{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,5]],"date-time":"2026-11-05T20:27:40Z","timestamp":1793910460723,"version":"4.8.0"},"reference-count":19,"publisher":"Public Library of Science (PLoS)","issue":"6","license":[{"start":{"date-parts":[[2022,6,30]],"date-time":"2022-06-30T00:00:00Z","timestamp":1656547200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Yangtze River Delta Regional Leading Talents Research Project on Immunization","award":["CSJP032"],"award-info":[{"award-number":["CSJP032"]}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Varicella is a contagious disease caused by varicella-zoster virus and varicella vaccine (VarV) is the most effective way to prevent and control varicella. Despite high VarV coverage there were still varicella outbreaks in schools and kindergartens. We aim to analyze the epidemiological characteristics of varicella outbreaks in Huangpu District, Shanghai, China from 2011 to 2020.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>For varicella outbreaks, case information and vaccination history were collected. Mann\u2013Kendall test and descriptive methods were used to analyzed the trend and epidemiological catachrestic of varicella outbreaks.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 57 varicella outbreaks were reported from 2011 to 2020, including 30 outbreaks (52.6%) in primary schools. The results of the Mann\u2013Kendall trend test (z = 1.97, p = 0.049) showed an upward trend in the number of cases during the study period, but the trend change was not statistically significant. Emergency vaccination was carried out in 42 (73.7%) outbreaks which influenced the duration of the epidemic (F = 4.53, p = 0.0379). A total of 573 varicella cases were reported, including 357 cases (62.3%) who had received at least one dose of varicella vaccine.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The number of varicella outbreaks has not changed significantly in the decade from 2011 to 2020. The strategy of varicella vaccination, the development and application of varicella vaccine, and the control measures after the occurrence of varicella outbreaks need to be optimized. In addition to vaccination, as a disease transmitted by contact, quarantine measures, good personal hygiene, environmental disinfection, and ventilation are also important.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pone.0270630","type":"journal-article","created":{"date-parts":[[2022,6,30]],"date-time":"2022-06-30T16:09:50Z","timestamp":1656605390000},"page":"e0270630","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":22,"title":["Varicella outbreaks in schools and kindergartens in Shanghai, China from 2011 to 2020"],"prefix":"10.1371","volume":"17","author":[{"given":"Jing","family":"Wang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhenhui","family":"Xu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3346-7112","authenticated-orcid":true,"given":"Qiang","family":"Gao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2022,6,30]]},"reference":[{"issue":"3","key":"pone.0270630.ref001","doi-asserted-by":"crossref","first-page":"326","DOI":"10.1016\/j.jiph.2017.09.023","article-title":"Varicella infection in a non-universally vaccinated population: Actual epidemiology in Bulgaria (2013\u20132015)","volume":"11","author":"TT Todorova","year":"2018","journal-title":"J Infect Public Health"},{"issue":"3","key":"pone.0270630.ref002","doi-asserted-by":"crossref","first-page":"645","DOI":"10.1080\/21645515.2018.1546525","article-title":"Global impact of varicella vaccination programs","volume":"15","author":"FH Varela","year":"2019","journal-title":"Hum Vaccin Immunother"},{"issue":"Suppl 1","key":"pone.0270630.ref003","doi-asserted-by":"crossref","first-page":"S27","DOI":"10.1016\/S0163-4453(17)30188-3","article-title":"Is chickenpox so bad, what do we know about immunity to varicella zoster virus, and what does it tell us about the future?","volume":"741","author":"AA Gershon","year":"2017","journal-title":"J Infect."},{"key":"pone.0270630.ref004","doi-asserted-by":"crossref","first-page":"e56","DOI":"10.1017\/S0950268819002188","article-title":"Research about the optimal strategies for prevention and control of varicella outbreak in a school in a central city of China: based on an SEIR dynamic model","volume":"148","author":"WT Zha","year":"2020","journal-title":"Epidemiol Infect"},{"issue":"9","key":"pone.0270630.ref005","first-page":"975","article-title":"Epidemiological characteristics and breakthrough cases of 32 varicella outbreaks in 2017, Jiangsu Province.","volume":"22","author":"L Zhang","year":"2018","journal-title":"Chin J Dis Control Prev"},{"key":"pone.0270630.ref006","doi-asserted-by":"crossref","first-page":"72","DOI":"10.1016\/j.ijid.2019.09.009","article-title":"Varicella outbreak trends in school settings during the voluntary single-dose vaccine era from 2006 to 2017 in Shanghai, China.","volume":"89","author":"QS Wu","year":"2019","journal-title":"Int J Infect Dis"},{"issue":"RR-6","key":"pone.0270630.ref007","first-page":"1","article-title":"Prevention of varicella. Update recommendations of the Advisory Committee on Immunization Practices (ACIP)","volume":"48","year":"1999","journal-title":"MMWR Recomm Rep."},{"issue":"RR-4","key":"pone.0270630.ref008","first-page":"1","article-title":"Prevention of varicella: recommendations of the Advisory Committee on Immunization Practices (ACIP)","volume":"56","author":"M Marin","year":"2007","journal-title":"MMWR Recomm Rep."},{"issue":"2","key":"pone.0270630.ref009","doi-asserted-by":"crossref","first-page":"198","DOI":"10.1016\/j.vaccine.2014.07.068","article-title":"Varicella and herpes zoster vaccines: WHO position paper, June 2014\u2014Recommendations","volume":"34","year":"2016","journal-title":"Vaccine"},{"issue":"1","key":"pone.0270630.ref010","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1016\/S1473-3099(20)30358-3","article-title":"Universal and targeted varicella vaccination","volume":"21","author":"P Bonanni","year":"2021","journal-title":"Lancet Infect Dis"},{"key":"pone.0270630.ref011","doi-asserted-by":"crossref","first-page":"101016","DOI":"10.1016\/j.pmedr.2019.101016","article-title":"Varicella-zoster virus post-exposure management and prophylaxis: A review","volume":"16","author":"AM Lachiewicz","year":"2019","journal-title":"Prev Med Rep."},{"issue":"34","key":"pone.0270630.ref012","doi-asserted-by":"crossref","first-page":"902","DOI":"10.15585\/mmwr.mm6534a4","article-title":"Epidemiology of Varicella During the 2-Dose Varicella Vaccination Program\u2014United States, 2005\u20132014","volume":"65","author":"AS Lopez","year":"2016","journal-title":"MMWR Morb Mortal Wkly Rep"},{"issue":"9","key":"pone.0270630.ref013","doi-asserted-by":"crossref","first-page":"843","DOI":"10.1080\/14760584.2020.1825947","article-title":"Varicella vaccination in Italy and Germany\u2014different routes to success: a systematic review","volume":"19","author":"F Kauffmann","year":"2020","journal-title":"Expert Rev Vaccines."},{"issue":"13","key":"pone.0270630.ref014","doi-asserted-by":"crossref","first-page":"2666","DOI":"10.1017\/S0950268817001546","article-title":"A systematic review of varicella seroprevalence in European countries before universal childhood immunization: deriving incidence from seroprevalence data","volume":"145","author":"K Bollaerts","year":"2017","journal-title":"Epidemiol Infect"},{"issue":"2","key":"pone.0270630.ref015","doi-asserted-by":"crossref","first-page":"122","DOI":"10.1093\/jpids\/piy010","article-title":"Varicella Outbreak Surveillance in Schools in Sentinel Jurisdictions, 2012\u20132015","volume":"8","author":"AS Lopez","year":"2019","journal-title":"J Pediatric Infect Dis Soc"},{"issue":"42","key":"pone.0270630.ref016","doi-asserted-by":"crossref","first-page":"1505","DOI":"10.15585\/mmwr.mm6942a1","article-title":"Vaccination Coverage by Age 24 Months Among Children Born in 2016 and 2017\u2014National Immunization Survey-Child, United States, 2017\u20132019","volume":"69","author":"HA Hill","year":"2020","journal-title":"MMWR Morb Mortal Wkly Rep"},{"issue":"1","key":"pone.0270630.ref017","first-page":"98","article-title":"Clinical characteristics and risk factors of breakthrough varicella in a primary school outbreak of Zunyi city","volume":"27","author":"Y Yang","year":"2021","journal-title":"Chinese Journal of Vaccines and Immunization"},{"issue":"9","key":"pone.0270630.ref018","first-page":"1684","article-title":"Case-control study on the protective effect of varicella vaccine","volume":"202047","author":"JF Jiang","journal-title":"Modern Preventive Medicine"},{"issue":"RR-3","key":"pone.0270630.ref019","first-page":"1","article-title":"Use of combination measles, mumps, rubella, and varicella vaccine: recommendations of the Advisory Committee on Immunization Practices (ACIP)","volume":"59","author":"M Marin","year":"2010","journal-title":"MMWR Recomm Rep."}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0270630","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,6,30]],"date-time":"2022-06-30T16:10:17Z","timestamp":1656605417000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0270630"}},"subtitle":[],"editor":[{"given":"A. K. M. Anisur","family":"Rahman","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2022,6,30]]},"references-count":19,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2022,6,30]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0270630","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,6,30]]}}}