An outbreak investigation of adolescent varicella in a dhamma school, Bangkok Yai District, Bangkok, Thailand, August–October 2019

Authors

  • Chanatip Chailek Field Epidemiology Training Program (FETP), Division of Epidemiology, Department of Disease Control
  • Patcharaporn Dejburum Field Epidemiology Training Program (FETP), Division of Epidemiology, Department of Disease Control
  • Suphanat Wongsanuphat Field Epidemiology Training Program (FETP), Division of Epidemiology, Department of Disease Control
  • Thanawadee Chantian Division of Epidemiology, Department of Disease Control, Ministry of Public Health

Keywords:

varicella, chickenpox, novice, Dhamma school, Bangkok

Abstract

Background: In August 2019, the Division of Epidemiology was notified a cluster of varicella among novices and monks in a Dhamma school in temple M, Bangkok. We conducted an outbreak investigation in the school to confirm the diagnosis and the outbreak, describe epidemiological characteristics, identify risk factors associated with the outbreak, and provide recommendations and control measures.
Methods: We conducted active case finding by interviewing cases and screening all novices and monks in the temple. A suspected case was defined as novices/monks with generalized and multiple stages of macular, vesicular rashes, or crusts from 26 June to 12 November 2019. Confirmed cases were suspected cases who had at least one of the confirmed laboratory tests either Tzanck smear or varicella IgM. A retrospective cohort study was conducted by recruiting novices and monks who stayed in dormitory 6A. Factors associated with the outbreak were collected and analyzed by multiple logistic regression. We also observed activities, behaviors, and environments.
Results: Of 426 novices and monks, forty–one cases (9.6%) met case definition. The median age was 13 years old (IQR 1 year). Eleven cases (26.8%) had a history of past infection. None of the case got vaccination. The attack rate by the dormitory showed the highest in the 6A (33%). The first case was sick on 6 August 2019 and periodically increased during 9–13 September. Only one specimen (12.5%) was positive on Tzanck smear. All four specimens were positive on varicella IgM. The factors associated with the outbreak were a history of varicella infection (Adjusted OR 0.32, 95% CI 0.12–0.90) and doing laundry with washing machine (Adjusted OR 0.35, 95% CI 0.13– 0.91). Some sick novices still played with their friends and did not wash their hands before eating.
Discussion and conclusion: The varicella outbreak in a Dhamma was confirmed. The transmission occurred mainly among novices/monks who stayed in the same dormitory. None of the novices/monks got vaccination. Early case detection and isolation were implemented. Varicella vaccination could be a prerequisite for the next academic year.

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Published

2021-05-21

How to Cite

Chailek, C., Dejburum, P., Wongsanuphat, S., & Chantian, T. (2021). An outbreak investigation of adolescent varicella in a dhamma school, Bangkok Yai District, Bangkok, Thailand, August–October 2019. Weekly Epidemiological Surveillance Report, 52(19), 269–277. retrieved from https://he05.tci-thaijo.org/index.php/WESR/article/view/1735

Issue

Vol. 52 No. 19 (2021): 19th Week

Section

Original article

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