Mumps epidemic in Portugal despite high vaccine coverage - preliminary report

Dias, José Alberto Caram de Souza; Cordeiro, Marli Tenório; Afzal, M.A.; Freitas, Maria Graça; Morgado, Mariana; Silva, J. L.; Nunes, Luciana; Lima, M. G.; Avilez, F

doi:10.2807/esm.01.04.00160-en

Cited by 29 publications

(15 citation statements)

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“…Substantial numbers of cases occurred in children of 1 to 4 years of age in kindergartens, schools, and other child care facilities and at least 40-60% of these had a history of mumps vaccination [Dias et al, 1996].…”

Section: Discussionmentioning

confidence: 99%

“…However, sporadic mumps outbreaks are reported even in countries which are known to have an excellent record of vaccine coverage [Briss et al, 1994;Kü nkel et al, 1994;Ströhle et al, 1996;Dias et al, 1996]. In order to distinguish whether the recent outbreak in Portugal was caused by endemic European strains or by imported genotypes, clinical specimens derived from patients were characterised by RT-PCR, nested PCR, and nucleotide sequencing.…”

Section: Introductionmentioning

confidence: 99%

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RT-PCR based diagnosis and molecular characterisation of mumps viruses derived from clinical specimens collected during the 1996 mumps outbreak in Portugal

Afzal¹,

Buchanan²,

Dias³

et al. 1997

J. Med. Virol.

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Clinical specimens collected during an outbreak of mumps were characterised by RT-PCR, nested PCR, and nucleotide sequencing. Mumps virus was positively identified in 12/21(57%) saliva, 9/21(43%), throat and 1/33(3%) urine specimens and further sequence comparison revealed that at least six strains of viruses, which differed from 0-9.43% at the nucleotide levels, were cocirculating during the epidemic. However, phylogenetic analysis showed that these viruses grouped with two previously identified lineages which were mostly composed of other European mumps virus isolates.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

RT-PCR based diagnosis and molecular characterisation of mumps viruses derived from clinical specimens collected during the 1996 mumps outbreak in Portugal

Afzal¹,

Buchanan²,

Dias³

et al. 1997

J. Med. Virol.

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“…In Italy, where until recently the Rubini strain was commonly used, modelled sero-conversion rates were very low -approximately 60 % [12]. The Rubini strain has been shown not to offer good protection against the disease [25,26], and the use of this strain in the MMR vaccine, as well as the poor vaccine coverage, may have contributed to the low mumps virus antibody positivity observed.…”

Section: Discussionmentioning

confidence: 99%

Sero-epidemiology of mumps in western Europe

Nardone¹,

Pebody²,

Hof

et al. 2003

Epidemiol. Infect.

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SUMMARYSix countries (Denmark, England and Wales, France, Germany, Italy and the Netherlands) conducted large serological surveys for mumps, in the mid-1990s, as part of the European Sero-Epidemiology Network (ESEN). The assay results were standardized and related to the schedules and coverage of the immunization programmes and the reported incidence of mumps. Low incidence of disease and few susceptibles amongst adolescents and young adults was observed in countries with high mumps vaccine coverage (e.g. the Netherlands). High disease incidence and large proportions of mumps virus antibody negative samples in adolescent and young adult age groups was noted in countries with poor vaccine coverage (e.g. Italy). The build-up of susceptibles in older children and adolescents in England and Wales, France, the former West Germany and Italy indicate the possibility of further mumps outbreaks in secondary school environments. To control mumps in western Europe, current MMR immunization programmes will need to be strengthened in a number of countries. Sero-surveillance of mumps is an important component of disease control and its usefulness will be enhanced by the development of an international mumps standard.

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“…In Portugal, MMR coverage of children aged 12-23 months has been >90% since 1991; despite this, a large mumps epidemic occurred in 1995-96 with the highest incidence among children aged 1-4 years. A plot of the number of cases according to their probable month and year of vaccination showed that there was a large increase in mumps incidence among children vaccinated after October 1992, which corresponded to the date when Portugal began to use the Rubini strain of mumps vaccine exclusively (63).…”

Section: Immunogenicity Efficacy and Safetymentioning

confidence: 99%

“…The number of reported mumps cases decreased from 2197 in 1987 to 627 in 1993. Subsequently, the country experienced a large epidemic, with 1841 mumps cases in 1995 and 7620 cases in the first 8 months of 1996 (63). Epidemiological investigations suggest the outbreak may have been related to exclusive use of Rubini strain vaccine since October 1992.…”

Section: European Regionmentioning

confidence: 99%