International Journal of Infectious Diseases
Volume 15, Issue 10, 2011, Pages e716-e721

Comparison of two strategies to prevent varicella outbreaks in housing facilities for asylum seekers (Article) (Open Access)

de Valliere S.* , Cani N. , Grossenbacher M. , Puig F. , Masserey E. , Bodenmann P.
  • a Department of Ambulatory Care and Community Medicine, University Hospital of Lausanne, Av du Bugnon 44, 1011 Lausanne, Switzerland
  • b Department of Ambulatory Care and Community Medicine, University Hospital of Lausanne, Av du Bugnon 44, 1011 Lausanne, Switzerland
  • c Department of Ambulatory Care and Community Medicine, University Hospital of Lausanne, Av du Bugnon 44, 1011 Lausanne, Switzerland
  • d Department of Ambulatory Care and Community Medicine, University Hospital of Lausanne, Av du Bugnon 44, 1011 Lausanne, Switzerland
  • e Public Health Department, Canton of Vaud, Switzerland
  • f Department of Ambulatory Care and Community Medicine, University Hospital of Lausanne, Av du Bugnon 44, 1011 Lausanne, Switzerland

Abstract

Background: The proportion of adults with positive varicella serology is lower in populations from tropical countries. Therefore immigrants to countries with a temperate climate are at risk of acquiring varicella infection during adulthood. Methods: We tested two different strategies to prevent varicella outbreaks in housing facilities for asylum seekers arriving in the Canton of Vaud, Switzerland. The first strategy consisted of a rapid response with isolation of the affected individuals and vaccination of the susceptible contacts. The second strategy consisted of a general vaccination upon arrival of all asylum seekers aged 15-39 years with no history of chickenpox. Results: From May 2008 to January 2009 we applied the rapid response strategy. Eight hundred and fifty-eight asylum seekers arrived in the Canton and an attack rate of 2.8% (seven cases among 248 exposed asylum seekers) was observed. The mean cost was US$ 31.35 per asylum seeker. The general vaccination strategy was applied from February 2009 to May 2010, a period during which 966 asylum seekers were registered. This second strategy completely prevented any outbreak at a mean cost of US$ 83.85 per asylum seeker. Conclusions: Of the two analyzed interventions to prevent varicella outbreaks in housing facilities for asylum seekers, the general vaccination strategy was more effective, more sustainable, and ethically preferable, although more costly. © 2011 International Society for Infectious Diseases.

Author Keywords

prevention Asylum seeker Varicella outbreak

Index Keywords

comparative effectiveness Herpesvirus 3, Human occupational disease human social isolation Refugees Patient Isolation chickenpox intermethod comparison Young Adult health care cost Humans Adolescent male varicella zoster vaccine female Child, Preschool Disease Outbreaks Article epidemic infection control mass immunization adult medical history vaccination herpes zoster Switzerland Child
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-80053234591&doi=10.1016%2fj.ijid.2011.06.001&partnerID=40&md5=086675753f7c34acdf6121ad1936f153
DOI: 10.1016/j.ijid.2011.06.001
ISSN: 12019712
Cited by: 14
Original Language: English