United States: Chickenpox outbreak reported in California

In the United States, two chickenpox outbreaks were reported in South Carolina in early March 2022: The first was reported on March 4 in the Lowcountry at a child care facility. The second was reported March 10 at an Upstate elementary school.
These two chickenpox outbreaks and a drop in childhood vaccination rates are prompting South Carolina health officials to encourage parents and health care providers to keep children up to date on their vaccinations.

Chickenpox memories:

Chickenpox is a common, highly contagious skin rash in childhood. It is caused by infection with the varicella virus, called VZV for varicella zona virus. It affects children in more than 90% of cases and is mostly benign. The adult forms are rarer but more severe.
The varicella-zoster virus is transmitted by the respiratory tract through contact with an infectious patient with chickenpox.

After about two weeks of incubation, a low-grade fever occurs, followed by a rash consisting of patches and blisters that are clear and then cloudy. These lesions appear all over the body (face, chest, abdomen, etc.) and turn into scabs before disappearing.

  • In children, serious complications are exceptional and healing occurs spontaneously without treatment in about ten days.
  • Complications that warrant special precautions are possible in pregnant women and newborns. The same applies to immunocompromised people who should avoid contact with a child with chickenpox.

Although this condition is not usually serious, it often causes children and their parents to miss school and work. Most cases of chickenpox in healthy children are treated with bed rest, fluid intake, and fever control.

These cases allow us to recall the French recommendations :

A generalized varicella vaccination of children from 12 months of age is not recommended from a public health perspective.

It is recommended for:

  • Adolescents aged 12 to 18 years with no clinical history of varicella or whose history is questionable; in this case, a previous serological test can be carried out;
  • Women of childbearing potential, particularly those with a projected pregnancy and without a clinical history of chickenpox; previous serological tests can be carried out;
  • Women with no clinical history of chickenpox (or whose history is doubtful) after a first pregnancy;
  • Adolescents 12 years and older and adults who have been exposed to varicella and are immunocompetent with no history of varicella or whose history is questionable (serological testing is optional), within 3 days of contact with a patient with a rash;
  • any person with no history of chickenpox (or whose history is doubtful) and whose serology is negative, who is in close contact with immunocompromised individuals (vaccinated individuals must be informed that in case of a general rash, contact with immunocompromised individuals must be avoided 10 days);
  • Transplant awaiting individuals, in the 6 months prior to organ transplantation, with no history of chickenpox (or whose history is equivocal) and whose serology is negative (post-transplant antibody monitoring is recommended).

Vaccination against chickenpox is contraindicated during pregnancy. Pregnancy should be avoided within one month after vaccination. Newly vaccinated women planning a pregnancy should be advised to postpone planning by one month.

Recommendations or contraindications to vaccination against chickenpox in immunocompromised or asplenic individuals are the subject of specific charts.

These general recommendations are supplemented by recommendations on where to vaccinate against chickenpox for chickenpox (vaccination recommendation within 3 days of exposure to a case of chickenpox or shingles for any immunocompetent person 12 years of age or older (excluding pregnant women) with no history). of chickenpox and no prior vaccination against chickenpox]and in certain professional contexts (professionals in contact with early childhood and health professionals).

Recommendations for travelers:

There is no specific recommendation. Staying in an epidemic area may not be advisable for unvaccinated adults, immunocompromised people, pregnant women or newborns.
The vaccination against chickenpox consists of two doses with an interval of at least one month between the 1st and 2nd dose, depending on the vaccine used and the age, a longer interval may be recommended.

Source : outbreak news today.

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