{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T15:21:02Z","timestamp":1786116062821,"version":"build-2736575974"},"reference-count":16,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T00:00:00Z","timestamp":1785715200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Public Health Rep"],"abstract":"<jats:p>An updated varicella case definition and classification from the Council of State and Territorial Epidemiologists became effective in 2024, emphasizing laboratory confirmation by requiring that confirmed cases be laboratory confirmed or epidemiologically linked to a laboratory-confirmed case, in addition to meeting clinical criteria. We assessed the impact of the changes using varicella reports in Minnesota from January 1, 2024, through May 31, 2025. Of 737 reports, 61.2% (n\u2009=\u2009451) met the new definition and 61.9% (n\u2009=\u2009456) met the old definition; 12.1% (n\u2009=\u200989) changed classifications. The proportion of cases classified as confirmed decreased by 17.5%, while those classified as probable increased by 28.0%; changes were primarily driven by the requirement to link reports to a laboratory-confirmed case. Reports not classified (ie, undefined; 26.9%; n\u2009=\u2009198) mostly lacked rash descriptions. The updated definition improves jurisdictions\u2019 ability to classify cases accurately, thus strengthening national surveillance by reflecting current varicella epidemiology. Improved reporting of rash description, epidemiologic information, and increased laboratory testing are needed to improve surveillance.<\/jats:p>","DOI":"10.1177\/00333549261463482","type":"journal-article","created":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T05:27:11Z","timestamp":1785821231000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Impact of the 2024 Council of State and Territorial Epidemiologists\u2019 Varicella Case Definition and Classification on Varicella Cases Reported in Minnesota"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7105-7424","authenticated-orcid":false,"given":"Gail","family":"Gustavson","sequence":"first","affiliation":[{"name":"Division of Infectious Disease Epidemiology, Prevention, and Control, Minnesota Department of Health, Saint Paul, MN, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9705-0511","authenticated-orcid":false,"given":"Mona","family":"Marin","sequence":"additional","affiliation":[{"name":"Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sif","family":"Nave","sequence":"additional","affiliation":[{"name":"Division of Infectious Disease Epidemiology, Prevention, and Control, Minnesota Department of Health, Saint Paul, MN, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5164-7555","authenticated-orcid":false,"given":"Jessica","family":"Leung","sequence":"additional","affiliation":[{"name":"Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0441-293X","authenticated-orcid":false,"given":"Cynthia","family":"Kenyon","sequence":"additional","affiliation":[{"name":"Division of Infectious Disease Epidemiology, Prevention, and Control, Minnesota Department of Health, Saint Paul, MN, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,8,3]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/jiac251"},{"issue":"36","key":"e_1_3_3_3_2","first-page":"785","article-title":"Assessment of varicella surveillance and outbreak control practices\u2014United States, 2012","volume":"63","author":"Lopez AS","year":"2014","unstructured":"Lopez AS, Lichtenstein M, Schmid SD, Bialek S. Assessment of varicella surveillance and outbreak control practices\u2014United States, 2012. MMWR Morb Mortal Wkly Rep. 2014;63(36):785-788.","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1086\/522150"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1128\/CMR.00031-09"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/jiac390"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm7311a3"},{"key":"e_1_3_3_8_2","unstructured":"Council of State and Territorial Epidemiologists. CSTE position statements. 2026. Accessed March 10 2026. https:\/\/www.cste.org\/page\/PSLanding"},{"key":"e_1_3_3_9_2","unstructured":"Council of State and Territorial Epidemiologists. Update to public health reporting and national notification of varicella. 2024. Accessed January 19 2024. https:\/\/cdn.ymaws.com\/www.cste.org\/resource\/resmgr\/ps\/ps_2023\/23-ID-09_Varicella.pdf"},{"key":"e_1_3_3_10_2","unstructured":"Council of State and Territorial Epidemiologists. Public health reporting and national notification for varicella. 2009. Accessed January 19 2024. https:\/\/cdn.ymaws.com\/www.cste.org\/resource\/resmgr\/PS\/09-ID-68.pdf"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/jiac221"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/jiac363"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1086\/653113"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinthera.2019.06.009"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/jis207"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/jis214"},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/158.1.238"}],"container-title":["Public Health Reports\u00ae"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/00333549261463482","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/00333549261463482","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/00333549261463482","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,6]],"date-time":"2026-08-06T07:17:35Z","timestamp":1786000655000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/00333549261463482"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,3]]},"references-count":16,"alternative-id":["10.1177\/00333549261463482"],"URL":"https:\/\/doi.org\/10.1177\/00333549261463482","relation":{},"ISSN":["0033-3549","1468-2877"],"issn-type":[{"value":"0033-3549","type":"print"},{"value":"1468-2877","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,3]]},"article-number":"00333549261463482"}}