches menées aux États-Unis, moins de 10 % des personnes séropositives ont déclaré un diagnostic d’HG. Le présent article porte sur le taux de cas d’HG diagnostiqués au Canada entre 2002 et 2007.

Méthodologie: Les chercheurs ont obtenu les données diagnostiques des cas primaires d’HG entre 2002 et 2007 dans l’Index canadien des maladies et traitements, une base de données commerciale qu’exploite Intercontinental Medical Statistics (IMS) Health Canada. Pendant cette période, IMS Health a colligé les carnets de prescriptions propres aux diagnostics auprès d’un échantillon de 652 des 45 000 à 49 000 médecins en pratique privée du Canada, stratifié selon la région géographique et représentant toutes les grandes spécialités.

Résultats: Entre 2002 et 2007, on a recensé chaque année de 84 398 à 122 456 cas d’HG suivis par un médecin au Canada. De 74 % à 93 % de ces cas diagnostiqués rendaient visite au médecin une fois par année. Le taux annuel de cas d’HG suivis par un médecin oscillait entre 261,2 personnes sur 100 000 habitants et 386,6 personnes sur 100 000 habitants.

Exposé: On expose pour la première fois, dans le présent rapport, le recours à des données administratives pour évaluer le taux annuel de cas d’HP suivis par un médecin au Canada. Les données incluent à la fois les cas incidents et prévalents et, selon toute probabilité, elles sous-évaluent le véritable nombre de cas, car elles représentent seulement les cas diagnostiqués qui consultent pour obtenir des soins médicaux. Il serait utile de mener d’autres projets de recherche systématiques, nationaux, séroépidémiologiques et cliniques pour évaluer le fardeau de l’infection et planifier des services diagnostiques, thérapeutiques et préventifs pertinents.

Keywords: Burden of HSV infection; Genital herpes; Herpes simplex virus; Physician visits; Rate of diagnosis.