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Ferrari C, Somma G, Treglia M, Pallocci M, Passalacqua P, Di Giampaolo L, Coppeta L. Questionable Immunity to Mumps among Healthcare Workers in Italy-A Cross-Sectional Serological Study. Vaccines (Basel) 2024; 12:522. [PMID: 38793772 PMCID: PMC11125717 DOI: 10.3390/vaccines12050522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2024] [Revised: 04/27/2024] [Accepted: 05/07/2024] [Indexed: 05/26/2024] Open
Abstract
Highly contagious diseases, such as mumps, are a global concern as new epidemics continue to emerge, even in highly vaccinated populations. The risk of transmission and spread of these viruses is even higher for individuals who are more likely to be exposed, including healthcare workers (HCWs). In healthcare settings, both HCWs and patients are at risk of infection during the care process, potentially leading to nosocomial epidemic outbreaks. Mumps is often underestimated compared with measles and rubella, despite being milder and less likely to spread. In fact, the risk of complications following mumps infection is extremely high, especially if the disease occurs in adulthood. The measles-mumps-rubella (MMR) vaccine has been shown to be an excellent preventive measure. Unfortunately, the mumps component appears to be less effective in inducing immunity than those for measles and rubella (two-dose effectiveness of 85%, 95% and 97%, respectively). The main aim of our study was to investigate the prevalence of detectable mumps antibodies (serum IgG antibodies) in a cohort of Italian and foreign HCWs in relation to personal and occupational factors. We included in the study 468 subjects who underwent health surveillance at the Occupational Medicine Unit of the Tor Vergata Polyclinic in Rome during the period from January 2021 to March 2023. In our study, the proportion of HCWs found to be unprotected against mumps was very high (8.3%), and those found to be immune are below the WHO threshold for herd immunity (95%). From our data, it seems essential that all occupational health services carry out an accurate screening with a dose of anti-mumps antibodies to assess serological protection before starting a job, regardless of an individual's vaccination history. This approach is proving to be beneficial, accurate, as it allows all serologically non-immune individuals to be vaccinated in the workplace, including those who would be protected by their vaccination history but have lost the antibody response.
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Affiliation(s)
- Cristiana Ferrari
- PhD Program in Social, Occupational and Medico-Legal Sciences, Department of Occupational Medicine, University of Rome Tor Vergata, Viale Oxford 81, 00133 Roma, Italy
| | - Giuseppina Somma
- Department of Occupational Medicine, University of Rome Tor Vergata, Viale Oxford 81, 00133 Roma, Italy; (G.S.); (M.T.); (L.C.)
| | - Michele Treglia
- Department of Occupational Medicine, University of Rome Tor Vergata, Viale Oxford 81, 00133 Roma, Italy; (G.S.); (M.T.); (L.C.)
| | - Margherita Pallocci
- PhD Program in Applied Medical Surgical Sciences, Department of Surgical Sciences, University of Rome Tor Vergata, Viale Oxford 81, 00133 Roma, Italy;
| | - Pierluigi Passalacqua
- Department of Occupational Medicine, University of Rome La Sapienza, 00185 Roma, Italy;
| | - Luca Di Giampaolo
- Department of Occupational Medicine, University of Chieti “G. D’Annunzio”, 66100 Chieti, Italy;
| | - Luca Coppeta
- Department of Occupational Medicine, University of Rome Tor Vergata, Viale Oxford 81, 00133 Roma, Italy; (G.S.); (M.T.); (L.C.)
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Sun J, Li M, Zhang L, Deng X, Hu Y, Chen Q, Wang Z, Sun X, Liu Y. Mumps-specific antibody persistence in children aged 3-7 years immunized with two doses of mumps-containing vaccines: A prospective cohort study in Jiangsu Province, China. Hum Vaccin Immunother 2023; 19:2166758. [PMID: 36653029 PMCID: PMC9980565 DOI: 10.1080/21645515.2023.2166758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
Mumps reemergence has been reported in developed countries with high levels of two-dose mumps-containing vaccine (MuCV) coverage. The effectiveness of the two-dose MuCV may be compromised by limitations in the persistence of immunity. This prospective cohort study evaluated the persistence of immunity of a two-dose MuCV in children aged 3-7 years from 2015 to 2020. Persistence of antibody to mumps, determined as the geometric mean antibody concentration (GMC), and seropositivity were analyzed for both repeated measurements from three follow-ups and on each cross-section, respectively. A total of 105 eligible subjects were recruited. Their overall seropositivity rate was relatively high and stable (92.4%-84.8%), while the overall GMC decreased from 547.6 U/ml to 333.3 U/ml. Analysis of waning immunity in 91 participants showed a significant and consistent downward trend for GMC, which differed significantly in boys and girls. The overall seropositivity rate decreased slightly from 2015 (95.6%) to 2016 (92.3%) but both were significantly higher than in 2018 (84.6%). The rates in girls remained stable, while those in boys declined to 75% in 2018. The seropositivity rate of the cross-section level decreased from 95.4% to 86.4% in 4 years. Although two-dose MuCV may result in a high level of immunity, antibody concentrations decay over 2 years after the second dose. Children with waning immunity after receiving two doses, especially boys, require further surveillance at 4 years and later to avoid future mumps epidemics.Clinical trial registration: NCT02901990.
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Affiliation(s)
- Jinfang Sun
- Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing, Jiangsu, China.,Department of Epidemiology and Biostatistics, School of Public Health, Southeast University, Nanjing, Jiangsu, China
| | - Mingma Li
- Department of Epidemiology and Biostatistics, School of Public Health, Southeast University, Nanjing, Jiangsu, China
| | - Lei Zhang
- Department of Expanded Programme on Immunization, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, Jiangsu, China
| | - Xiuying Deng
- Department of Expanded Programme on Immunization, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, Jiangsu, China
| | - Ying Hu
- Department of Expanded Programme on Immunization, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, Jiangsu, China
| | - Qiang Chen
- Department of Expanded Programme on Immunization, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, Jiangsu, China
| | - Zhiguo Wang
- Department of Expanded Programme on Immunization, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, Jiangsu, China
| | - Xiang Sun
- Department of Expanded Programme on Immunization, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, Jiangsu, China
| | - Yuanbao Liu
- Department of Expanded Programme on Immunization, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, Jiangsu, China
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Foley DJ, Connell AR, Gonzalez G, Connell J, Leahy TR, De Gascun C, Hassan J. Mumps-specific IgG, IgG subclasses and neutralization titres to the vaccine and outbreak mumps strains differ in vaccinated healthy controls, breakthrough mumps infection cases and naturally infected individuals. J Clin Virol 2022; 157:105296. [PMID: 36209622 DOI: 10.1016/j.jcv.2022.105296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Revised: 08/22/2022] [Accepted: 09/19/2022] [Indexed: 12/15/2022]
Abstract
BACKGROUND Despite widespread use of the mumps vaccine resulting in significant reduction in the incidence of symptomatic mumps infection, large outbreaks continue to occur in highly vaccinated populations. OBJECTIVES We examined the mumps-specific IgG, IgG subclasses and neutralization titres to the outbreak Genotype G5 and Jeryl Lynn vaccine (Genotype A) mumps strains. STUDY DESIGN Sera from 207 individuals were classified into five distinct cohorts: healthy controls and mumps cases of 5-17 years and 18-25 years, and naturally infected individuals of 50+ years. Mumps specific IgG and IgG subclass levels were measured using modified ELISA assays with lysates and nucleoprotein antigens from both the mumps vaccine and circulating Genotype G5 strains. All sera were investigated for in vitro neutralizing antibody titres (GMT) using focus reduction neutralization assays. Data was analysed using the Kruskal-Wallis test and pairwise Wilcoxon tests. RESULTS Mumps cases had higher mumps IgG levels compared to controls, to both the vaccine and outbreak strains, however levels decreased with age. Mumps IgG3 levels were significantly raised in mumps cases (p < 0.001). Neutralization titres were lower to the outbreak strain in all cohorts with titres markedly lower in the mumps cohorts compared to healthy controls. Mean GMT to the vaccine strain increased with age. The naturally infected group displayed the highest GMT to the JL vaccine and the lowest GMT to the outbreak strain. CONCLUSIONS Antigenic differences between mumps vaccine strain and circulating mumps viruses decrease the cross-neutralization capacity of vaccine-induced antibodies which may play a role in breakthrough infection.
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Affiliation(s)
- Deirdre Jane Foley
- Department of Paediatric Immunology and Infectious Diseases, Children's Health Ireland at Crumlin, Dublin 12, Ireland
| | - Anna Rose Connell
- National Children's Research Centre, Children's Health Ireland at Crumlin, Dublin 12, Ireland
| | - Gabriel Gonzalez
- National Virus Reference Laboratory, University College Dublin, Dublin 4, Belfield, Ireland; International Collaboration Unit, Research Center for Zoonosis Control, Hokkaido University, N20 W10 Kita-ku, Sapporo, 001-0020, Japan
| | - Jeff Connell
- National Virus Reference Laboratory, University College Dublin, Dublin 4, Belfield, Ireland
| | - Timothy Ronan Leahy
- Department of Paediatric Immunology and Infectious Diseases, Children's Health Ireland at Crumlin, Dublin 12, Ireland; Department of Paediatrics, University of Dublin, Trinity College, Dublin 2, Ireland
| | - Cillian De Gascun
- National Virus Reference Laboratory, University College Dublin, Dublin 4, Belfield, Ireland
| | - Jaythoon Hassan
- National Children's Research Centre, Children's Health Ireland at Crumlin, Dublin 12, Ireland; National Virus Reference Laboratory, University College Dublin, Dublin 4, Belfield, Ireland.
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Azimaqin N, Peng Z, Ren X, Wei Y, Liu X. Vaccine Failure, Seasonality and Demographic Changes Associate with Mumps Outbreaks in Jiangsu Province, China: Age-structured Mathematical Modelling Study. J Theor Biol 2022; 544:111125. [DOI: 10.1016/j.jtbi.2022.111125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 04/07/2022] [Accepted: 04/10/2022] [Indexed: 10/18/2022]
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Connell AR, Connell J, Leahy TR, Hassan J. Mumps Outbreaks in Vaccinated Populations-Is It Time to Re-assess the Clinical Efficacy of Vaccines? Front Immunol 2020; 11:2089. [PMID: 33072071 PMCID: PMC7531022 DOI: 10.3389/fimmu.2020.02089] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Accepted: 07/31/2020] [Indexed: 01/05/2023] Open
Abstract
History illustrates the remarkable public health impact of mass vaccination, by dramatically improving life expectancy and reducing the burden of infectious diseases and co-morbidities worldwide. It has been perceived that if an individual adhered to the MMR vaccine schedule that immunity to mumps virus (MuV) would be lifelong. Recent mumps outbreaks in individuals who had received two doses of the Measles Mumps Rubella (MMR) vaccine has challenged the efficacy of the MMR vaccine. However, clinical symptoms, complications, viral shedding and transmission associated with mumps infection has been shown to be reduced in vaccinated individuals, demonstrating a benefit of this vaccine. Therefore, the question of what constitutes a good mumps vaccine and how its impact is assessed in this modern era remains to be addressed. Epidemiology of the individuals most affected by the outbreaks (predominantly young adults) and variance in the circulating MuV genotype have been well-described alluding to a collection of influences such as vaccine hesitancy, heterogeneous vaccine uptake, primary, and/or secondary vaccine failures. This review aims to discuss in detail the interplay of factors thought to be contributing to the current mumps outbreaks seen in highly vaccinated populations. In addition, how mumps diagnoses has progressed and impacted the understanding of mumps infection since a mumps vaccine was first developed, the limitations of current laboratory tests in confirming protection in vaccinated individuals and how vaccine effectiveness is quantified are also considered. By highlighting knowledge gaps within this area, this state-of-the-art review proposes a change of perspective regarding the impact of a vaccine in a highly vaccinated population from a clinical, diagnostic and public perspective, highlighting a need for a paradigm shift on what is considered vaccine immunity.
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Affiliation(s)
- Anna R Connell
- National Children's Research Centre, Children's Health Ireland, Dublin, Ireland
| | - Jeff Connell
- National Virus Reference Laboratory, University College Dublin, Dublin, Ireland
| | - T Ronan Leahy
- Children's Health Ireland, Dublin, Ireland.,Department of Pediatrics, University of Dublin, Trinity College, Dublin, Ireland
| | - Jaythoon Hassan
- National Children's Research Centre, Children's Health Ireland, Dublin, Ireland.,National Virus Reference Laboratory, University College Dublin, Dublin, Ireland
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Hassan J, Kelly J, De Gascun C. Presence of low mumps-specific IgG in oral fluids is associated with high mumps viral loads. J Clin Virol 2020; 129:104517. [PMID: 32629188 DOI: 10.1016/j.jcv.2020.104517] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Revised: 04/03/2020] [Accepted: 06/21/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND Mumps outbreaks continue to occur in highly vaccinated populations. Although the diagnosis of mumps is primarily based on clinical symptoms, other viral infections such as parainfluenza can manifest in a similar manner. Therefore, laboratory confirmation of mumps virus infection is important. OBJECTIVES The aims of this study were to examine mumps cases during the January 2018 to March 2019 period in Ireland as well as to evaluate the association between mumps RNA viral loads, mumps IgG levels, age and gender among patients with laboratory-confirmed mumps virus infection. STUDY DESIGN Oral fluid samples requested for mumps RNA testing (n = 1296) were included in the study. The mumps N gene was detected by real time PCR and reported as Ct values. RESULTS The proportion of samples received monthly with detectable mumps RNA increased from 10.26%-70.3% during the recent outbreak. Acute mumps cases occurred predominantly in the 16-25 years old age cohort (67.5 %) and in males (55.9 %). Mumps RNA viral loads were significantly higher in females (p < 0.001). During the outbreak, a significantly higher proportion of samples had Ct <30 (p < 0.05). A significant correlation was observed between mumps IgG levels and Ct values in oral fluid samples (p < 0.0001). CONCLUSIONS The presence of low mumps virus-specific IgG in oral fluids is significantly associated with high mumps viral loads. Our findings show that mumps virus is maintained in circulation in the non-outbreak period and acute mumps cases occur predominantly in the MMR vaccinated young adult male population.
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Affiliation(s)
- Jaythoon Hassan
- National Virus Reference Laboratory, University College Dublin, Belfield, Dublin 4, Ireland.
| | - James Kelly
- National Virus Reference Laboratory, University College Dublin, Belfield, Dublin 4, Ireland
| | - Cillian De Gascun
- National Virus Reference Laboratory, University College Dublin, Belfield, Dublin 4, Ireland
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Sun X, Tang F, Hu Y, Deng X, Wang Z, Zhou M, Liu Y. High risk of mumps infection in children who received one dose of mumps-containing vaccine: waning immunity to mumps in children aged 2-5 years from kindergartens in Jiangsu Province, China. Hum Vaccin Immunother 2020; 16:1738-1742. [PMID: 31977281 DOI: 10.1080/21645515.2019.1708162] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND During the period of immunization with a single-dose measles-mumps-rubella (MMR) vaccine, which has been available since 2008in China, the incidence of mumps in children aged 2-5 years has been high. The aim of this study was to determine the immunity profile of mumps in children aged 2-5 years as part of the assessment of the MMR vaccination strategy. METHODS A cross-sectional survey of IgG antibodies against mumps virus in children aged 2-5 years was performed. Analysis by enzyme-linked immune sorbent assay(ELISA)was performed to measure IgG antibodies against mumps virus in the sera of 2-to5-year-old children who had been vaccinated with at least one dose of MMR vaccine. RESULTS Mumps outbreaks mainly occurred in kindergarten and primary schools and primarily involved children in kindergarten from 2015-2016 in Jiangsu Province. In total, 4,033 children were surveyed. The overall seroprevalence of mumps antibodies was 79.0% (95% CI:78.4-79.6), and the geometric mean concentration (GMC) was 323.6 mIU/ml (309.0-338.8). Both univariate and multivariate survival analysis of seroprevalence showed that several factors contributed to having significant seroprevalence among the 2-to-5-year-old group (P < .05). The seroprevalence of children with a single-dose MMR vaccine regimen (78.4%, 95% CI: 77.8-80.4) was significantly lower than that of children with a two-dose MMR vaccine regimen (96.5%, 95% CI: 88.6%-96.1%). The seroprevalence rate was negatively correlated with time since inoculation (P < .01). CONCLUSION Children who received a single dose of MMR vaccine in kindergarten, particularly the 2-year-old group in the northern region of Jiangsu Province, China, are at high risk of mumps infection. Our study demonstrates thata single-dose MMR vaccine regimen has a limited effect on controlling mumps, which highlights the benefit of introducing a two-dose MMR vaccine schedule.
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Affiliation(s)
- Xiang Sun
- Department of Expanded Program on Immunization, Jiangsu Provincial Center for Disease Control and Prevention , Nanjing, Jiangsu Province, China
| | - Fenyang Tang
- Department of Expanded Program on Immunization, Jiangsu Provincial Center for Disease Control and Prevention , Nanjing, Jiangsu Province, China
| | - Ying Hu
- Department of Expanded Program on Immunization, Jiangsu Provincial Center for Disease Control and Prevention , Nanjing, Jiangsu Province, China
| | - Xiuying Deng
- Department of Expanded Program on Immunization, Jiangsu Provincial Center for Disease Control and Prevention , Nanjing, Jiangsu Province, China
| | - Zhiguo Wang
- Department of Expanded Program on Immunization, Jiangsu Provincial Center for Disease Control and Prevention , Nanjing, Jiangsu Province, China
| | - Minghao Zhou
- Department of Expanded Program on Immunization, Jiangsu Provincial Center for Disease Control and Prevention , Nanjing, Jiangsu Province, China
| | - Yuanbao Liu
- Department of Expanded Program on Immunization, Jiangsu Provincial Center for Disease Control and Prevention , Nanjing, Jiangsu Province, China
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Sikhosana ML, Kuonza L, Motaze NV. Epidemiology of laboratory-confirmed mumps infections in South Africa, 2012-2017: a cross-sectional study. BMC Public Health 2020; 20:668. [PMID: 32397991 PMCID: PMC7216493 DOI: 10.1186/s12889-020-08835-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2020] [Accepted: 05/03/2020] [Indexed: 08/30/2023] Open
Abstract
Background Data on the burden of mumps in South Africa are limited and the epidemiology of mumps in this setting is not well understood. We present an analysis of mumps data in South Africa from 2012 to 2017. Methods This cross-sectional study included secondary data on laboratory-confirmed mumps infections from 2012 to 2017, archived at the South African National Health Laboratory Services’ data repository as well as from four private laboratories. Mumps-specific immunoglobulin M (IgM) and/or viral nucleic acid positive results represented acute infections. We used age-specific mid-year population estimates for each study year as denominators when calculating annual cumulative incidence. Seasonality was based on the season that showed a peak in infections. Results Out of 48,580 records obtained from the public and private sectors, 46,713 (96.2%) were from the private sector. Over the study period, there were 7494 acute infections, 7085 (94.5%) of which were recorded in the private sector. Of these 7494 infections, 3924 (52.4%) occurred in males. The proportion of samples tested that were IgM positive was 18.6% (1058/5682) in 2012, 15% (1016/6790) in 2013, 15.8% (1280/8093) in 2014, 15.5% (1384/8944) in 2015, 13.1% (1260/9629) in 2016 and 15.8% (1496/9442) in 2017. The cumulative incidence rate per 100,000 was highest in children between one and 9 years throughout the study period. The cumulative incidence of infections was highest in the Western Cape, Gauteng and the Northern Cape. Infections peaked in June and November. Conclusion Laboratory-confirmed mumps infections predominantly occurred in spring, affecting children below 10 years of age and individuals who were male. There were fewer tests performed in the public sector compared to the private sector. Since only laboratory data was analysed our results represent and underestimate of disease burden. Further studies that include clinical data are required to provide better estimates of disease burden in South Africa.
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Affiliation(s)
- Mpho Lerato Sikhosana
- South African Field Epidemiology Training Programme, National Institute for Communicable Diseases, Division of the National Health Laboratory Service, Johannesburg, South Africa.
| | - Lazarus Kuonza
- South African Field Epidemiology Training Programme, National Institute for Communicable Diseases, Division of the National Health Laboratory Service, Johannesburg, South Africa.,Division of Public Health Surveillance and Response, National Institute for Communicable Diseases, Division of the National Health Laboratory Service, Johannesburg, South Africa.,School of Health Systems and Public Health, University of Pretoria, Pretoria, South Africa
| | - Nkengafac Villyen Motaze
- Centre for Vaccines and Immunology, National Institute for Communicable Diseases, a division of the National Health Laboratory Service, Johannesburg, South Africa.,Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa
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Assessing the Changes of Mumps Characteristics with Different Vaccination Strategies Using Surveillance Data: Importance to Introduce the 2-Dose Schedule in Quzhou of China. J Immunol Res 2020; 2020:8130760. [PMID: 32300606 PMCID: PMC7140127 DOI: 10.1155/2020/8130760] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Revised: 02/20/2020] [Accepted: 03/03/2020] [Indexed: 11/18/2022] Open
Abstract
Background From 2005 to 2016, the prevention and control of mumps in China have undergone three stages of transition. These include the use of MuCV as a self-supported vaccine, the introduction of one-dose MMR to the Expanded Program on Immunization (EPI), and the administration of two-dose MuCV following supplementary immunization activities (SIAs) using MM. Here, using surveillance data, we assessed the epidemiology of mumps during the three stages. Methods Children in Quzhou of China born from 2005 to 2016 and registered in the Zhejiang Provincial Immunization Information System (ZJIIS) were included. We analyzed the epidemic data and calculated incidence and MuCV coverage via birth cohorts. Results The average incidence of mumps in 2005-2006, 2007-2010, and 2011-2016 was 51.57, 41.02, and 12.53 per 100,000 individuals, respectively. The highest incidence was in children aged 6-14 years from 2005-2016, of which the majority were school students (67.84%). Approximately 90% of the reported outbreaks occurred in school children (primary school/middle school). The seasonal characteristics of mumps were less obvious from 2011 to 2016. The coverage of one-dose MMR in the 2005 birth cohort was 71.38%. For the 2006-2010 birth cohort, the coverage of one-dose MuCV was 96.82% and the coverage of two-dose MuCV was 17.68%. The children born from 2011 to 2016 were only free vaccinated with MMR; the coverage of one-dose MuCV was 99.10%. The mumps incidence in the three birth cohorts significantly declined (X2 = 805.90, P < 0.001 for trend). Except the children less than two years old, the mumps incidence for the children born from 2006 to 2010 was higher than that for the children born from 2011 to 2016. Conclusion The mumps incidence significantly declined following the introduction of one-dose MMR. The SIA using MM led to a rapid reduction of mumps cases. Therefore, we recommend a two-dose MuCV routine immunization schedule and improved vaccination coverage.
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10
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Plotkin SA. Mumps: A Pain in the Neck. J Pediatric Infect Dis Soc 2018; 7:91-92. [PMID: 29718326 DOI: 10.1093/jpids/piy038] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2018] [Accepted: 04/19/2018] [Indexed: 11/13/2022]
Affiliation(s)
- Stanley A Plotkin
- Emeritus Professor of Pediatrics, University of Pennsylvania, Vaxconsult, Doylestown, Pennsylvania
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11
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Liu Y, Liu Z, Deng X, Hu Y, Wang Z, Lu P, Guo H, Sun X, Xu Y, Tang F, Zhu FC. Waning immunity of one-dose measles-mumps-rubella vaccine to mumps in children from kindergarten to early school age: a prospective study. Expert Rev Vaccines 2018; 17:445-452. [PMID: 29478347 DOI: 10.1080/14760584.2018.1445529] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
BACKGROUND In China, one dose measles-mumps-rubella vaccine (MMR) was administered to children aged 18-24 months. The mumps incidence was still high. Data on the waning immunity to mumps after MMR vaccination are limited. This study aimed to describe the waning immunity to mumps in kindergarten and primary school children to provide a scientific basis for confirming an optimal age for a second dose. METHODS An observational, prospective study on one-dose MMR in children in kindergarten and primary school was conducted from 2015 to 2016. Waning immunity to mumps in terms of seropositivity and geometric antibody concentration (GMC) with time was analyzed. RESULTS In total, 7436 eligible subjects in kindergarten (3435) and primary school (4001) were included in 2015. The overall GMC (201.7 U/ml) and seropositivity (75.4%) to mumps antibodies in 2016 were significantly lower compared to those in 2015 (218.7 U/ml, 78.4%). Asymptomatic infection occurred within one year in 8.8% of children who received one-dose MMR. CONCLUSIONS Children who received one-dose MMR in kindergarten and primary school were at high risk of mumps infection, and waning immunity occurred with time. Determining the optimal age for the second dose of MMR in children should be prioritized to prevent mumps epidemics.
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Affiliation(s)
- Yuanbao Liu
- a Department of Expanded Programme on Immunization , Jiangsu Provincial Center for Disease Control and Prevention , Nanjing , China
| | - Zhihao Liu
- b Department of Health education , Jiangsu Provincial Center for Disease Control and Prevention , Nanjing , China
| | - Xiuying Deng
- a Department of Expanded Programme on Immunization , Jiangsu Provincial Center for Disease Control and Prevention , Nanjing , China
| | - Ying Hu
- a Department of Expanded Programme on Immunization , Jiangsu Provincial Center for Disease Control and Prevention , Nanjing , China
| | - Zhiguo Wang
- a Department of Expanded Programme on Immunization , Jiangsu Provincial Center for Disease Control and Prevention , Nanjing , China
| | - Peishan Lu
- a Department of Expanded Programme on Immunization , Jiangsu Provincial Center for Disease Control and Prevention , Nanjing , China
| | - Hongxiong Guo
- a Department of Expanded Programme on Immunization , Jiangsu Provincial Center for Disease Control and Prevention , Nanjing , China
| | - Xiang Sun
- a Department of Expanded Programme on Immunization , Jiangsu Provincial Center for Disease Control and Prevention , Nanjing , China
| | - Yan Xu
- a Department of Expanded Programme on Immunization , Jiangsu Provincial Center for Disease Control and Prevention , Nanjing , China
| | - Fenyang Tang
- a Department of Expanded Programme on Immunization , Jiangsu Provincial Center for Disease Control and Prevention , Nanjing , China
| | - Feng-Cai Zhu
- c Department of Vaccine Clinical Evaluation , Jiangsu Provincial Center for Disease Control and Prevention , Nanjing , China
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12
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Ho YH, Tsai CC, Tsai YW, Wang YC, Lin TY, Lee DJ, Chen CJ. Humoral immunity to mumps in a highly vaccinated population in Taiwan. JOURNAL OF MICROBIOLOGY, IMMUNOLOGY, AND INFECTION = WEI MIAN YU GAN RAN ZA ZHI 2017; 52:379-385. [PMID: 29046249 DOI: 10.1016/j.jmii.2017.09.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/04/2017] [Revised: 09/14/2017] [Accepted: 09/25/2017] [Indexed: 10/18/2022]
Abstract
BACKGROUND A resurgence of mumps was noted recently and outbreaks were increasingly reported in populations with high vaccine coverage. We aimed to evaluate the seroprevalence to mumps in Taiwan, where a two-dose childhood mumps-containing vaccine program, with a high coverage rate, had been implemented for >20 years. METHODS The anti-mumps IgG was determined in 3552 participants of all ages in Taiwan. The age-specific seropositivity rates were calculated and the sociodemographic variables associated with the seronegative sera were analyzed with a logistic regression method. RESULTS The overall seroprevalence to mumps was 71%, with a higher rate in adults ≥19 years old than in the pediatric population <19 years old (80.4% versus 62.0%, P < 0.0001). In participants aged 2-20 years, who had been given at least one mumps-containing vaccine, the seropositivity fluctuated across different age subgroups and the lowest rate (36.8%) occurred in the 17-18 years age group. The multivariate analysis identified age within 17-18 years (adjusted odds ratio [aOR] 8.598, 95% confidence interval [CI] 2.990-24.722, P < 0.0001), within 19-20 years (aOR 5.076, 95% CI 1.702-15.133, P = 0.0080), and being a resident of the suburban area of northern Taiwan (aOR 1.089, 95% CI 0.823-1.414, P = 0.0008) as independent factors associated with an increased risk of seronegative sera. CONCLUSION The seropositivity to mumps was unexpectedly low in highly vaccinated generations, and with a significant geographical discrepancy in Taiwan, which may have been responsible for the sustained reports of mumps cases in Taiwan.
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Affiliation(s)
- Yu-Huai Ho
- Section of Infectious Disease, Department of Medicine, Buddhist Tzu Chi General Hospital, Hualien, Taiwan; School of Medicine, Tzu Chi University, Hualien, Taiwan
| | - Chen-Chi Tsai
- School of Medicine, Tzu Chi University, Hualien, Taiwan; Section of Infectious Disease, Department of Medicine, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi, Taiwan
| | - Ya-Wen Tsai
- School of Medicine, College of Medicine, Chang Gung University, 333, Taoyuan, Taiwan
| | - Yu-Chiang Wang
- School of Medicine, College of Medicine, Chang Gung University, 333, Taoyuan, Taiwan
| | - Tzou-Yien Lin
- School of Medicine, College of Medicine, Chang Gung University, 333, Taoyuan, Taiwan; Division of Pediatric Infectious Diseases, Department of Pediatrics, Chang Gung Children's Hospital and Chang Gung Memorial Hospital, 333, Taoyuan, Taiwan
| | - De-Jen Lee
- Physical Education Office, Chang Gung University, 333, Taoyuan, Taiwan.
| | - Chih-Jung Chen
- School of Medicine, College of Medicine, Chang Gung University, 333, Taoyuan, Taiwan; Division of Pediatric Infectious Diseases, Department of Pediatrics, Chang Gung Children's Hospital and Chang Gung Memorial Hospital, 333, Taoyuan, Taiwan.
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An outbreak of mumps with genetic strain variation in a highly vaccinated student population in Scotland. Epidemiol Infect 2017; 145:3219-3225. [PMID: 28903791 DOI: 10.1017/s0950268817002102] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
An outbreak of mumps within a student population in Scotland was investigated to assess the effect of previous vaccination on infection and clinical presentation, and any genotypic variation. Of the 341 cases, 79% were aged 18-24. Vaccination status was available for 278 cases of whom 84% had received at least one dose of mumps containing vaccine and 62% had received two. The complication rate was 5·3% (mainly orchitis), and 1·2% were admitted to hospital. Genetic sequencing of mumps virus isolated from cases across Scotland classified 97% of the samples as genotype G. Two distinct clusters of genotype G were identified, one circulating before the outbreak and the other thereafter, suggesting the virus that caused this outbreak was genetically different from the previously circulating virus. Whilst the poor vaccine effectiveness we found may be due to waning immunity over time, a contributing factor may be that the current mumps vaccine is less effective against some genotypes. Although the general benefits of the measles-mumps-rubella (MMR) vaccine should continue to be promoted, there may be value in reassessing the UK vaccination schedule and the current mumps component of the MMR vaccine.
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