Varicella (Chickenpox) outbreak in Bhutanese refugee camps in Eastern Nepal
Bibliographic record
Abstract
Background: Approximately 100,000 Bhutanese refugees live in seven camps in southeastern Nepal. For those offered resettlement to the USA, Canada, Australia, New Zealand, Denmark, Norway, or Netherlands, the International Organization for Migration (IOM) in Nepal conducts medical screening and arranges travel, moving up to 15,000 refugees annually. Varicella spreads primarily by airborne droplets and patients with infectious varicella are prohibited from the air travel. Varicella vaccine in Nepal is not licensed. In March 2009, an outbreak of varicella was detected at a refugee transit center (TC). Outbreak response was conducted jointly by UNHCR, IOM, and Association of Medical Doctors of Asia (AMDA), implementing partner for refugee camp health services. Methods: A varicella case was defined as an illness with acute onset of diffuse papulovesicular rash without other apparent cause. Refugees received additional health education regarding signs and symptoms of varicella and importance of limiting contacts with sick people. Prior to travel, medical staff screened departing refugees for fever and conducted careful skin inspection. For cases with imminent travel, cases and their family were deferred from travel or travel-related screening for 21 days. Refugees identified with varicella in TC were isolated until lesions crusted. Results: From 25 February to 25 May 2009, 473 cases of Varicella were registered (cumulative incidence 50 per 10,000 refugees). Among the seven camps, incidence ranged from 9 per 10,000 to 124 per 10,000; outbreak duration ranged from 37 to 87 days. The age ranged from 01 month to 30 years, mean 6.5 years. The incidence was the highest among children of 0-4 years (242 per 10,000), and decreased with each successive age group. Eight cases and their families (total 21 refugees) were deferred from travel for 21 days. 14 refugees and their families (total 63 refugees) were deferred from travel-related screening. 3,860 refugees departed during the outbreak period to United States. No refugees were reported to develop varicella during the flight or upon arrival to the final destination. Conclusion: In a setting with endemic varicella transmission, systematic surveillance, combined with isolation of cases, likely decreased transmission and prevented travel related outbreaks of varicella. Abstracts for SupplementInternational Journal of Infectious DiseasesVol. 14Preview Full-Text PDF Open Archive
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.002 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".