Varicella zoster and fever rash surveillance in Lao People's Democratic Republic.

Abstract:

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: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: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: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.

journal_name

BMC Infect Dis

journal_title

BMC infectious diseases

authors

Nouanthong P,Hübschen JM,Billamay S,Mongkhoune S,Vilivong K,Khounvisith V,Sinner R,Grandadam M,Phonekeo D,Black AP,Muller CP

doi

10.1186/s12879-019-3990-7

subject

Has Abstract

pub_date

2019-05-08 00:00:00

pages

392

issue

1

issn

1471-2334

pii

10.1186/s12879-019-3990-7

journal_volume

19

pub_type

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