title: [Chickenpox case estimation in acyclovir pharmacy survey and early bioterrorism detection].
abstract: OBJECTIVE
  Early potential health hazards and bioterrorism threats require early detection. Smallpox cases caused by terrorist could, for example, be treated by prescribing acyclovir to those having fever and vesicle exanthema diagnosed as chicken pox. We have constructed real-time pharmacy surveillance scenarios using information technology (IT) to monitor acyclovir prescription.
  
  
  METHODS
  We collected the number of acyclovir prescriptions from 5138 pharmacies using the Application Server Provider System (ASP) to estimate the number of cases. We then compared the number of those given acyclovir under 15 years old from pharmacy surveillance and sentinel surveillance for chickenpox under the Infection Disease Control Law.
  
  
  RESULTS
  The estimated number of under 15 years old prescribed acyclovir in pharmacy surveillance resembled sentinel surveillance results and showed a similar seasonal chickenpox pattern. The correlation coefficient was 0.8575. The estimated numbers of adults, older than 15 but under 65 years old, and elderly, older than 65, prescribed acyclovir showed no clear seasonal pattern.
  
  
  CONCLUSIONS
  Pharmacy surveillance for acyclovir identified the baseline and can be used to detect unusual chickenpox outbreak. Bioterrorism attack could potentially be detected using smallpox virus when acyclovir prescription for adults suddenly increases without outbreaks in children or the elderly. This acyclovir prescription monitoring such as an application is, to our knowledge, the first of its kind anywhre.
authors.affiliation: Infectious Disease Surveillance Center, National Institute of Infectious Diseases.
authors.forename: Tamie
authors.initials: T
authors.lastname: Sugawara
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Ohkusa
authors.forename: Hirokazu
authors.initials: H
authors.lastname: Kawanohara
authors.forename: Kiyosu
authors.initials: K
authors.lastname: Taniguchi
authors.forename: Nobuhiko
authors.initials: N
authors.lastname: Okabe
mesh_terms: D000212:Acyclovir / Q000627:therapeutic use*; D000293:Adolescent; D000328:Adult; D000368:Aged; D000998:Antiviral Agents / Q000627:therapeutic use*; D023482:Bioterrorism; D002644:Chickenpox / Q000453:epidemiology*; D003625:Data Collection; D004363:Drug Utilization; D006801:Humans; D008875:Middle Aged; D055656:Prescriptions / Q000706:statistics & numerical data; D012621:Seasons
chemical_list: D000998:Antiviral Agents; D000212:Acyclovir