{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,13]],"date-time":"2026-11-13T04:13:47Z","timestamp":1794543227886,"version":"4.9.1"},"reference-count":17,"publisher":"Cambridge University Press (CUP)","license":[{"start":{"date-parts":[[2020,2,10]],"date-time":"2020-02-10T00:00:00Z","timestamp":1581292800000},"content-version":"unspecified","delay-in-days":40,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-sa\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Epidemiol. Infect."],"published-print":{"date-parts":[[2020]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Chickenpox is caused by varicella-zoster-virus (VZV) and is highly contagious. Immigration detention settings are a high-risk environment for primary VZV transmission, with large, rapidly-changing populations in close quarters, and higher susceptibility among non-UK-born individuals. During outbreaks, operational challenges occur in detention settings because of high-turnover and the potential need to implement population movement restriction for prolonged periods. Between December 2017 and February 2018, four cases of chickenpox were notified amongst 799 detainees in an immigration removal centre (IRC). Microbiological investigations included case confirmation by vesicular fluid polymerase chain reaction, and VZV serology for susceptibility testing. Control measures involved movement restrictions, isolation of cases, quarantining and cohorting of non-immune contacts and extending VZV immunity testing to the wider detainee population to support outbreak management. Immunity was tested for 301\/532 (57%) detainees, of whom 24 (8%) were non-immune. The level of non-immunity was lower than expected based on the existing literature on VZV seroprevalence in detained populations in England. Serology results identified non-immune contacts who could be cohorted and, due to the lack of isolation capacity, allowed the placement of cases with immune detainees. The widespread immunity testing of all detainees was proving challenging to sustain because it required significant resources and was having a severe impact on operational capacity and the ability to maintain core business activities at the IRC. Therefore, mathematical modelling was used to assess the impact of scaling back mass immunity testing. Modelling demonstrated that interrupting testing posed a risk of one additional case compared to continuing with testing. As such, the decision was made to stop testing, and the outbreak was successfully controlled without excessive strain on resources. Operational challenges generated learning for future outbreaks, with implications for a local and national policy on IRC staff occupational health requirements, and proposed reception screening of detainees for VZV immunity.<\/jats:p>","DOI":"10.1017\/s095026882000014x","type":"journal-article","created":{"date-parts":[[2020,2,10]],"date-time":"2020-02-10T09:50:17Z","timestamp":1581328217000},"source":"Crossref","is-referenced-by-count":6,"title":["New approaches to controlling an outbreak of chickenpox in a large immigration detention setting in England: the role of serological testing and mathematical modelling"],"prefix":"10.1017","volume":"148","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6596-4500","authenticated-orcid":false,"given":"Xu-Sheng","family":"Zhang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandra","family":"Smith","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bharat","family":"Patel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charlotte","family":"Anderson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Pomeroy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gillian","family":"Higgins","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"\u00c9amonn","family":"O'Moore","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yimmy","family":"Chow","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christina","family":"Atchison","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2020,2,10]]},"reference":[{"key":"S095026882000014X_ref17","unstructured":"Immigration statistics, year ending June 2018. Available at https:\/\/www.gov.uk\/government\/statistics\/immigration-statistics-year-ending-june-2018."},{"key":"S095026882000014X_ref16","doi-asserted-by":"publisher","DOI":"10.1287\/mnsc.16.8.B466"},{"key":"S095026882000014X_ref15","doi-asserted-by":"publisher","DOI":"10.1038\/35077149"},{"key":"S095026882000014X_ref14","doi-asserted-by":"publisher","DOI":"10.1126\/science.1061020"},{"key":"S095026882000014X_ref12","volume-title":"The Mathematical Theory of Infectious Diseases and its Applications","author":"Bailey","year":"1975"},{"key":"S095026882000014X_ref11","first-page":"651","volume-title":"The Prevention of Malaria","author":"Ross","year":"1911"},{"key":"S095026882000014X_ref8","unstructured":"Government UK. The Detention Centre Rules 2001. Statutory Instrument No. 238 IMMIGRATION. 2nd April 2001. Available at: http:\/\/www.legislation.gov.uk\/uksi\/2001\/238\/introduction\/made."},{"key":"S095026882000014X_ref13","doi-asserted-by":"crossref","DOI":"10.1093\/oso\/9780198545996.001.0001","volume-title":"Infectious Diseases of Humans: Dynamics and Control","author":"Anderson","year":"1991"},{"key":"S095026882000014X_ref5","article-title":"An outbreak of chickenpox in an asylum seeker centre in Italy: outbreak investigation and validity of reported chickenpox history, December 2015\u2013May 2016","volume":"22","author":"Vairo","year":"2017","journal-title":"Euro Surveillance"},{"key":"S095026882000014X_ref3","doi-asserted-by":"publisher","DOI":"10.3109\/00365548.2010.511259"},{"key":"S095026882000014X_ref7","unstructured":"Dapaah E and Perkins S (2011) Prevention of infection and communicable disease control in prisons and places of detention: A manual for healthcare workers. In Health Protection Agency and Department of Health - Offender Health, editor."},{"key":"S095026882000014X_ref2","unstructured":"O'Moore \u00c9 and Howes S (2017) Guidance on Infection Control for Chickenpox and Shingles in Prisons, Immigration Removal Centres and other Prescribed Places of Detention. In: Public Health England. 4th edition ed. London."},{"key":"S095026882000014X_ref1","unstructured":"Public Health England (2015) Varicella: the green book, chapter 34. [cited 11.04.2018]. In: Immunisation against infectious disease [Internet]. [cited 11.04.2018]. Available at https:\/\/www.gov.uk\/government\/publications\/varicella-the-green-book-chapter-34."},{"key":"S095026882000014X_ref6","unstructured":"Ockerman E . Migrant detention centers are getting slammed with mumps and chickenpox. Vice news Jun 14 2019, 7:39pm. Available at https:\/\/www.vice.com\/en_us\/article\/mb8k5q\/migrant-detention-centers-are-getting-slammed-with-mumps-and-chicken-pox."},{"key":"S095026882000014X_ref9","unstructured":"Government UK. Immigration Act 1971. 01 Jan 1973. Available at: http:\/\/www.legislation.gov.uk\/ukpga\/1971\/77\/introduction."},{"key":"S095026882000014X_ref4","doi-asserted-by":"publisher","DOI":"10.1080\/00365540802308449"},{"key":"S095026882000014X_ref10","first-page":"1","article-title":"Essai d'une nouvelle analyse de la mortalit\u00e9 caus\u00e9e par la petite v\u00e9role","volume":"1","author":"Bernoulli","year":"1766","journal-title":"M\u00e9moires de math\u00e9matique et de physique, present\u00e9s \u00e0 l'Acad\u00e9mie royale des sciences, par divers s\u00e7avans and l\u00fbs dans ses assembl\u00e9es"}],"container-title":["Epidemiology and Infection"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S095026882000014X","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,7,31]],"date-time":"2024-07-31T10:43:35Z","timestamp":1722422615000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S095026882000014X\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020]]},"references-count":17,"alternative-id":["S095026882000014X"],"URL":"https:\/\/doi.org\/10.1017\/s095026882000014x","relation":{},"ISSN":["0950-2688","1469-4409"],"issn-type":[{"value":"0950-2688","type":"print"},{"value":"1469-4409","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020]]},"article-number":"e25"}}