Varicella surveillance practices--United States, 2004.

Varicella became a reportable disease in the United States in 1972, with states reporting weekly aggregate data to the National Notifiable Disease Surveillance System (NNDSS). In 1981, varicella reporting was removed from the national notifiable diseases list because reporting of this common disease was becoming a burden in the absence of a vaccine. This action was followed by additional changes in varicella surveillance practices. In 1995, varicella vaccine was licensed and added to the routine childhood vaccination schedule. In 2002, the Council of State and Territorial Epidemiologists (CSTE) recommended that varicella casebased surveillance be implemented in all states by 2005; in 2003, varicella again was added to the national notifiable diseases list to allow for monitoring of the effect of varicella vaccine on varicella incidence. In 2004, to assess the progress in varicella surveillance in the United States, CDC surveyed immunization program managers in selected public health jurisdictions. This report describes the results of that survey, which indicated that substantial progress has been made toward the implementation of case-based surveillance as recommended by CSTE in 2002. As of 2004, however, 28 jurisdictions still had not implemented case-based surveillance. To monitor the effect of the vaccination program on the changing epidemiology of varicella disease, every state should now be conducting case-based surveillance for varicella. This is particularly important in light of the 2006 recommendation by the Advisory Committee on Immunization Practices for a routine second dose of varicella vaccine for children aged 4-6 years because enhanced surveillance is needed to further monitor varicella epidemiology.