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Epidemiol Infect. 2014 May;142(5):1002-7. doi: 10.1017/S095026881300174X. Epub 2013 Jul 26.

Varicella zoster virus in American Samoa: seroprevalence and predictive value of varicella disease history in elementary and college students.

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National Center for Immunization and Respiratory Diseases, Centers for Diseases Control and Prevention, Atlanta, GA, USA.
Immunization Program, American Samoa Department of Health, LBJ Tropical Medical Center, Pago Pago, American Samoa, USA.
National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Diseases Control and Prevention, Atlanta, GA, USA.
Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, GA, USA.
National Center for Injury Prevention and Control, Centers for Diseases Control and Prevention, Atlanta, GA, USA.


The epidemiology of varicella is believed to differ between temperate and tropical countries. We conducted a varicella seroprevalence study in elementary and college students in the US territory of American Samoa before introduction of a routine varicella vaccination programme. Sera from 515 elementary and 208 college students were tested for the presence of varicella-zoster virus (VZV) IgG antibodies. VZV seroprevalence increased with age from 76·0% in the 4-6 years group to 97·7% in those aged ⩾23 years. Reported history of varicella disease for elementary students was significantly associated with VZV seropositivity. The positive and negative predictive values of varicella disease history were 93·4% and 36·4%, respectively, in elementary students and 97·6% and 3·0%, respectively, in college students. VZV seroprevalence in this Pacific island appears to be similar to that in temperate countries and suggests endemic VZV circulation.

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