Symptomatic mumps virus reinfections

Abstract

Although natural mumps virus infection is believed to induce lifelong immunity, our laboratory was confronted with 82 patients who developed mumps-evoking lesions but exhibited serological evidence of a booster immune response, namely a rise or a high titer of virus-specific IgG, without IgM. In order to provide arguments favoring the existence of recurrent mumps attacks, the age, symptomatology, and humoral response of these patients (group 1) were compared to that of 82 randomly selected true primary infected patients (group 2), 10 parainfluenza virus-infected patients (group 3), and 20 noninfected mumps-immune subjects (group 4). Enzyme-linked immunosorbent assay (ELISA) procedures with different viral antigenic preparations were used for determination of specific IgM, IgA, IgG, IgG subclasses, and IgG avidity. The patients of group 1, older than those of group 2 (28 vs. 10 years, P < 0.0001), presented a significantly less severe and less typical symptomatology. Against the whole virus they exhibited IgG of higher avidity (P < 0.001), a lower prevalence and titer of IgA (10 vs. 68%, P < 0.0001 and 278 vs. 5,009, P < 0.001, respectively). Values obtained for IgG 1, 2, and 3 were significantly different between the two groups. Prevalence and absorbance of nucleocapsid-directed IgG 3 were significantly lower in group 1 (27 vs. 46%, P < 0.01 and 0.444 vs. 0.869, P < 0.01, respectively). A significant discrepancy also allowed patients from group 1 to be distinguished from those of groups 3 and 4.(ABSTRACT TRUNCATED AT 250 WORDS)

Dynamics of the serologic response in vaccinated and unvaccinated mumps cases during an epidemic

“…It is striking that 4 out of the 7 unvaccinated mumps cases were aged 40 years, and it is likely, although not certain, that these persons had encountered wild-type mumps virus earlier in life. However, although natural infection with mumps is thought to confer lifelong protection, incidentally cases of reinfections have been described, [26][27][28] and with the absence of circulating wild-type mumps virus also naturally-acquired immunity against mumps may diminish. In addition, it must be kept in mind that in our assays antibodies were measured against the mumps vaccine strain, which may result in a relatively lower response in persons with naturally-acquired immunity induced by other mumps virus strain(s).…”

Estimates of Mumps Seroprevalence May Be Influenced by Antibody Specificity and Serologic Method

“…Although antigen drift has been hypothesized as a logical culprit, it has been repeatedly shown that the most divergent strains can be neutralized in vitro with only slight variations in serum titers (typically 2-to 8-fold) (13)(14)(15). The observation that naturally acquired wild-type mumps infection does not necessarily confer life-long protection (16,17) suggests that the immune memory to mumps may be inherently unreliable and that breakthrough infection among certain vaccinated individuals could arguably be expected. Furthermore, estimates of mumps vaccine efficacy among two-dose recipients vary, but most are approximately 90% (10,18).…”

Characterization of Large Mumps Outbreak among Vaccinated Palestinian Refugees

“…Hersh et al initially investigated a large mumps outbreak (n ϭ 269) in Kansas and attributed the resurgence of mumps to primary vaccine failure or failure to vaccinate but did not rule out the possibility that secondary vaccine failure could have played a part in the outbreak (15). Mumps reinfection was also discussed by Gut et al who reported 82 mumps patients with evidence of a booster immune response similar to that in the outbreak described in this paper (13). Our data suggest that waning immunity (secondary vaccine failure) was the main cause of the outbreak in the West Bank refugee camps and they underscore the need for a second vaccine dose as part of the standard immunization program.…”

“…Whether mumps secondary vaccine failure (reinfection) occurs is controversial (13,15,26). Hersh et al initially investigated a large mumps outbreak (n ϭ 269) in Kansas and attributed the resurgence of mumps to primary vaccine failure or failure to vaccinate but did not rule out the possibility that secondary vaccine failure could have played a part in the outbreak (15).…”

“…Park et al also reported a mumps outbreak in a highly vaccinated 17-to 18-year-old Korean school population (26). The relative contribution of waning immunity to vaccine failure is still controversial (6,13,37).…”