Assessment of Varicella Surveillance and Outbreak Control Practices — United States, 2012

Case-based varicella (chickenpox) surveillance is important for monitoring the impact of the varicella vaccination program. In 2002, the Council of State and Territorial Epidemiologists (CSTE) recommended that all states move toward case-based varicella surveillance by 2005; in 2003, varicella was made nationally notifiable. To ease the transition to case-based reporting, CSTE and CDC recommended starting with sentinel site or outbreak surveillance and then moving to statewide case-based surveillance when feasible. To gauge progress in varicella surveillance, in 2012 CDC and CSTE developed a survey for assessing varicella surveillance practices, which CSTE administered to all states and the District of Columbia (DC). As of 2012, varicella was reportable in 44 (86.3%) of the 51 jurisdictions surveyed, of which 37 (84.1%) conduct statewide case-based surveillance. Of the 38 jurisdictions conducting statewide or sentinel site varicella case-based surveillance, more than 84% reported collecting information on age, sex, and race/ethnicity (all 97.4%), vaccination status (94.7%), outbreak association (86.8%), and disease severity (84.2%). Nineteen (43.2%) of the 44 jurisdictions where reporting was mandated transmitted varicella-specific data to CDC using Health Level 7 (HL7) messaging. Currently, HL7 messaging is the only mechanism available for states to send varicella-specific data to CDC. Although public health agencies have made much progress to strengthen varicella surveillance throughout the United States, strategies are needed to facilitate transmission of varicella-specific data to CDC from all jurisdictions, using HL7 messaging, and to increase the number of jurisdictions collecting the varicella-specific data necessary to monitor varicella epidemiology and the impact of the vaccination program nationally.