Varicella (Chickenpox) outbreak in Bhutanese refugee camps in Eastern Nepal

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.