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CDC: Varicella surveillance requires improvement in US
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Although varicella surveillance has significantly increased, some areas require improvement, such as data transmission from local jurisdictions to CDC and collection of varicella-specific data, according to a recent MMWR report.
Adriana S. Lopez, MHS, of the CDC’s National Center for Immunization and Respiratory Diseases, and colleagues assessed data from a survey administered to all states and the District of Columbia by the CDC and the Council of State and Territorial Epidemiologists in 2012. The survey evaluated varicella surveillance practices in the United States.
Forty-four of the 51 jurisdictions indicated varicella was reportable in their jurisdiction, indicating an increase of 63% since 2004. Of these, 37 conducted statewide case-based surveillance and 38 conducted case-based surveillance. Varicella cases were reported by schools (95.4%), hospitals (90.9%) and health care providers (84.1%).
Approximately 97% of jurisdictions that conducted statewide or case-based surveillance collected information on age, sex and race/ethnicity, 94.7% collected data on vaccination status, 86.8% reported on outbreak association, and 84.2% reported on disease severity.
Hospitalization and death data were collected by 92.1% and 89.5%, respectively. Collection of clinical information ranged from 28 jurisdictions for treatment to 36 jurisdictions for rash onset and laboratory testing.
Approximately 80% of jurisdictions (41 of 51) reported they were capable of testing for varicella in a laboratory, although only 17 jurisdictions routinely provided laboratory testing. Most testing was part of outbreak investigation and control in 36 jurisdictions. PCR was the most common testing method and was available in 26 jurisdictions.
Nineteen of 44 jurisdictions reported varicella-specific data to the CDC via Health Level 7 (HL7) messaging. HL7 messaging is currently the only system available for states to send varicella data to CDC, according to the researchers.
Fourteen of the 22 jurisdictions that did not send data via HL7 messaging reported they had not transitioned to HL7 messaging. Seven reported they had other data transmission methods or were not collecting case-based data, and one jurisdiction did not plan to transition to HL7. Competing priorities and lack of staff or funds were reported barriers to HL7 transition.
Approximately 25% of jurisdictions reported requiring only one dose of varicella for school entry and 39.2% required two doses. About one-third of jurisdictions had a one- or two-dose requirement, depending on grade level.
“As varicella incidence continues to decline and vaccination coverage increases, monitoring disease severity, outcomes, and epidemiology among all age groups, including those not targeted for vaccination, remains important,” the researchers concluded.
Disclosure: The researchers report no relevant financial disclosures.
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