MMWR Morb Mortal Wkly Rep. 2014 Sep 12;63(36):785-8.
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.
基于病例的水痘(带状疱疹)监测对于监测水痘疫苗接种计划的影响很重要。2002 年,州和地区流行病学家理事会(CSTE)建议所有州在 2005 年前实现基于病例的水痘监测;2003 年,水痘被全国通报。为了顺利过渡到基于病例的报告,CSTE 和 CDC 建议从哨点或暴发监测开始,然后在可行的情况下转向全州基于病例的监测。为了评估水痘监测的进展,2012 年 CDC 和 CSTE 制定了一项评估水痘监测实践的调查,CSTE 将其分发给所有州和哥伦比亚特区(DC)。截至 2012 年,在接受调查的 51 个管辖区中,有 44 个(86.3%)报告了水痘病例,其中 37 个(84.1%)开展全州范围的基于病例的监测。在开展全州或哨点基于病例的水痘监测的 38 个管辖区中,超过 84%的管辖区报告了收集有关年龄、性别和种族/族裔(均为 97.4%)、疫苗接种状况(94.7%)、暴发关联(86.8%)和疾病严重程度(84.2%)的信息。在需要报告的 44 个管辖区中,有 19 个(43.2%)通过 HL7 消息向 CDC 传输了特定于水痘的数据。目前,HL7 消息传递是各州向 CDC 发送特定于水痘的数据的唯一机制。尽管公共卫生机构在美国各地加强了水痘监测方面取得了很大进展,但仍需要制定策略,通过 HL7 消息传递,从所有管辖区向 CDC 传输特定于水痘的数据,并增加收集必要的水痘特定数据的管辖区数量,以监测水痘流行病学和疫苗接种计划在全国范围内的影响。