{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,5]],"date-time":"2026-11-05T20:27:18Z","timestamp":1793910438775,"version":"4.8.0"},"reference-count":25,"publisher":"Cambridge University Press (CUP)","issue":"10","license":[{"start":{"date-parts":[[2017,4,27]],"date-time":"2017-04-27T00:00:00Z","timestamp":1493251200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":["www.cambridge.org"],"crossmark-restriction":true},"short-container-title":["Epidemiol. Infect."],"published-print":{"date-parts":[[2017,7]]},"abstract":"<jats:title>SUMMARY<\/jats:title>\n                  <jats:p>\n                    The outbreaks of varicella occurring in kindergartens and schools are increasingly notified in Shanghai despite the implementation of one-dose varicella vaccination. We analyzed surveillance data on the notified outbreaks of varicella in Minhang District of Shanghai during 2008\u20132014. A total of 13 511 varicella cases and 154 outbreaks involving 1558 (11\u00b75%) cases were reported. Annual attack rates of outbreak-associated varicella in outbreak classes were 5\u00b75%\u201312%. The mean age of the outbreak-associated cases was 8\u00b76 \u00b1 3\u00b71 years. Among 1558 outbreak cases, 660 (42\u00b74%) received one-dose varicella vaccine previously. The proportions of breakthrough varicella infection during outbreaks ranged from 21\u00b75% in 2008 to 86\u00b71% in 2014. Annual breakthrough infection rates in outbreak classes ranged from 5\u00b74% to 7\u00b74%. Breakthrough cases as index cases results in 9\u00b77% of outbreaks, and the average duration of outbreaks was significantly longer in vaccinated cases as index cases than in unvaccinated cases as index cases (11\u00b73 \u00b1 5\u00b78 days\n                    <jats:italic>vs<\/jats:italic>\n                    . 8\u00b76 \u00b1 6\u00b71 days,\n                    <jats:italic>P<\/jats:italic>\n                    &lt; 0\u00b705). The mean time of breakthrough infection since vaccination was 6\u00b72 \u00b1 2\u00b73 years (range 0\u00b76\u201313\u00b74 years). One-dose varicella vaccination cannot prevent the varicella outbreaks in kindergartens and schools. A second dose of varicella vaccine should be recommended for children.\n                  <\/jats:p>","DOI":"10.1017\/s0950268817000772","type":"journal-article","created":{"date-parts":[[2017,4,27]],"date-time":"2017-04-27T00:35:59Z","timestamp":1493253359000},"page":"2129-2136","update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":30,"title":["Epidemiological characteristics of breakthrough varicella infection during varicella outbreaks in Shanghai, 2008\u20132014"],"prefix":"10.1017","volume":"145","author":[{"given":"Y. F.","family":"ZHU","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Y. F.","family":"LI","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Y.","family":"DU","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"ZENG","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2017,4,27]]},"reference":[{"key":"S0950268817000772_ref10","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa042271"},{"key":"S0950268817000772_ref1","doi-asserted-by":"publisher","DOI":"10.1016\/B978-0-7020-3468-8.50211-X"},{"key":"S0950268817000772_ref15","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/jiq081"},{"key":"S0950268817000772_ref4","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2005-2085"},{"key":"S0950268817000772_ref2","doi-asserted-by":"publisher","DOI":"10.1016\/j.vaccine.2011.01.092"},{"key":"S0950268817000772_ref21","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa021662"},{"key":"S0950268817000772_ref14","first-page":"1","article-title":"Prevention of varicella: recommendations of the Advisory Committee on Immunization Practices (ACIP)","volume":"56","author":"Marin","year":"2007","journal-title":"Morbidity and Mortality Weekly Report Recommendations and Reports"},{"key":"S0950268817000772_ref8","doi-asserted-by":"publisher","DOI":"10.1086\/522145"},{"key":"S0950268817000772_ref16","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/jiq052"},{"key":"S0950268817000772_ref17","doi-asserted-by":"publisher","DOI":"10.1097\/01.inf.0000109287.97518.67"},{"key":"S0950268817000772_ref9","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2004-0012"},{"key":"S0950268817000772_ref6","doi-asserted-by":"publisher","DOI":"10.1016\/j.vaccine.2013.06.075"},{"key":"S0950268817000772_ref5","doi-asserted-by":"publisher","DOI":"10.1016\/j.vaccine.2012.05.072"},{"key":"S0950268817000772_ref18","doi-asserted-by":"publisher","DOI":"10.1017\/S0950268809990860"},{"key":"S0950268817000772_ref7","doi-asserted-by":"publisher","DOI":"10.1053\/j.spid.2004.09.010"},{"key":"S0950268817000772_ref19","doi-asserted-by":"publisher","DOI":"10.1542\/peds.113.3.455"},{"key":"S0950268817000772_ref20","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2004-1826"},{"key":"S0950268817000772_ref23","doi-asserted-by":"publisher","DOI":"10.1016\/j.vaccine.2013.10.060"},{"key":"S0950268817000772_ref24","first-page":"485","article-title":"Effect evaluation of a 2 dose varicella vaccine immunization strategy implemented to control outbreaks in school and kindergarten settings","volume":"49","author":"Suo","year":"2015","journal-title":"Chinese Journal of Preventive Medicine"},{"key":"S0950268817000772_ref25","first-page":"271","article-title":"Genetic characteristics of breakthrough varicella-zoster virus infection during the varicella outbreaks in Minhang District of Shanghai","volume":"36","author":"Lu","year":"2016","journal-title":"Chinese Journal of Microbiology and Immunology"},{"key":"S0950268817000772_ref11","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa064040"},{"key":"S0950268817000772_ref13","first-page":"437","article-title":"An epidemiological investigation on varicella vaccination among children in some areas of Shanghai","volume":"18","author":"Wu","year":"2006","journal-title":"Shanghai Journal of Preventive Medicine"},{"key":"S0950268817000772_ref3","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2012-3303"},{"key":"S0950268817000772_ref22","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijid.2011.03.016"},{"key":"S0950268817000772_ref12","doi-asserted-by":"publisher","DOI":"10.1016\/j.vaccine.2014.04.069"}],"container-title":["Epidemiology and Infection"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S0950268817000772","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2019,8,20]],"date-time":"2019-08-20T08:23:52Z","timestamp":1566289432000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S0950268817000772\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,4,27]]},"references-count":25,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2017,7]]}},"alternative-id":["S0950268817000772"],"URL":"https:\/\/doi.org\/10.1017\/s0950268817000772","relation":{},"ISSN":["0950-2688","1469-4409"],"issn-type":[{"value":"0950-2688","type":"print"},{"value":"1469-4409","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,4,27]]},"assertion":[{"value":"Copyright \u00a9 Cambridge University Press 2017\u00a0","name":"license","label":"License","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}}]}}