Risk Factors for Transmission of Mumps in a Highly Vaccinated Population in Orange County, NY, 2009–2010

Kutty, Preeta K.; McLean, Huong Q.; Lawler, Jacqueline; Schulte, Cynthia; Hudson, Jean M.; Blog, Debra; Wallace, Gregory S.

doi:10.1097/inf.0000000000000020

Cited by 26 publications

(20 citation statements)

References 31 publications

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“…Similar studies also reported that mumps outbreaks among highly vaccinated populations tended to occur in highdensity settings such as universities and schools, with teenagers as the most vulnerable group. 8,10,[14][15][16]18,19 These findings indicate that among highly vaccinated populations, despite herd immunity, intense exposures to one or more mumps cases may increase the risk of transmission, even in the most recently vaccinated children. It is possible that such risk factors may overcome vaccine-induced immunity resulting in persistence of transmission of the disease.…”

Section: Discussionmentioning

confidence: 87%

“…[12][13][14][15][16] Between October 2012 and March 2013, 148 cases of mumps were notified in the Central Region of Portugal to the Regional Health Administration. In contrast, there was no evidence of outbreaks elsewhere in the country between 2009 and 2012.…”

Section: Discussionmentioning

confidence: 99%

“…17 From 2012 no official data was published. As done by others, [12][13][14][15][16] we used a case definition adapted from the European Community Case Definitions for Communicable Diseases, 9 contemplating the existence of possible cases of mumps without fever. The disease may present without fever or asymptomatic, especially in patients with some degree of immunity.…”

Section: Discussionmentioning

confidence: 99%

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Mumps Outbreak among Highly Vaccinated Teenagers and Children in the Central Region of Portugal, 2012-2013

et al. 2015

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Results: Over six months, 148 outbreak-related cases were reported: 87.8% occurred in three of the 16 affected counties and 78.4% had a known epidemiological link. Median age was 14.5 years (2-62) and 70.3% were 11-20 years old; 61.5% were male. The mean duration of disease was seven days (2-20). The disease was generally mild; 80.4% had fever and in 55.4% there was unilateral involvement of the parotid gland. Seven cases had orchitis, one oophoritis and one had nephritis. Two cases were hospitalized. School transmission predominated and class attack rates were < 30%. Most of the cases occurred in vaccinated individuals (92%) of whom 86.8% had received 2 doses; 17.7% had received one dose of the vaccine containing the Rubini strain. Mumps virus genotype G was identified in 4 cases. Discussion: This mumps outbreak among a highly vaccinated population, occurring mostly in teenagers at school, could be due to the partial effectiveness of the vaccine against the disease (particularly in the group vaccinated with Rubini strain), waning immunity overtime and genotype mismatch.Conclusions: This outbreak report shows the importance of discussion about the need of more booster dose of the actual vaccine or new vaccine including more genotypes to improve immunogenicity.

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Section: Discussionmentioning

confidence: 87%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Mumps Outbreak among Highly Vaccinated Teenagers and Children in the Central Region of Portugal, 2012-2013

et al. 2015

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“…In the OC village, the larger household size in general and high-density settings such as schools may have resulted in transmission of mumps. 27 In previously reported studies crowded educational settings such as schools, universities, and camps, have played an important role in transmission of mumps. 5,[28][29][30][31][32][33] No evidence has suggested that other factors such as handling changes and vaccine lots were risk factors for vaccine failure.…”

Section: Discussionmentioning

confidence: 99%

Epidemiology and the economic assessment of a mumps outbreak in a highly vaccinated population, Orange County, New York, 2009–2010

Kutty

Lawler

Rausch‐Phung

et al. 2014

Human Vaccines & Immunotherapeutics

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“…Outbreaks among unvaccinated groups are easily explained, but, interestingly, there have been several reports of outbreaks among highly immunized groups (1)(2)(3)(4), some of which included cases of patients previously immunized with two doses of the measles-mumps-rubella (MMR) vaccine (2,(4)(5)(6)(7)(8). In light of the high efficacy of the MMR vaccine against mumps, the reason for these outbreaks is unclear.…”

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confidence: 99%

Challenges in Interpretation of Diagnostic Test Results in a Mumps Outbreak in a Highly Vaccinated Population

Trotz-Williams

Mercer

Paphitis

et al. 2017

Clin Vaccine Immunol

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In spite of a greatly reduced incidence rate due to vaccination, mumps outbreaks continue to occur in several areas of the world, sometimes in vaccinated populations. This article describes an outbreak in a highly vaccinated population in southwestern Ontario, Canada, and the challenges encountered in interpreting the results of diagnostic tests used in the outbreak. During the outbreak, patients were interviewed and classified according to the outbreak case definition, and specimens were collected for diagnostic testing according to Ontario guidelines. Twentyseven individuals were classified as confirmed cases (n ϭ 19) or suspect cases (n ϭ 8) according to the case definition, only 9 of which were laboratory-confirmed cases: 7 confirmed by reverse transcriptase PCR (RT-PCR) and 2 by IgM serology. All 19 confirmed cases represented patients who were associated with secondary schools in the local area and had been vaccinated against mumps with one (n ϭ 2) or two (n ϭ 17) doses of the measles-mumps-rubella (MMR) vaccine. This is the first published report of an outbreak of mumps in Ontario in which all confirmed cases had been vaccinated against the disease. It highlights the limitations of and difficulties in interpreting current mumps diagnostic tests when used in vaccinated individuals.

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Risk Factors for Transmission of Mumps in a Highly Vaccinated Population in Orange County, NY, 2009–2010

Abstract: 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.

Cited by 26 publications

References 31 publications

Mumps Outbreak among Highly Vaccinated Teenagers and Children in the Central Region of Portugal, 2012-2013

Mumps Outbreak among Highly Vaccinated Teenagers and Children in the Central Region of Portugal, 2012-2013

Epidemiology and the economic assessment of a mumps outbreak in a highly vaccinated population, Orange County, New York, 2009–2010

Challenges in Interpretation of Diagnostic Test Results in a Mumps Outbreak in a Highly Vaccinated Population

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