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J Infect Dis. 2008 Mar 1;197 Suppl 2:S108-13. doi: 10.1086/522138.

Varicella outbreak reporting, response, management, and national surveillance.

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  • 1National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA.


Two national surveys were conducted to evaluate the status of varicella case-based surveillance and outbreak response. Although progress toward national surveillance has been significant, a large number of jurisdictions are still without case-based surveillance. For jurisdictions beginning case-based surveillance with limited resources, a staged approach is recommended. The national outbreak survey showed that a significant number of varicella outbreaks continue to occur. The majority of jurisdictions respond to these outbreaks, although the response varies considerably. Depending on the outbreak-response approach, costs per outbreak ranged from $3000 for a typical, or passive, response to $6000 for a more active response. As varicella surveillance and outbreak control improves, jurisdictions may benefit from more-standardized outbreak-control practices. The recent recommendation by the Advisory Committee on Immunization Practices for a routine second dose of varicella vaccine should lead to better varicella disease control, making case-based surveillance and appropriate outbreak response even more feasible.

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