Varicella zoster and fever rash surveillance in Lao People's Democratic Republic.
Adolescent
Adult
Antibodies, Viral
/ blood
Chickenpox
/ diagnosis
Child
Child, Preschool
Dengue
/ epidemiology
Disease Outbreaks
Enzyme-Linked Immunosorbent Assay
Exanthema
/ epidemiology
Female
Fever
/ epidemiology
Herpes Zoster
/ epidemiology
Herpesvirus 3, Human
/ genetics
Humans
Infant
Laos
/ epidemiology
Male
Measles
/ diagnosis
Middle Aged
Rubella
/ diagnosis
Seroepidemiologic Studies
Varicella Zoster Virus Infection
/ epidemiology
Fever-rash
Measles
Serostudy
Surveillance
Varicella
Journal
BMC infectious diseases
ISSN: 1471-2334
Titre abrégé: BMC Infect Dis
Pays: England
ID NLM: 100968551
Informations de publication
Date de publication:
08 May 2019
08 May 2019
Historique:
received:
07
02
2018
accepted:
15
04
2019
entrez:
10
5
2019
pubmed:
10
5
2019
medline:
30
7
2019
Statut:
epublish
Résumé
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. 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). 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. 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.
Sections du résumé
BACKGROUND
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
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
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
CONCLUSIONS
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.
Identifiants
pubmed: 31068140
doi: 10.1186/s12879-019-3990-7
pii: 10.1186/s12879-019-3990-7
pmc: PMC6507166
doi:
Substances chimiques
Antibodies, Viral
0
Types de publication
Journal Article
Langues
eng
Pagination
392Subventions
Organisme : Luxembourg Ministry of Foreign and European Affairs
ID : PARECIDS
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