An outbreak of mumps in Sweden, February-April 2004.
ABSTRACT Between 24 February and 26 April 2004, Västra Götaland county in Sweden reported 42 cases of suspected mumps. A descriptive study of the cases was undertaken. A questionnaire was administered by telephone and vaccine effectiveness was calculated using the screening method. Seventy four per cent (31/42) of the suspected cases were interviewed by telephone. Eight out of the 42 serum samples were positive or equivocal for mumps IgM by ELISA. Mumps virus genome was identified in 21/42 (50%) saliva samples. Eleven were selected for sequencing and all were confirmed to be mumps virus. Cases were predominantly from 2 small towns. Eighteen out of 19 cases that developed bilateral swelling could be linked to one small town. The median age of interviewed cases was 43 years (range 5 to 88). Six cases were admitted to hospital, 5 of which were older than 30 years. The highest incidence occurred in the 35 to 44 years age group. Vaccine effectiveness was estimated to be 65% for 1 dose and 91% for 2 doses. This descriptive study shows the increasing age of mumps cases with increasing vaccine coverage. Vaccine effectiveness was particularly high for 2 doses. Second-dose uptake must be ensured, as primary vaccine failure is well documented in mumps. Stronger precautions must be taken to avoid pools of susceptible older individuals accumulating due to the increased risk of complications.
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ABSTRACT: Mumps is caused by the mumps virus (MuV), a member of the Paramyxoviridae family of enveloped, non-segmented, negative sense RNA viruses. Mumps is characterized by painful inflammatory symptoms, such as parotitis and orchitis. The virus is highly neurotropic with laboratory evidence of central nervous system (CNS) infection in approximately half of cases. Symptomatic CNS infection occurs less frequently; nonetheless, prior to the introduction of routine vaccination, MuV was a leading cause of aseptic meningitis and viral encephalitis in many developed countries. Despite being one of the oldest recognized diseases with a worldwide distribution, surprisingly little attention has been given to its study. Cases of aseptic meningitis associated with some vaccine strains and a global resurgence of cases, including in highly vaccinated populations, has renewed interest in the virus, particularly in its pathogenesis and the need for development of clinically-relevant models of disease. In this review we summarize the current state of knowledge on the virus, its pathogenesis, and its clinical and pathological outcomes.The Journal of Pathology 09/2014; 235(2). DOI:10.1002/path.4445 · 7.33 Impact Factor
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ABSTRACT: In 2009-2010, we investigated a mumps outbreak among a highly vaccinated Orthodox Jewish population in a village in Orange County (OC), New York, to identify risk factors associated with mumps transmission among persons with two doses of mumps-containing vaccine. Demographic and epidemiologic characteristics were collected on students in grades 6-12 in three schools. A mumps case was defined as a student, who self-reported parotitis, orchitis, jaw swelling, and/or a mumps-related complication or whose mumps illness was reported to the OC Health Department during September 1, 2009-January 18, 2010. Log-binomial regression analyses were conducted separately for boys and girls as they attended different schools and had different hours of study. Of the 2503 students with two documented doses of mumps-containing vaccine, 320 (13%) developed mumps. Risk of mumps increased with increasing number of mumps cases in the class [≥8versus ≤3 cases: boys aRR=3.1 (95% CI: 2.0-5.0); girls aRR=2.6 (95% CI: 1.6-4.1)] and household [>1 versus 0 cases: boys aRR=4.3 (95%CI: 3.7-5.6); girls aRR=10.1 (95%CI: 7.1-14.3)]. Age at first dose, time since last dose, time between first and second dose, school, class size, number of hours at school per week, and household size were not significantly associated with having mumps. Two doses of mumps-containing vaccine may not be as effective in outbreak settings with multiple, prolonged, and intense exposure. Additional studies are required to understand why such mumps outbreaks occur and how they can be prevented in the future.The Pediatric Infectious Disease Journal 08/2013; 33(2). DOI:10.1097/INF.0000000000000020 · 3.14 Impact Factor
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ABSTRACT: Although mumps-containing vaccines were introduced in China in 1990s, mumps continues to be a public health concern due to the lack of decline in reported mumps cases. To assess the mumps vaccine effectiveness (VE) in Guangzhou, China, we performed a 1:1 matched case-control study. Among children in Guangzhou aged 8 mo to 12 y during 2006 to 2012, we matched one healthy child to each child with clinically diagnosed mumps. Cases with clinically diagnosed mumps were identified from surveillance sites system and healthy controls were randomly sampled from the Children's Expanded Programmed Immunization Administrative Computerized System in Guangzhou. Conditional logistic regression was used to calculate VE. We analyzed the vaccination information for 1983 mumps case subjects and 1983 matched controls and found that the overall VE for 1 dose of mumps vaccine, irrespective of the manufacture, was 53.6% (95% confidence interval [CI], 41.0-63.5%) to children aged 8 mo to 12 y. This post-marketing mumps VE study found that immunization with one dose of the mumps vaccine confers partial protection against mumps disease. Evaluation of the VE for the current mumps vaccines, introduction of a second dose of mumps vaccine, and assessment of modifications to childhood immunization schedules is essential.Human Vaccines & Immunotherapeutics 08/2013; 9(12). DOI:10.4161/hv.26113 · 3.64 Impact Factor