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VACCINE PREVENTABLE DISEASE SECTION Reporting All Cases of Varicella All cases of varicella (chickenpox) are required to be reported to the Minnesota Department of Health (MDH). Why is case-based reporting of varicella important? What is the clinical presentation of varicella? Case-based reporting of varicella provides the data needed to assess the changing epidemiology of varicella and evaluate the effectiveness of current immunization strategies. It also provides greater opportunity to implement exposure follow-up for high-risk contacts and outbreak control measures. The CDC case definition for varicella is: an illness with acute onset of diffuse (generalized) maculopapulovesicular rash without other apparent cause. Which varicella cases should be reported? ▪ Clinically diagnosed cases (without laboratory confirmation) seen by a provider in a health care setting, ▪ Clinically diagnosed cases based on symptoms relayed by phone to the provider by the patient or parent/guardian, and ▪ Laboratory-confirmed cases. It is important to report all of the above cases so that MDH can adequately assess the incidence of varicella. Cases not seen by a provider but diagnosed by phone are thought to currently represent a large proportion of total cases. MDH will collect data on how the case was diagnosed, as well as differentiate phone diagnosed cases from those that are seen by a provider and/or are laboratory confirmed. Vaccinated ("breakthrough") cases may have a milder and atypical clinical presentation, with macules and papules but few or no vesicles. Will reported varicella cases be entered into MIIC? Cases that meet the clinical case definition and are confirmed by laboratory testing will be entered into the Minnesota Immunization Information Connection (MIIC) by MDH staff. This documentation may subsequently be used as evidence of immunity to varicella. Upon provider request, clinically diagnosed cases that meet the CDC case definition but are not confirmed by laboratory testing will be entered into MIIC by MDH. How should cases be reported? Cases may be reported through any available method for reporting communicable diseases, including: ▪ Varicella Reporting Form (www.health.state.mn.us/divs/idepc/dtopic s/reportable/forms/varicellaform.html) ▪ Phone: 651-201-5414 or 1-877-676-5414 (12/2016) Page 1 of 2 REPORTING ALL CASES OF VARICELLA ▪ Fax: 651-201-4820 (for vaccine-preventable diseases) or 651-201-5743 (for all reportable diseases) ▪ Mail (please mark the envelope “confidential”): Infectious Disease, Epidemiology, Prevention and Control 625 North Robert St. PO Box 64975 St. Paul, MN 55164 Varicella cases should be reported within one working day (Monday through Friday) so that public health interventions may be implemented in a timely manner. Why can’t providers rely on laboratories to report varicella cases? Provider reporting is needed because: ▪ Laboratory testing does not distinguish varicella (chickenpox) from zoster (shingles). ▪ False negative results may occur, especially in mild cases of breakthrough disease (in fully- or partially-vaccinated cases). ▪ Currently, laboratory testing is not performed on all varicella cases. It is important to report cases that are not laboratory-confirmed to determine the true incidence of varicella. Minnesota Department of Health Vaccine Preventable Disease Section PO Box 64975, St. Paul, MN 55164 651-201-5414 or 1-877-676-5414 www.health.state.mn.us/immunize To obtain this information in a different format, call: 651-201-5414 (12/2016) Page 2 of 2