ARRA-317-Varicella Active Surveillance Project

自1994年以来，洛杉矶县卫生服务部的急性传染病控制中心通过其在加利福尼亚州羚羊谷的水痘主动监测项目(VASP)与疾控中心合作。我们建议继续积极监测水痘和带状疱疹，并将该项目扩展到圣克拉里塔市，将人口增加到500,000人以上。我们计划保持对水痘和HZ的积极监测，标准化病例核实，完成病例报告，记录水痘疫苗使用情况，并继续监测数据评估。 从1994年至今，VASP与其他水痘监测研究地点在各种流行病学项目中进行了合作。我们计划进行两个应用流行病学研究项目。第一个项目将评估对易感水痘的学生进行主动现场水痘疫苗接种与一旦第一例水痘确诊后将儿童转介至其医疗提供者的标准做法是否会减少后续水痘病例的数量。第二个项目将利用ICD-9出院代码来分析1992-2007年间带状疱疹的住院情况，前8个出院诊断以ICD-9代码表示。我们将回顾医疗图表，并分析水痘疫苗广泛使用前后的发病率趋势。 此外，我们正在申请进行轮状病毒感染(RVI)的监测。我们将利用现有的VASP基础设施，并在整个AV和圣克拉里塔市开发RVI主动监视地点。我们将在主动监测点建立每两周一次的RVI数据收集，并将确定诊所、急诊室和住院环境中RVI的发病率。我们将通过使用ICD-9出院诊断代码计算医院和急诊室的RVI腹泻发病率来评估我们的系统。当新的轮状病毒疫苗Rotashield发布时，我们将衡量疫苗的使用情况及其对RVI发病率的影响。

Since 1994 the County of Los Angeles Department of Health Services' Acute Communicable Disease Control has collaborated with CDC through its Varicella Active Surveillance Project (VASP) in Antelope Valley, CA. We propose to continue varicella and herpes zoster (HZ) active surveillance and extend the project to the city of Santa Clarita to increase the population to over 500,000. We plan to maintain active surveillance for both varicella and HZ, standardize case verification, complete case reports, document varicella vaccine usage, and continue surveillance data evaluation. VASP has collaborated with other varicella surveillance study sites in various epidemiological projects from 1994-present. We plan to conduct two applied epidemiologic research projects. The first project will evaluate if proactive on-site school varicella vaccination of susceptible students versus the standard practiceof referring children to their medical provider once the first varicella case is confirmed will decrease number of subsequent varicella cases. The second project will analyze zoster hospitalizations from 1992-2007, utilizing ICD-9 discharge codes denoted with the first 8 hospital discharge diagnoses. We will review medical charts and analyze HZ rates for incidence trends pre- and post-widespread varicella vaccine usage. Additionally, we are applying to conduct surveillance for rotavirus infection (RVI). We will utilize the existing VASP infrastructure and develop sites for RVI active surveillance throughout AV and the city of Santa Clarita. We will establish biweekly RVI data collection at active surveillance sites and will determine the incidence of RVI in clinic, emergency room, and inpatient settings. We will evaluate our system by calculating incidence of diarrhea due to RVI in hospital and emergency room utilizing ICD-9 discharge diagnosis codes for diarrhea due to RVI. When the new RV vaccine, Rotashield, is released, we will measure vaccine usage and its impact on RVI incidence.