http://www.medscape.com/viewarticle/457183?WebLogicSession=Pv59w6XB2bbvGYz6aZ5t7Lf7ANv81XMPEeJmfZ9IZJUh6bhJWiMr|-7445435953090347069/184161392/6/7001/7001/7002/7002/7001/-1

By Megan Rauscher

NEW YORK (Reuters Health) Jun 12 - Officials at the Centers for Disease Control and Prevention are concerned that deaths due to varicella infection continue to occur in the U.S., despite the availability of a varicella vaccine since 1995.

Preventing varicella-related deaths is a "public health priority," Dr. Mona Marin of the CDC's National Immunization Program said in a telephone interview with Reuters Health. "Varicella is a vaccine-preventable disease and we encourage physicians to use the vaccine because it was proven safe and effective in outbreak investigations."

In the June 13th issue of the Morbidity and Mortality Weekly Report, the CDC describes two of nine fatal cases of varicella--one in an adult and one in a child--reported to CDC during 2002. "Both patients were susceptible, unvaccinated, and exposed to unvaccinated children [with varicella]" Dr. Marin said. Both patients were previously healthy.

Importantly, Dr. Marin said, there continues to be "substantial underreporting" of varicella-related deaths, despite a mandate in 1999 that such deaths be reported to the National Immunization Program. "We don't really know exactly how many varicella-related deaths are occurring. There may be many more," she said.

For example, according to data from the National Center for Health Statistics for the year 2000, varicella was listed as the primary cause of death on 44 death certificates from 23 states and the District of Columbia, but only 9 (20%) were reported to the CDC.

These varicella-related deaths emphasize the importance of implementing recommended strategies for varicella disease prevention, including routine administration of varicella vaccine at 12 to 18 months of age and to older susceptible children, teens and adults. The vaccine should also be administered upon exposure to varicella in susceptible persons.

In addition, Dr. Marin told Reuters Health, the CDC is "trying to implement school requirements for immunity to varicella either by having had varicella or being vaccinated. This will decrease virus circulation."

MMWR 2003;52:545-547.

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