Georgia Uses Emergency Department Data to Strengthen Case-Based Surveillance of Varicella (Chickenpox)

Gril with thermometer in mouth and hand on forehead close crop

Public Health Problem

Syndromic surveillance is an essential part of a comprehensive public health surveillance system because of its versatility. Not only can syndromic surveillance be used for early detection of emerging health threats, but it can also enhance routine reporting of notifiable diseases. Public health analysts often use emergency department data to collect suspect case reports. Although traditional and syndromic surveillance reporting methods collect data differently, they can be used in tandem to monitor for disease and injury that affect public health.

Actions Taken

The Georgia Department of Public Health (GDPH) conducts case-based surveillance for notifiable conditions, including vaccine preventable diseases (for details, visit the GDPH webpage: Analysts at GDPH use syndromic surveillance to strengthen case-based surveillance of varicella (chickenpox), as reported in Public Health Reports. They used syndromic data from visits to urgent care centers and emergency departments that mentioned “varicella” or “chickenpox” in the discharge diagnosis to identify suspect varicella reports. Then they assessed the accuracy of all reporting sources, including laboratories, health care providers, and schools. They compared features of varicella reported through syndromic surveillance of automated electronic emergency department data to varicella reported through other sources.


Early intervention is key to preventing others from getting the disease, and Georgia’s results showed that patients identified through emergency department data were detected early, compared with other reporting sources. Among the reporting sources assessed, syndromic data ranked second highest in detecting varicella cases, and these patients were much less likely to be associated with an outbreak. Public health departments are finding that other reportable conditions can also be detected early using syndromic surveillance.

Public Health Reports: Syndromic Surveillance as a Tool for Case-Based Varicella Reporting in Georgia, 2016–2019

What Does CDC Say About Chickenpox?

Chickenpox is a highly contagious disease caused by the varicella-zoster virus1 that can cause an itchy, blistering rash and a fever.2 If one person has it, up to 90% of the people close to that person who are not immune will also become infected. 1 Chickenpox can be serious, even life-threatening, especially in babies, adolescents, adults, pregnant women, and people with weakened immune systems.2 It is one of many diseases that public health departments monitor to protect the health of people in their communities.

Getting vaccinated is the best way to prevent chickenpox. Children should get one chickenpox vaccination when they are 12 months old and another when they are 4 years old. Healthy people 13 years and older who have never had chickenpox or been vaccinated should get two doses of the chickenpox vaccine four to eight weeks apart.


René Borroto
Syndromic Surveillance Epidemiologist and Program Coordinator
Georgia Department of Public Health

Centers for Disease Control and Prevention
Office of Public Health Data, Surveillance, and Technology
Division of Health Informatics and Surveillance

This success story shows how NSSP

  • Improves Data Representativeness.
  • Strengthens Syndromic Surveillance Practice.
  • Improves data quality timeliness and use.
  • Informs public health action or response.

The findings and outcomes described in this syndromic success story are those of the authors and do not necessarily represent the official position of the National Syndromic Surveillance Program or the Centers for Disease Control and Prevention.