The Indiana State Department of Health is currently recruiting physician's offices, schools, and day care centers to become sentinel reporters for the Varicella Disease Sentinel Surveillance System. Sentinel reporting sites will submit data on cases of varicella (chickenpox) to the State Department of Health. Currently in Indiana, only cases resulting in hospitalization and death are required to be reported.
To enroll as a sentinel site, please fill out the Varicella Sentinel Surveillance Enrollment Form and return it to the Epidemiology Resource Center at the Indiana State Department of Health. Once the State Department of Health receives the enrollment form, an acknowledgement letter will be sent to the new sentinel site with blank report forms. Copies of the Varicella Disease Surveillance Monthly Report forms are also available by clicking here.
Sentinel sites may start recording varicella cases on the Varicella Disease Surveillance Monthly Report Form beginning September 2004. Each case should be reported on a separate line on the form. Completed forms should be submitted to the Epidemiology Resource Center at the Indiana State Department of Health by the 10th of the month following the reporting month. (Example: September’s report should be submitted by the 10th of October.)
The Indiana State Department of Health will issue periodic reports. At the close of each monthly reporting period, the State Department of Health will provide copies of completed Varicella Surveillance Monthly Reporting forms back to the local health department in whose jurisdiction they were reported. In addition, the State Department of Health will periodically summarize the data received and provide feedback to providers and local health departments.
Local Health Departments are encouraged to distribute this information and solicit potential reporters for this system.
Varicella in Indiana:
Varicella (chickenpox) vaccine was licensed in the United States in March 1995. In 1996, the Advisory Committee for Immunization Practices (ACIP) recommended routine chickenpox vaccination of infants at 12-18 months of age. In 2003, the national varicella vaccine coverage rate for infants 19-35 months was 83 percent, while Indiana’s rate was 67 percent. According to health officials, both national and state varicella immunization rates continue to rise.
A national surveillance system for monitoring varicella morbidity is lacking, and most states do not have systematic surveillance to evaluate the ongoing impact of vaccination on varicella morbidity. The primary reason for insufficient surveillance is due to the large number of varicella cases during the pre-and early vaccination era, which made individual case reporting not feasible due to limited resources of most states.
Since the implementation of universal immunization of infants in 1996, the disease has declined nearly 80 percent, and the epidemiology of varicella is changing. The Centers for Disease Control and Prevention (CDC) estimates that approximately 25,000 cases of chickenpox still occur in Indiana each year. Indiana’s sentinel surveillance system is being designed to track 5 percent of these, or approximately 1,250 cases, annually.
Currently in Indiana, only cases resulting in hospitalization and death are required to be reported. The Indiana State Department of Health is implementing case-based reporting this year using a form specifically designed for that purpose. Initially it will be a sentinel system with the reporting of only four basic items of information: 1) Age, 2) Disease Onset Date, 3) Vaccination History, and 4) Severity of Disease (based on CDC criteria for number of lesions). Case information received by telephone contact with the patient or family is acceptable for reporting purposes. The Varicella Disease Surveillance Monthly Report form should be used for individual case reporting, The patient does not need to be seen in a physician’s office to be reported.
For additional information on the Varicella Disease Sentinel Surveillance System or on becoming a sentinel reporting site, contact us.