Vaccines and Preventable Diseases:

Appendix Files
Strategies for the Control and Investigation of Varicella Outbreaks 2008

 

Appendix A: Sample varicella outbreak reporting worksheet

Sample varicella outbreak reporting worksheet (85 KB/1 page)    
(text-only version) (34 KB/6 pages)

 

Appendix B: Sample exposure letters

Available from the Connecticut Department of Health at: http://ct.gov/dph/lib/dph/ChickenpoxSampleExpLetter.pdf (13KB/1 page) Feb 27, 2008
(text-only version) (10 KB/1 page)

Shingles Exposure at Daycare Sample Exposure Letter (19KB/1 page) June 24, 2008

DRAFT MEMO Example provided by the Connecticut Department of Health To: Parent or Guardian From: Director, Daycare X Subject: Shingles Exposure at Daycare Date: Any Date ___________________________________________________ Dear Parent or Guardian: This letter is to notify you that a case of shingles has been reported at Daycare X and that your child may have been exposed. Shingles is a form of chickenpox (also known as varicella). In about 15-20% of persons who get chickenpox, the virus will remain in their body in a part of a nerve near the spinal cord. As a person becomes older, the virus may become active again and cause a local, painful rash along the path of that nerve. This rash is known as shingles. Because shingles results from an earlier chickenpox infection becoming active again within the person, shingles is not spread from one person to another. However, because the same virus causes shingles and chickenpox, persons with shingles can spread the chickenpox virus. In persons with shingles, the virus is usually transmitted by contact with fluid from the rash. Those persons who have had chickenpox or have received the chickenpox (varicella) vaccine are protected against infection from exposure to shingles. Those persons who have not had chickenpox or have not received the chickenpox (varicella) vaccine are susceptible to infection from exposure to shingles. Susceptible persons develop chickenpox rather than shingles. Though chickenpox is usually a mild disease, it can be more severe in older persons. Daycare X and the Connecticut Department of Health recommend that susceptible individuals contact their regular health care provider to seriously consider getting vaccinated now. Vaccination against chickenpox greatly reduces both the mild and serious risks of chickenpox and future shingles and can also stop the spread of the chickenpox virus to others who are susceptible. A copy of an informational handout from the Connecticut Department of Public Health is included to help answer any questions you may have about chicken pox, shingles, and the chickenpox (varicella) vaccine. For additional information, please call your health care provider. Sincerely,

Appendix C: Sample survey to identify cases of varicella in setting

This survey is to be filled out by parents and/or guardians. The child can return it to his or her teacher.

Sample varicella case investigation form (67 KB/2 pages)   
 (text-only version) (29 KB/4 pages)

Appendix D: Sample letters of notification of varicella outbreak

Available from the Connecticut Department of Health website at: http://ct.gov/dph/lib/dph/ChickenpoxSampleOutbreakLetterPrinciple.pdf (12KB/1 page) Feb 27, 2008
(text-only version) (9 KB/1 page)

Varicella Exposure at Daycare Sample Exposure Letter (19KB/1 page) Feb 27, 2008

Dear parents/guardians, This letter is to notify you that some children attending ______________________ (insert name of school) have contracted chickenpox. Varicella causes an acute illness with a rash that results in children missing days at school while they have a rash and parents missing work when they stay home to take care of their children. Most children now are vaccinated with at least one dose of varicella vaccine but because one dose of the vaccine is 80-85% effective for preventing chickenpox, it is not unusual to see breakthrough disease. Two doses of varicella vaccine are now routinely recommended for children. Background Chickenpox is a very contagious infection caused by a virus. It is spread from person to person by direct contact or through the air from an infected person’s coughing or sneezing. It causes a blister-like rash, itching, tiredness, and fever lasting an average of 4 to 6 days. Most children recover without any problems. Chickenpox can be spread for 1-2 days before the rash starts and until all blisters are crusted or no new lesions appear within a 24-hour period. It takes between 10-21 days after contact with an infected person for someone to develop chickenpox. Chickenpox in vaccinated persons is generally mild, with a shorter duration of illness and fewer than 50 lesions. The rash may be atypical with red bumps and few or no blisters. What should you do? __________________ ( insert name of health department ) strongly encourages you to have your child receive their first or second dose of varicella vaccine if your child has not been vaccinated and has never had chickenpox. For children who had received 1 dose, a second dose is recommended. If your child or anyone in your household currently has symptoms that look like chickenpox: Contact your regular health care provider to discuss your child's symptoms and to see if anyone in the home needs to be vaccinated. Contact the school nurse to report your child's chickenpox. Anyone who has chickenpox should avoid contact with others who have not had chickenpox or who are not vaccinated against chickenpox. They should not attend school, day care, work, parties and/or other gatherings until the blisters become crusted (about 4-6 days after rash appears), or no new lesions appear within a 24-hours period. Keep all chickenpox spots and blisters and other wounds clean and watch for possible signs of infection; including increasing redness, swelling, drainage and pain at the wound site. If you or anyone else in your household has a weakened immune system or is pregnant and has never had chickenpox or the vaccine, talk with your doctor immediately. Controlling the Outbreak __________________ (insert name of health department) is working with the school to implement prevention strategies. It is now recommended that children with one dose of varicella vaccine receive a second dose routinely. If your child does develop chickenpox, he/she should be kept from attending school until the rash has crusted over. We are also trying to learn more about why children develop chickenpox and how we can best prevent this disease. In the attached questionnaire, we ask a few questions about your child and whether or not he/she has had chickenpox or received the varicella vaccine. Please complete and return the questionnaire as soon as possible. If you have any further questions or concerns, you can contact (insert name of contact person) or call (insert contact phone number).

Appendix E: Sample varicella case investigation form

Sample varicella case investigation form (112 KB/5 pages)   
 (text-only version) (112 KB/5 pages)

Appendix F: Useful formulas for the investigation of varicella outbreaks

Useful formulas for the investigation of varicella outbreaks. Includes:

1. varicella vaccination coverage
2. attack rate calculations
3. vaccine effectiveness calculations

Useful formulas for investigation of outbreaks (70KB/1 page)   
 (text-only version) (18KB/1 page)

Appendix G: Sample of varicella surveillance worksheet

Available from the CDC vaccines website at: http://www.cdc.gov/vaccines/vpd-vac/varicella/downloads/varicella_surv_wksht.pdf (227KB/3 pages)  
 (text-only version) (136KB/10 pages)

 

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