Officials now required to report chicken pox cases

Public health department monitoring disease to determine need for vaccine


Colorado hospitals, laboratories and public health agencies will be required to report cases of chicken pox to the state health department as part of an effort to monitor disease trends in the vaccination era.

Mandatory reporting of varicella, or chicken pox, will begin Friday, according to an order issued by the Colorado Department of Public Health and Environment. Also added to the list of reportable diseases were Severe Acute Respiratory Syndrome (SARS) and smallpox.

"The one that surprised me was chicken pox, which could lead us to be pretty busy," said Susan Bowler, public health nurse manager for the Northwest Colorado Visiting Nurse Association. Varicella must be reported to the state health department within seven days of its discovery. SARS and smallpox must be reported within 24 hours.

The diseases join a list of more than 50 conditions that must be reported.

Bowler said the VNA usually begins seeing cases of chicken pox in spring, or toward the end of winter.

The common childhood disease is spread through the air, by coughing or sneezing, or by contact with fluid from chicken pox blisters. According to the state health department, 12,000 people are hospitalized for chicken pox in the United States each year.

Despite a lax attitude many parents hold regarding chicken pox, Bowler said the disease can lead to severe complications and even death. If pregnant women contract the disease, it can lead to a fetal mortality rate as high as 30 percent, Bowler said.

"Yeah, a lot of kids get it and don't have problems," Bowler said. "When it's your child who has complications, it's no longer just a routine childhood illness."

The disease is communicable one to two days before a rash appears, making it difficult to control an outbreak. By the time a child shows blisters, he or she may have infected numerous classmates or family members.

Vaccination for varicella has been mandatory for several years for children entering school. Children in daycare, along with kindergarten through third-grade students must be vaccinated before attending school.

"It's one of the required immunizations in Colorado," Bower said. "We were offering it even before it was required."

The vaccine was licensed for use in the United States beginning in 1995, although the vaccine had been used in Japan for decades, Bowler said.

The move to require agencies to report varicella cases was made in part to monitor "disease trends in the vaccine era," according to the state health department. The data collected may guide future immunization policy. The department estimates the vaccine has reduced incidence of the disease by as much as 80 percent.

Unlike most afflictions on the state's list of reportable diseases, chicken pox does not need to be confirmed by laboratory test results. A clinical diagnosis based on symptoms alone is sufficient for a report to be generated.

"It's a rash illness," Bowler said. "A mother may say it is chicken pox, but I'm gonna want verbal confirmation from a doctor."

Jeremy Browning can be reached at 824-7031 or

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