The epidemiology of varicella cases among children in Beijing's Fengtai District from 2008 to 2012

Zhao, Xue; Yu, Yuncui; Zhang, Jie; Huang, Shengtian; Wang, Zhongzhan; Zhang, Jianjun; Yan, Yuxiang; Liu, Fen; Zhao, Jingjing; He, Yan

doi:10.1016/j.vaccine.2014.04.069

Cited by 16 publications

(15 citation statements)

References 12 publications

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“…This study found that the vaccination coverage rate of healthy children in Jiangsu Province was low (43.1%), and it was lower than the estimated coverage rate of varicella in Jiangsu Province’s vaccine management system (approximately 55–65%). The overall antibody positive rate (43.5%) and antibody GMC (225.4 mU/ ml) were lower than those reported in relevant studies in Beijing city and Shanghai city [ 14 – 16 ]. According to several clinical trial and observational studies in the domestic and foreign literature, relatively low vaccination rates and sero-conversion rates will lead to an increase in varicella outbreaks [ 17 – 19 ].…”

Section: Discussioncontrasting

confidence: 66%

Analysis of sero-epidemiological characteristics of varicella in healthy children in Jiangsu Province, China

Zhang

Liu

et al. 2018

BMC Infect Dis

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BackgroundIn recent years, outbreaks of varicella have continued to occur, and the coverage rate of varicella vaccine in Jiangsu Province, China, remains unclear. This study aims to analyse the levels of immune antibody against varicella and obtain a comprehensive understanding of the varicella attenuated live vaccine (VarV) coverage rate in children aged 1–9 years in Jiangsu Province.MethodsFrom June to October 2016, a cross-sectional survey was conducted to collect 3631 serum samples from healthy children aged 1–9 years in Jiangsu Province. The immunoglobulin G (IgG) antibody levels of varicella were detected by enzyme-linked immunosorbent assay (ELISA).ResultsThe VarV coverage rate of healthy children was only 43.1% (95% CI: 41.1–44.7%). The seroprevalence after vaccination with a single dose of VarV was only 57.1%, and the overall seropositivity and geometric antibody titre (GMC) were 43.5% and 225.4 mU/ml, respectively. The seropositivity was significantly higher in girls than in boys (χ2 = 18.82, P < 0.001). The difference in seropositivity between the 5–9 age group and 1–4 age group was statistically significant (χ2 = 84.31, P < 0.001). The difference in seropositivity between different regions was statistically significant, with the highest seropositivity in the northern area, 53.7% (χ2 = 35.64, P < 0.001). The seropositivity in the group receiving one dose of VarV was significantly higher than that of the unvaccinated group (χ2 = 205.16, P < 0.001). Linear regression analysis suggested that the GMC of varicella antibodies wanes with the time since vaccination (F = 65.01, P = 0.002).ConclusionThe VarV coverage rate of healthy children in Jiangsu Province was low. Sero-conversion rates were also low after one dose of VarV, and the immune effectiveness of a single dose of VarV was limited. To control the spread of varicella, VarV should be included in the routine immunization program, and strengthened immunization measures for the varicella-susceptible population warrant additional consideration.

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Section: Discussioncontrasting

confidence: 66%

Analysis of sero-epidemiological characteristics of varicella in healthy children in Jiangsu Province, China

Zhang

Liu

et al. 2018

BMC Infect Dis

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“…This study found that the proportion of BV cases among all outbreak-related cases was 56.5%, higher than the results of a population-based survey (22%) (Chaves et al, 2008), but within the range of several outbreak-based studies (42-76%) (Leung et al, 2015;Zhang et al, 2014b;Zhu et al, 2017). It was also found that the proportion of BV cases showed an increasing trend from 30.4% in 2008 to 85.7% in 2017.…”

Section: Discussioncontrasting

confidence: 40%

Varicella outbreak trends in school settings during the voluntary single-dose vaccine era from 2006 to 2017 in Shanghai, China

Xian

Liu

et al. 2019

International Journal of Infectious Diseases

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To investigate varicella outbreak trends among schoolchildren during the voluntary singledose varicella vaccine (VarV) era in Shanghai, China. Methods: Trends in school varicella outbreaks from 2006 to 2017 were assessed using joinpoint regression models. The impacts of changes in single-dose VarV coverage among schoolchildren and implementation of post-exposure prophylaxis (PEP) strategies on outbreak trends were further analyzed. Results: In total, 265 varicella outbreaks involving 3263 cases were reported in Shanghai from 2006 to 2017. The number of outbreaks showed an increasing trend from 2006 to 2017 (t = 2.62, p = 0.026), especially in kindergartens. The proportion of breakthrough varicella cases among all outbreak-related cases showed an increasing trend from 30.4% in 2008 to 85.7% in 2017 (t = 7.45, p < 0.001). Single-dose VarV coverage among schoolchildren was 88.1%, and showed a significant increase from the 1996 to the 2008 birth cohorts, followed by a non-significant decline from the 2008 to the 2014 birth cohorts. During school outbreaks in which PEP campaigns were conducted, the varicella attack rate was significantly lower than those in outbreaks without PEP campaigns (1.2% vs. 1.4%; Chi-square = 23.35, p < 0.001). Conclusions: Even with high coverage, single-dose VarV is insufficient to prevent school outbreaks. The administration of VarV as PEP is an appropriate intervention for varicella outbreak control prior to implementing a two-dose VarV schedule.

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“…Among 1558 outbreak-associated cases, 660 (42•4%) were breakthrough cases who had received one dose of varicella vaccine at age >1 year and 898 (57•6%) were unvaccinated. The ratios of male-female were 1 [12]. These epidemiological studies raise our awareness of varicella breakthrough infection after one-dose childhood varicella vaccination and highlight that one-dose varicella vaccine does not prevent outbreaks in kindergartens and schools even in highly vaccinated school children.…”

Section: Characteristics Of Breakthrough Varicella During Outbreaksmentioning

confidence: 77%

Epidemiological characteristics of breakthrough varicella infection during varicella outbreaks in Shanghai, 2008–2014

Zhu

et al. 2017

Epidemiol. Infect.

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The outbreaks of varicella occurring in kindergartens and schools are increasingly notified in Shanghai despite the implementation of one-dose varicella vaccination. We analyzed surveillance data on the notified outbreaks of varicella in Minhang District of Shanghai during 2008-2014. A total of 13 511 varicella cases and 154 outbreaks involving 1558 (11·5%) cases were reported. Annual attack rates of outbreak-associated varicella in outbreak classes were 5·5%-12%. The mean age of the outbreak-associated cases was 8·6 ± 3·1 years. Among 1558 outbreak cases, 660 (42·4%) received one-dose varicella vaccine previously. The proportions of breakthrough varicella infection during outbreaks ranged from 21·5% in 2008 to 86·1% in 2014. Annual breakthrough infection rates in outbreak classes ranged from 5·4% to 7·4%. Breakthrough cases as index cases results in 9·7% of outbreaks, and the average duration of outbreaks was significantly longer in vaccinated cases as index cases than in unvaccinated cases as index cases (11·3 ± 5·8 days vs. 8·6 ± 6·1 days, P < 0·05). The mean time of breakthrough infection since vaccination was 6·2 ± 2·3 years (range 0·6-13·4 years). One-dose varicella vaccination cannot prevent the varicella outbreaks in kindergartens and schools. A second dose of varicella vaccine should be recommended for children.

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The epidemiology of varicella cases among children in Beijing's Fengtai District from 2008 to 2012

Cited by 16 publications

References 12 publications

Analysis of sero-epidemiological characteristics of varicella in healthy children in Jiangsu Province, China

Analysis of sero-epidemiological characteristics of varicella in healthy children in Jiangsu Province, China

Varicella outbreak trends in school settings during the voluntary single-dose vaccine era from 2006 to 2017 in Shanghai, China

Epidemiological characteristics of breakthrough varicella infection during varicella outbreaks in Shanghai, 2008–2014

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