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A pilot project for case-based reporting of varicella Shannon A. Rowe, MPH Immunization Epidemiologist Ohio Department of Health Bea Burkholder, RN BSN Infectious Disease Control Consultant Ohio Department of Health Background

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a pilot project for case based reporting of varicella

A pilot project for case-based reporting of varicella

Shannon A. Rowe, MPH

Immunization Epidemiologist

Ohio Department of Health

Bea Burkholder, RN BSN

Infectious Disease Control Consultant

Ohio Department of Health

background
Background
  • Vaccination of school-aged children thought to reduce incidence and severity
  • One dose of vaccine at any visit on or after 12 months of age
  • Updated vaccine recommendations include requirements for child care and school entry
vaccine and reporting laws
Vaccine and Reporting Laws
  • Vaccination requirements will be phased in for Ohio children beginning fall, 2006
  • Will need proof of varicella vaccination or disease history
  • January, 2006: case-based reporting of varicella became law in Ohio
  • Varicella is a Class A (3) disease to be reported by the end of the work week
methods
Methods
  • August, 2004 – May, 2005 school year
  • Data collected from 134 school districts in 55 counties across Ohio
  • Information collected:
    • Report date
    • Onset date
    • Birth date
    • Severity of disease
    • Vaccination status
    • Vaccination date
  • Spot Severity:
    • Severity I: < 50 spots within 30 seconds
    • Severity II: 50-500 spots
    • Severity III: > 500 spots
case definition
Case Definition
  • A first occurrence of acute, generalized maculopapulovesicular rash, without other cause (CSTE, 1998), in a school student and at least one of the following:
      • Physician diagnosis of varicella;
      • School nurse diagnosis of varicella; or
      • Parental description consistent with varicella, when clinician examination was absent.
results
Results
  • 1,641 reports of varicella
  • 194 nurses or their representatives from 134 school districts reported
slide9
ODH School Pilot Surveillance Project Percent of Cases by Vaccination Status and Age of OnsetAugust, 2004 – May, 2005
slide10
ODH School Pilot Surveillance ProjectNumber of Cases Reported by Spot SeverityAugust, 2004 – May, 2005
discussion
Discussion
  • 2005 target year for national case-based surveillance
  • Sentinel varicella surveillance acceptable interim measure before establishing statewide surveillance
    • determine the incidence and severity of disease
case based reporting in ohio 2006
Case-based reporting in Ohio, 2006
  • Cases reported via the Ohio Disease Reporting System (web-based system)
  • 342 cases reported in the first two weeks
  • 1,998 cases reported through February 25, 2006
  • Large number of reports attributed to:
    • Reporting began during start of peak season
    • Reporting awareness
    • School outbreaks
conclusions
Conclusions
  • Case-based varicella reporting will be a daunting task for the local and state health departments to manage
  • Time and cooperation to determine logistics
  • More studies are needed to determine vaccine efficacy
acknowledgements
Acknowledgements
  • Thanks to all the school nurses who made this pilot project possible
questions

Questions?

Shannon.Rowe@odh.ohio.gov

Bea.Burkholder@odh.ohio.gov