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BMC Infect Dis. 2019 May 8;19(1):392. doi: 10.1186/s12879-019-3990-7.

Varicella zoster and fever rash surveillance in Lao People's Democratic Republic.

Author information

1
Institut Pasteur du Laos, Vientiane, Lao People's Democratic Republic.
2
Department of Infection and Immunity, Luxembourg Institute of Health, 29, rue Henri Koch, L-4354, Esch-sur-Alzette, Grand Duchy of Luxembourg.
3
Children's Hospital, Vientiane, Lao People's Democratic Republic.
4
Arbovirus and Emerging Viral diseases Laboratory, Institut Pasteur du Laos, Vientiane, Lao People's Democratic Republic.
5
Institut Pasteur du Laos, Vientiane, Lao People's Democratic Republic. claude.muller@lih.lu.
6
Department of Infection and Immunity, Luxembourg Institute of Health, 29, rue Henri Koch, L-4354, Esch-sur-Alzette, Grand Duchy of Luxembourg. claude.muller@lih.lu.
7
Laboratoire National de Santé, Dudelange, Luxembourg. claude.muller@lih.lu.

Abstract

BACKGROUND:

In Lao PDR, the epidemiology of varicella infection is uncertain, since it is not a notifiable disease and VZV outbreaks are rarely reported as fever/rash (F/R) diseases.

METHODS:

We estimated the seroprevalence of VZV (IgG ELISA) in different age cohorts (9 months to 46 years; N = 3139) and investigated VZV and 6 other viruses in patients during F/R outbreaks and in an ad hoc sentinel site in the context of the national reporting system (IgM ELISA, PCR).

RESULTS:

At least 80% of the sampled population had evidence of VZV infection before the age of 15. The largest increase in seroprevalence occurred between the age groups 1 to 5 and 6 to 7 year-olds. A VZV outbreak (clade 2) also occurred in this age group mostly during the first year of primary school (median age 6 years, interquartile range 4.0-7.5). During a dengue outbreak, 6% had varicella. At our F/R sentinel site, 14% of children with viral etiology were laboratory diagnosed as varicella and among others, a sizeable number of measles (N = 12) and rubella cases (N = 25) was detected compared to those reported for the whole country (N = 56 and 45), highlighting nationwide a large challenge of underreporting or misdiagnosis of these notifiable diseases because of lack of diagnostic laboratory capacity.

CONCLUSION:

We recommend strengthening the clinical and laboratory diagnosis of VZV, measles and rubella, the surveillance and reporting of notifiable F/R diseases by retraining of healthcare workers and by setting up sentinel sites and enhancing laboratory capacity.

KEYWORDS:

Fever-rash; Measles; Serostudy; Surveillance; Varicella

PMID:
31068140
PMCID:
PMC6507166
DOI:
10.1186/s12879-019-3990-7
[Indexed for MEDLINE]
Free PMC Article

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