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Deng X, Hu Y, Lu P, Wang Z, Guo H. Genetic characteristic of mumps virus from 2012 to 2016 and its serum antibody level among general healthy population during 2018-2020 in Jiangsu Province, China. BMC Infect Dis 2024; 24:718. [PMID: 39039455 PMCID: PMC11265432 DOI: 10.1186/s12879-024-09609-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Accepted: 07/12/2024] [Indexed: 07/24/2024] Open
Abstract
Mumps is a vaccine-preventable disease with high contagious capability. Its incidence declined rapidly since one dose of mumps vaccine was introduced into Expanded Program of Immunization (EPI) in 2008 in China. Nonetheless, the outbreaks of mumps remain frequent in China. Here we aim to assess herd immunity level followed by one-dose mumps ingredient vaccine and to elucidate the genetic characteristics of mumps viruses circulating in the post vaccine era in Jiangsu province of China. The complete sequences of mumps virus small hydrophobic(SH) gene were amplified and sequenced; coalescent-based Bayesian method was used to perform phylogenetic analysis with BEAST 1.84 software. Commercially available indirect enzyme-linked immune-sorbent IgG assay was used for the quantitative detection of IgG antibody against mumps virus. Our results show that genotype F was the predominant mumps viruses and belonged to indigenous spread, and most of Jiangsu sequences clustered together and formed a monophyly. The prevalence of mumps reached a peak in 2012 and subsequently declined, which presented an obvious different trajectory with virus circulating in other regions of China. The gene diversity of viruses circulating in Jiangsu province was far less than those in China. The antibody prevalence reached 70.42% in the general population during 2018 to 2020. The rising trend of antibody level was also observed. Although mumps antibody prevalence does not reach expected level, mumps virus faces higher pressure in Jiangsu province than the whole of China. To reduce further the prevalence of mumps viruses, two doses of mumps vaccine should be involved into EPI.
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Affiliation(s)
- Xiuying Deng
- NHC Key Laboratory of Enteric Pathogenic Microbiology, Jiangsu Provincial Center for Disease Control and Prevention, 172 Jiangsu Road, Nanjing, China
| | - Ying Hu
- NHC Key Laboratory of Enteric Pathogenic Microbiology, Jiangsu Provincial Center for Disease Control and Prevention, 172 Jiangsu Road, Nanjing, China
| | - Peishan Lu
- NHC Key Laboratory of Enteric Pathogenic Microbiology, Jiangsu Provincial Center for Disease Control and Prevention, 172 Jiangsu Road, Nanjing, China
| | - Zhiguo Wang
- NHC Key Laboratory of Enteric Pathogenic Microbiology, Jiangsu Provincial Center for Disease Control and Prevention, 172 Jiangsu Road, Nanjing, China
| | - Hongxiong Guo
- NHC Key Laboratory of Enteric Pathogenic Microbiology, Jiangsu Provincial Center for Disease Control and Prevention, 172 Jiangsu Road, Nanjing, China.
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Yang T, Wang Y, Zhao Q, Guo X, Yu S, Zhao Z, Deng B, Huang J, Liu W, Su Y, Chen T. Age-specific transmission dynamic of mumps: A long-term large-scale modeling study in Jilin Province, China. Front Public Health 2022; 10:968702. [PMID: 36420012 PMCID: PMC9678053 DOI: 10.3389/fpubh.2022.968702] [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: 06/14/2022] [Accepted: 10/13/2022] [Indexed: 11/09/2022] Open
Abstract
Objectives Despite the adoption of a new childhood immunization program in China, the incidence of mumps remains high. This study aimed to describe the epidemiological characteristics of mumps in Jilin Province from 2005 to 2019 and to assess the transmissibility of mumps virus among the whole population and different subgroups by regions and age groups. Methods The Non-age-specific and age-specific Susceptible-Exposed-Pre-symptomatic-Infectious-Asymptomatic-Recovered (SEPIAR) models were fitted to actual mumps incidence data. The time-varying reproduction number (R t ) was used to evaluate and compare the transmissibility. Results From 2005 to 2019, a total of 57,424 cases of mumps were reported in Jilin Province. The incidence of mumps was the highest in people aged 5 to 9 years (77.37 per 100,000). The two SEPIAR models fitted the reported data well (P < 0.01). The median transmissibility (R t ) calculated by the two SEPIAR models were 1.096 (range: 1.911 × 10-5-2.192) and 1.074 (range: 0.033-2.114) respectively. The age-specific SEPIAR model was more representative of the actual epidemic of mumps in Jilin Province from 2005-2019. Conclusions For mumps control, it is recommended that mumps-containing vaccines (MuCV) coverage be increased nationwide in the 5-9 years age group, either by a mumps vaccine alone or by a combination of vaccines such as measles-mumps-rubella (MMR) vaccine. The coverage of vaccines in Jilin Province should be continuously expanded to establish solid immunity in the population. China needs to redefine the optimal time interval for MuCV immunization.
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Affiliation(s)
- Tianlong Yang
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen, China
| | - Yao Wang
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen, China
| | - Qinglong Zhao
- Jilin Provincial Center for Disease Control and Prevention, Changchun, China
| | - Xiaohao Guo
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen, China
| | - Shanshan Yu
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen, China
| | - Zeyu Zhao
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen, China
| | - Bin Deng
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen, China
| | - Jiefeng Huang
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen, China
| | - Weikang Liu
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen, China
| | - Yanhua Su
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen, China,*Correspondence: Tianmu Chen
| | - Tianmu Chen
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen, China,Yanhua Su
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A Multi-Age-Group Interrupted Time-Series Study for Evaluating the Effectiveness of National Expanded Program on Immunization on Mumps. Vaccines (Basel) 2022; 10:vaccines10101587. [PMID: 36298452 PMCID: PMC9610758 DOI: 10.3390/vaccines10101587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2022] [Revised: 09/18/2022] [Accepted: 09/19/2022] [Indexed: 11/16/2022] Open
Abstract
The national Expanded Program on Immunization (EPI) in China has covered vaccines for measles, mumps, and rubella, among children aged 18–24 months since September 2008. However, no previous studies have quantified the effectiveness of the EPI on mumps incidence. There are methodological challenges in assessing the effect of an intervention that targets a subpopulation but finally influences the whole population. In this study, monthly data on mumps incidence were collected in Guangzhou, China, during 2005–2019. We proposed a multi-age-group interrupted time-series design, setting the starting time of exerting effect separately for 14 different age groups. A mixed-effects quasi-Poisson regression was applied to analyze the effectiveness of the EPI on mumps incidence, after controlling for long-term and seasonal trends, and meteorological factors. The model also accounted for the first-order autocorrelation within each age group. Between-age-group correlations were expressed using the contact matrix of age groups. We found that 70,682 mumps cases were reported during 2005–2019, with an annual incidence rate of 37.91 cases per 100,000 population. The effect of EPI strengthened over time, resulting in a decrease in the incidence of mumps by 16.6% (EPI-associated excess risk% = −16.6%, 95% CI: −27.0% to −4.7%) in September 2009 to 40.1% (EPI-associated excess risk% = −40.1%, 95% CI: −46.1% to −33.3%) in September 2019. A reverse U-shape pattern was found in age-specific effect estimates, with the largest reduction of 129 cases per 100,000 population (95% CI: 14 to 1173) in those aged 4–5 years. The EPI is effective in reducing the mumps incidence in Guangzhou. The proposed modeling strategy can be applied for simultaneous assessment of the effectiveness of public health interventions across different age groups, with adequate adjustment for within- and between-group correlations.
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Di Pietrantonj C, Rivetti A, Marchione P, Debalini MG, Demicheli V. Vaccines for measles, mumps, rubella, and varicella in children. Cochrane Database Syst Rev 2021; 11:CD004407. [PMID: 34806766 PMCID: PMC8607336 DOI: 10.1002/14651858.cd004407.pub5] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND Measles, mumps, rubella, and varicella (chickenpox) are serious diseases that can lead to serious complications, disability, and death. However, public debate over the safety of the trivalent MMR vaccine and the resultant drop in vaccination coverage in several countries persists, despite its almost universal use and accepted effectiveness. This is an update of a review published in 2005 and updated in 2012. OBJECTIVES To assess the effectiveness, safety, and long- and short-term adverse effects associated with the trivalent vaccine, containing measles, rubella, mumps strains (MMR), or concurrent administration of MMR vaccine and varicella vaccine (MMR+V), or tetravalent vaccine containing measles, rubella, mumps, and varicella strains (MMRV), given to children aged up to 15 years. SEARCH METHODS We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (the Cochrane Library 2019, Issue 5), which includes the Cochrane Acute Respiratory Infections Group's Specialised Register, MEDLINE (1966 to 2 May 2019), Embase (1974 to 2 May 2019), the WHO International Clinical Trials Registry Platform (2 May 2019), and ClinicalTrials.gov (2 May 2019). SELECTION CRITERIA We included randomised controlled trials (RCTs), controlled clinical trials (CCTs), prospective and retrospective cohort studies (PCS/RCS), case-control studies (CCS), interrupted time-series (ITS) studies, case cross-over (CCO) studies, case-only ecological method (COEM) studies, self-controlled case series (SCCS) studies, person-time cohort (PTC) studies, and case-coverage design/screening methods (CCD/SM) studies, assessing any combined MMR or MMRV / MMR+V vaccine given in any dose, preparation or time schedule compared with no intervention or placebo, on healthy children up to 15 years of age. DATA COLLECTION AND ANALYSIS Two review authors independently extracted data and assessed the methodological quality of the included studies. We grouped studies for quantitative analysis according to study design, vaccine type (MMR, MMRV, MMR+V), virus strain, and study settings. Outcomes of interest were cases of measles, mumps, rubella, and varicella, and harms. Certainty of evidence of was rated using GRADE. MAIN RESULTS We included 138 studies (23,480,668 participants). Fifty-one studies (10,248,159 children) assessed vaccine effectiveness and 87 studies (13,232,509 children) assessed the association between vaccines and a variety of harms. We included 74 new studies to this 2019 version of the review. Effectiveness Vaccine effectiveness in preventing measles was 95% after one dose (relative risk (RR) 0.05, 95% CI 0.02 to 0.13; 7 cohort studies; 12,039 children; moderate certainty evidence) and 96% after two doses (RR 0.04, 95% CI 0.01 to 0.28; 5 cohort studies; 21,604 children; moderate certainty evidence). The effectiveness in preventing cases among household contacts or preventing transmission to others the children were in contact with after one dose was 81% (RR 0.19, 95% CI 0.04 to 0.89; 3 cohort studies; 151 children; low certainty evidence), after two doses 85% (RR 0.15, 95% CI 0.03 to 0.75; 3 cohort studies; 378 children; low certainty evidence), and after three doses was 96% (RR 0.04, 95% CI 0.01 to 0.23; 2 cohort studies; 151 children; low certainty evidence). The effectiveness (at least one dose) in preventing measles after exposure (post-exposure prophylaxis) was 74% (RR 0.26, 95% CI 0.14 to 0.50; 2 cohort studies; 283 children; low certainty evidence). The effectiveness of Jeryl Lynn containing MMR vaccine in preventing mumps was 72% after one dose (RR 0.24, 95% CI 0.08 to 0.76; 6 cohort studies; 9915 children; moderate certainty evidence), 86% after two doses (RR 0.12, 95% CI 0.04 to 0.35; 5 cohort studies; 7792 children; moderate certainty evidence). Effectiveness in preventing cases among household contacts was 74% (RR 0.26, 95% CI 0.13 to 0.49; 3 cohort studies; 1036 children; moderate certainty evidence). Vaccine effectiveness against rubella, using a vaccine with the BRD2 strain which is only used in China, is 89% (RR 0.11, 95% CI 0.03 to 0.42; 1 cohort study; 1621 children; moderate certainty evidence). Vaccine effectiveness against varicella (any severity) after two doses in children aged 11 to 22 months is 95% in a 10 years follow-up (rate ratio (rr) 0.05, 95% CI 0.03 to 0.08; 1 RCT; 2279 children; high certainty evidence). Safety There is evidence supporting an association between aseptic meningitis and MMR vaccines containing Urabe and Leningrad-Zagreb mumps strains, but no evidence supporting this association for MMR vaccines containing Jeryl Lynn mumps strains (rr 1.30, 95% CI 0.66 to 2.56; low certainty evidence). The analyses provide evidence supporting an association between MMR/MMR+V/MMRV vaccines (Jeryl Lynn strain) and febrile seizures. Febrile seizures normally occur in 2% to 4% of healthy children at least once before the age of 5. The attributable risk febrile seizures vaccine-induced is estimated to be from 1 per 1700 to 1 per 1150 administered doses. The analyses provide evidence supporting an association between MMR vaccination and idiopathic thrombocytopaenic purpura (ITP). However, the risk of ITP after vaccination is smaller than after natural infection with these viruses. Natural infection of ITP occur in 5 cases per 100,000 (1 case per 20,000) per year. The attributable risk is estimated about 1 case of ITP per 40,000 administered MMR doses. There is no evidence of an association between MMR immunisation and encephalitis or encephalopathy (rate ratio 0.90, 95% CI 0.50 to 1.61; 2 observational studies; 1,071,088 children; low certainty evidence), and autistic spectrum disorders (rate ratio 0.93, 95% CI 0.85 to 1.01; 2 observational studies; 1,194,764 children; moderate certainty). There is insufficient evidence to determine the association between MMR immunisation and inflammatory bowel disease (odds ratio 1.42, 95% CI 0.93 to 2.16; 3 observational studies; 409 cases and 1416 controls; moderate certainty evidence). Additionally, there is no evidence supporting an association between MMR immunisation and cognitive delay, type 1 diabetes, asthma, dermatitis/eczema, hay fever, leukaemia, multiple sclerosis, gait disturbance, and bacterial or viral infections. AUTHORS' CONCLUSIONS: Existing evidence on the safety and effectiveness of MMR/MMRV vaccines support their use for mass immunisation. Campaigns aimed at global eradication should assess epidemiological and socioeconomic situations of the countries as well as the capacity to achieve high vaccination coverage. More evidence is needed to assess whether the protective effect of MMR/MMRV could wane with time since immunisation.
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Affiliation(s)
- Carlo Di Pietrantonj
- Servizio Regionale di Riferimento per l'Epidemiologia, SSEpi-SeREMI, Azienda Sanitaria Locale ASL AL, Alessandria, Italy
| | - Alessandro Rivetti
- Dipartimento di Prevenzione - S.Pre.S.A.L, ASL CN2 Alba Bra, Alba, Italy
| | - Pasquale Marchione
- Signal Management Unit, Post-Marketing Surveillance Department, Italian Medicine Agency - AIFA, Rome, Italy
| | | | - Vittorio Demicheli
- Servizio Regionale di Riferimento per l'Epidemiologia, SSEpi-SeREMI, Azienda Sanitaria Locale ASL AL, Alessandria, Italy
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Yin Z, Zheng C, Fang Q, Gong X, Cao G, Li J, Xiang Z, Song W. Introduction of Two-Dose Mumps-Containing Vaccine into Routine Immunization Schedule in Quzhou, China, Using Cox-Proportional Hazard Model. J Immunol Res 2021; 2021:5990417. [PMID: 34778466 PMCID: PMC8589524 DOI: 10.1155/2021/5990417] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2021] [Revised: 10/08/2021] [Accepted: 10/13/2021] [Indexed: 12/02/2022] Open
Abstract
Mumps is a vaccine-preventable disease caused by the mumps virus, but the incidence of mumps has increased among the children who were vaccinated with one-dose measles-mumps-rubella (MMR) in recent years. In this study, we analyzed the influence of different doses of mumps-containing vaccine (MuCV) against mumps using Cox-proportional hazard model. We collected 909 mumps cases of children who were born from 2006 to 2010 and vaccinated with different doses of MuCV in Quzhou during 2006-2018, which were all clinically diagnosed. Kaplan-Meier survival methods and Cox-proportional hazard model were used to estimate the hazard probabilities. Kaplan-Meier curves showed that the cumulative hazard of male and female has no difference; lower hazards were detected among those who were vaccinated with two-dose MuCV, born in 2006, and infected after supplementary immunization activities (SIA). Cox-proportional hazard regression suggested that onset after SIA, born in 2006, and vaccinated with two-dose MuCV were protective factors against infection even after adjusting for potential confounding effects. Our study showed that it was necessary to revise the diagnostic criteria of mumps and identify RT-PCR as the standard for mumps diagnosis in China. We suggested that routine immunization schedule should introduce two doses of MMR and prevaccination screening should be performed before booster immunization in vaccinated populations.
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Affiliation(s)
- Zhiying Yin
- Quzhou Center for Disease Control and Prevention, Quzhou, 324000 Zhejiang, China
| | - Canjie Zheng
- Quzhou Center for Disease Control and Prevention, Quzhou, 324000 Zhejiang, China
| | - Quanjun Fang
- Quzhou Center for Disease Control and Prevention, Quzhou, 324000 Zhejiang, China
| | - Xiaoying Gong
- Quzhou Center for Disease Control and Prevention, Quzhou, 324000 Zhejiang, China
| | - Guoping Cao
- Quzhou Center for Disease Control and Prevention, Quzhou, 324000 Zhejiang, China
| | - Junji Li
- Quzhou Center for Disease Control and Prevention, Quzhou, 324000 Zhejiang, China
| | - Ziling Xiang
- Quzhou Center for Disease Control and Prevention, Quzhou, 324000 Zhejiang, China
| | - Wei Song
- Quzhou Women & Children's Hospital, Quzhou, 324000 Zhejiang, China
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Xu L, Li N, Zhang L, Ma R, Fang T, Liu Z, Zhan S. Febrile Seizures and Measles-Containing Vaccines in China: A Self-Controlled Case Series Study. Vaccines (Basel) 2021; 9:vaccines9101073. [PMID: 34696181 PMCID: PMC8541362 DOI: 10.3390/vaccines9101073] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Revised: 09/16/2021] [Accepted: 09/22/2021] [Indexed: 01/25/2023] Open
Abstract
Little is known about the risk of febrile seizures (FS) after vaccination with measles-containing vaccines (MCVs) in middle- and low-income countries. This self-controlled case series study aimed to evaluate the risk of FSs in Chinese children using data from the Ningbo Regional Health Information Platform. The observation period was 0-12 and 13-24 months of age for the MR and MMR vaccines, respectively. The relative incidences (RIs) within 0-6 days, 7-13 days, 14-27 days, and 28-42 days after vaccination with MCVs were estimated. The remaining observation period was the control period. The RIs within 0-6 days, 7-13 days, 14-27 days, and 28-42 days after MR vaccination were 1.11 [95% confidence interval (CI) 0.33 to 3.70], 0.80 (95% CI 0.23 to 2.86), 1.67 (95% CI 0.81 to 3.42), and 1.02 (95% CI 0.49 to 2.14), respectively. The corresponding RIs after MMR vaccination were 0.99 (95% CI 0.56 to 1.75), 1.17 (95% CI 0.68 to 2.01), 0.87 (95% CI 0.54 to 1.39), and 0.85 (95% CI 0.54 to 1.34), respectively. This study suggests that China's vaccination schedule for MCVs, as suggested by the World Health Organization (WHO) for countries with a high risk of measles mortality and ongoing transmission, does not increase the risk of FSs.
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Affiliation(s)
- Lu Xu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China; (L.X.); (Z.L.)
| | - Ning Li
- Ningbo Municipal Center for Disease Control and Prevention, Ningbo 315010, China; (N.L.); (L.Z.); (R.M.); (T.F.)
| | - Liang Zhang
- Ningbo Municipal Center for Disease Control and Prevention, Ningbo 315010, China; (N.L.); (L.Z.); (R.M.); (T.F.)
| | - Rui Ma
- Ningbo Municipal Center for Disease Control and Prevention, Ningbo 315010, China; (N.L.); (L.Z.); (R.M.); (T.F.)
| | - Ting Fang
- Ningbo Municipal Center for Disease Control and Prevention, Ningbo 315010, China; (N.L.); (L.Z.); (R.M.); (T.F.)
| | - Zhike Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China; (L.X.); (Z.L.)
| | - Siyan Zhan
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China; (L.X.); (Z.L.)
- Research Center of Clinical Epidemiology, Peking University Third Hospital, Beijing 100191, China
- Center for Intelligent Public Health, Institute for Artificial Intelligence, Peking University, Beijing 100191, China
- Correspondence:
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Lin CY, Su SB, Peng CJ, Chen KT. The incidence of mumps in Taiwan and its association with the meteorological parameters: An observational study. Medicine (Baltimore) 2021; 100:e27267. [PMID: 34664880 PMCID: PMC8447993 DOI: 10.1097/md.0000000000027267] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Accepted: 08/31/2021] [Indexed: 11/27/2022] Open
Abstract
Mumps is an acute and common childhood disease caused by paramyxovirus. It has been reported that the occurrence of mumps is influenced by seasonality. However, the role of meteorological variables in the incidence of mumps remains unclear. The purpose of this study was to explore the relationship between meteorological factors and the incidence of mumps infection. Poisson regression analysis was used to study the relationship between weather variability and the incidence of mumps in Taiwan. Between 2012 and 2018, 5459 cases of mumps cases were reported to the Centers for Disease Control, Taiwan (Taiwan CDC). The occurrence of mumps virus infections revealed significant seasonality in the spring and summer seasons in Taiwan. The incidence of mumps virus infections began to increase at temperatures of 15°C and started to decline if the temperature was higher than 29°C (r2 = 0.387, P = .008). Similarly, the number of mumps cases began to increase at a relative humidity of 65% to 69% (r2 = 0.838, P < .029). The number of mumps cases was positively associated with temperature and relative humidity during the period preceding the infection. This study showed that the occurrence of mumps is significantly associated with increasing temperature and relative humidity in Taiwan. Therefore, these factors could be regarded as early warning signals and indicate the need to strengthen the intervention and prevention of mumps.
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Affiliation(s)
- Cheng-Yao Lin
- Division of Hematology-Oncology, Department of Internal Medicine, Chi-Mei Medical Center, Liouying, Tainan, Taiwan
- Department of Senior Welfare and Services, Southern Taiwan University of Science and Technology, Tainan, Taiwan
- Department of Environmental and Occupational Health, National Cheng Kung University, Tainan, Taiwan
| | - Shih-Bin Su
- Department of Occupational Medicine, Chi-Mei Medical Center, Tainan, Taiwan
| | - Cheau-Jane Peng
- Department of Senior Welfare and Services, Southern Taiwan University of Science and Technology, Tainan, Taiwan
| | - Kow-Tong Chen
- Department of Occupational Medicine, Tainan Municipal Hospital, Tainan, Taiwan
- Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan
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Wang D, Nie T, Pan F, Wang Y, Wang J, Qin W. Loss of protective immunity of two-dose mumps-containing vaccine over time: concerns with the new strategy of the mumps immunization program in China. Hum Vaccin Immunother 2021; 17:2072-2077. [PMID: 33545016 DOI: 10.1080/21645515.2020.1861877] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Abstract
Background: Currently, children aged 6-9 years have the highest incidence rate of mumps in China. Although China has introduced a two-dose schedule of measles-mumps-rubella vaccine into routine immunization (at 8 months and 18 months), the incidence rate of mumps in high-risk populations might not decrease due to waning immunity. Here we report a mumps outbreak supporting this hypothesis.Methods: The descriptive epidemiological method was used to summarize the overall characteristics of the course of the outbreak. We conducted a retrospective cohort study to evaluate the vaccine effectiveness (VE) of mumps-containing vaccine (MuCV).Results: A total of 78 cases were identified during the outbreak and the estimated vaccination coverage was 84.7%. Of 454 vaccinated students, 335 (73.8%) had received one-dose MuCV, 93 (20.5%) two-dose, and 26 (5.7%) three-dose. The VEs for both the one-dose (-17.0%, 95%CI: -120.3-38.2%) and two-dose groups (-10.0%, 95%CI: -138.0-48.8%) were not performed well, whereas the VE for the three-dose group was 100%. However, we found that the overall VE was 74.2% (95% CI: 9.7-92.6%) for students vaccinated within 5 years. We also observed that there was a broadly linear increase in mumps infection risk in both one-dose and two-dose group when the time since last dose vaccination was more than 5 years.Conclusions: The overall VE for both one-dose and two-dose MuCV was discouraging, but it appeared to be moderately effective within 5 years after vaccination. Further surveillance and seroepidemiological data are needed to understand the impact of the new vaccination strategy on mumps in China.
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Affiliation(s)
- Danni Wang
- Teaching Center for Preventive Medicine, School of Public Health, Anhui Medical University, Hefei, China
| | - Tingyue Nie
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, China
| | - Fan Pan
- Department of Expanded Program on Immunization, Lu'an Municipal Center for Disease Control and Prevention, Lu'an, China
| | - Yao Wang
- Department of Expanded Program on Immunization, Lu'an Municipal Center for Disease Control and Prevention, Lu'an, China
| | - Jian Wang
- Department of Infectious Disease Control, Yu'an District Center for Disease Control and Prevention, Lu'an, China
| | - Wei Qin
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, China.,Department of Expanded Program on Immunization, Lu'an Municipal Center for Disease Control and Prevention, Lu'an, China
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Development of Improved Mumps Vaccine Candidates by Mutating Viral mRNA Cap Methyltransferase Sites in the Large Polymerase Protein. Virol Sin 2020; 36:521-536. [PMID: 33284397 PMCID: PMC7719854 DOI: 10.1007/s12250-020-00326-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2020] [Accepted: 10/20/2020] [Indexed: 10/26/2022] Open
Abstract
Although a live attenuated vaccine is available for controlling mumps virus (MuV), mumps still outbreaks frequently worldwide. The attenuated MuV vaccine strain S79 is widely used in mumps vaccination in China, but still with many shortcomings, among which the most prominent are the side effects and decreased immunity. Therefore, there is a need to further improve the safety and efficacy of the current MuV vaccine. In the present study, we further attenuated MuV S79 vaccine strain by inhibiting viral mRNA methyltransferase (MTase). We generated a panel of eight recombinant MuVs (rMuVs) carrying mutations in the MTase catalytic site or S-adenosylmethionine (SAM) binding site in the large (L) polymerase protein. These rMuVs are genetically stable and seven rMuVs are more attenuated in replication in cell culture and five rMuVs are more attenuated in replication in lungs of cotton rats compared with the parental vaccine strain S79. Importantly, cotton rats vaccinated with these seven rMuV mutants produced high levels of serum neutralizing antibodies and were completely protected against challenge with a wild-type MuV strain (genotype F). Therefore, our results demonstrate that alteration in the MTase catalytic site or SAM binding site in MuV L protein improves the safety or the immunogenicity of the MuV vaccine and thus mRNA cap MTase may be an effective target for the development of new vaccine candidates for MuV.
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Di Pietrantonj C, Rivetti A, Marchione P, Debalini MG, Demicheli V. Vaccines for measles, mumps, rubella, and varicella in children. Cochrane Database Syst Rev 2020; 4:CD004407. [PMID: 32309885 PMCID: PMC7169657 DOI: 10.1002/14651858.cd004407.pub4] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND Measles, mumps, rubella, and varicella (chickenpox) are serious diseases that can lead to serious complications, disability, and death. However, public debate over the safety of the trivalent MMR vaccine and the resultant drop in vaccination coverage in several countries persists, despite its almost universal use and accepted effectiveness. This is an update of a review published in 2005 and updated in 2012. OBJECTIVES To assess the effectiveness, safety, and long- and short-term adverse effects associated with the trivalent vaccine, containing measles, rubella, mumps strains (MMR), or concurrent administration of MMR vaccine and varicella vaccine (MMR+V), or tetravalent vaccine containing measles, rubella, mumps, and varicella strains (MMRV), given to children aged up to 15 years. SEARCH METHODS We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (the Cochrane Library 2019, Issue 5), which includes the Cochrane Acute Respiratory Infections Group's Specialised Register, MEDLINE (1966 to 2 May 2019), Embase (1974 to 2 May 2019), the WHO International Clinical Trials Registry Platform (2 May 2019), and ClinicalTrials.gov (2 May 2019). SELECTION CRITERIA We included randomised controlled trials (RCTs), controlled clinical trials (CCTs), prospective and retrospective cohort studies (PCS/RCS), case-control studies (CCS), interrupted time-series (ITS) studies, case cross-over (CCO) studies, case-only ecological method (COEM) studies, self-controlled case series (SCCS) studies, person-time cohort (PTC) studies, and case-coverage design/screening methods (CCD/SM) studies, assessing any combined MMR or MMRV / MMR+V vaccine given in any dose, preparation or time schedule compared with no intervention or placebo, on healthy children up to 15 years of age. DATA COLLECTION AND ANALYSIS Two review authors independently extracted data and assessed the methodological quality of the included studies. We grouped studies for quantitative analysis according to study design, vaccine type (MMR, MMRV, MMR+V), virus strain, and study settings. Outcomes of interest were cases of measles, mumps, rubella, and varicella, and harms. Certainty of evidence of was rated using GRADE. MAIN RESULTS We included 138 studies (23,480,668 participants). Fifty-one studies (10,248,159 children) assessed vaccine effectiveness and 87 studies (13,232,509 children) assessed the association between vaccines and a variety of harms. We included 74 new studies to this 2019 version of the review. Effectiveness Vaccine effectiveness in preventing measles was 95% after one dose (relative risk (RR) 0.05, 95% CI 0.02 to 0.13; 7 cohort studies; 12,039 children; moderate certainty evidence) and 96% after two doses (RR 0.04, 95% CI 0.01 to 0.28; 5 cohort studies; 21,604 children; moderate certainty evidence). The effectiveness in preventing cases among household contacts or preventing transmission to others the children were in contact with after one dose was 81% (RR 0.19, 95% CI 0.04 to 0.89; 3 cohort studies; 151 children; low certainty evidence), after two doses 85% (RR 0.15, 95% CI 0.03 to 0.75; 3 cohort studies; 378 children; low certainty evidence), and after three doses was 96% (RR 0.04, 95% CI 0.01 to 0.23; 2 cohort studies; 151 children; low certainty evidence). The effectiveness (at least one dose) in preventing measles after exposure (post-exposure prophylaxis) was 74% (RR 0.26, 95% CI 0.14 to 0.50; 2 cohort studies; 283 children; low certainty evidence). The effectiveness of Jeryl Lynn containing MMR vaccine in preventing mumps was 72% after one dose (RR 0.24, 95% CI 0.08 to 0.76; 6 cohort studies; 9915 children; moderate certainty evidence), 86% after two doses (RR 0.12, 95% CI 0.04 to 0.35; 5 cohort studies; 7792 children; moderate certainty evidence). Effectiveness in preventing cases among household contacts was 74% (RR 0.26, 95% CI 0.13 to 0.49; 3 cohort studies; 1036 children; moderate certainty evidence). Vaccine effectiveness against rubella is 89% (RR 0.11, 95% CI 0.03 to 0.42; 1 cohort study; 1621 children; moderate certainty evidence). Vaccine effectiveness against varicella (any severity) after two doses in children aged 11 to 22 months is 95% in a 10 years follow-up (rate ratio (rr) 0.05, 95% CI 0.03 to 0.08; 1 RCT; 2279 children; high certainty evidence). Safety There is evidence supporting an association between aseptic meningitis and MMR vaccines containing Urabe and Leningrad-Zagreb mumps strains, but no evidence supporting this association for MMR vaccines containing Jeryl Lynn mumps strains (rr 1.30, 95% CI 0.66 to 2.56; low certainty evidence). The analyses provide evidence supporting an association between MMR/MMR+V/MMRV vaccines (Jeryl Lynn strain) and febrile seizures. Febrile seizures normally occur in 2% to 4% of healthy children at least once before the age of 5. The attributable risk febrile seizures vaccine-induced is estimated to be from 1 per 1700 to 1 per 1150 administered doses. The analyses provide evidence supporting an association between MMR vaccination and idiopathic thrombocytopaenic purpura (ITP). However, the risk of ITP after vaccination is smaller than after natural infection with these viruses. Natural infection of ITP occur in 5 cases per 100,000 (1 case per 20,000) per year. The attributable risk is estimated about 1 case of ITP per 40,000 administered MMR doses. There is no evidence of an association between MMR immunisation and encephalitis or encephalopathy (rate ratio 0.90, 95% CI 0.50 to 1.61; 2 observational studies; 1,071,088 children; low certainty evidence), and autistic spectrum disorders (rate ratio 0.93, 95% CI 0.85 to 1.01; 2 observational studies; 1,194,764 children; moderate certainty). There is insufficient evidence to determine the association between MMR immunisation and inflammatory bowel disease (odds ratio 1.42, 95% CI 0.93 to 2.16; 3 observational studies; 409 cases and 1416 controls; moderate certainty evidence). Additionally, there is no evidence supporting an association between MMR immunisation and cognitive delay, type 1 diabetes, asthma, dermatitis/eczema, hay fever, leukaemia, multiple sclerosis, gait disturbance, and bacterial or viral infections. AUTHORS' CONCLUSIONS Existing evidence on the safety and effectiveness of MMR/MMRV vaccines support their use for mass immunisation. Campaigns aimed at global eradication should assess epidemiological and socioeconomic situations of the countries as well as the capacity to achieve high vaccination coverage. More evidence is needed to assess whether the protective effect of MMR/MMRV could wane with time since immunisation.
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Affiliation(s)
- Carlo Di Pietrantonj
- Azienda Sanitaria Locale ASL AL, Servizio Regionale di Riferimento per l'Epidemiologia, SSEpi-SeREMI, Via Venezia 6, Alessandria, Italy, 15121
| | - Alessandro Rivetti
- ASL CN2 Alba Bra, Dipartimento di Prevenzione - S.Pre.S.A.L, Via Vida 10, Alba, Piemonte, Italy, 12051
| | - Pasquale Marchione
- Italian Medicine Agency - AIFA, Signal Management Unit, Post-Marketing Surveillance Department, Via del Tritone 181, Rome, Italy, 00187
| | | | - Vittorio Demicheli
- Azienda Sanitaria Locale ASL AL, Servizio Regionale di Riferimento per l'Epidemiologia, SSEpi-SeREMI, Via Venezia 6, Alessandria, Italy, 15121
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11
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Zhou C, Song W, Yin Z, Li S, Gong X, Fang Q, Wang S. 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] [MESH Headings] [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 (X 2 = 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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Affiliation(s)
- Chunting Zhou
- Women & Children Health Care Hospital of Quzhou, Quzhou, 324000 Zhejiang, China
| | - Wei Song
- Women & Children Health Care Hospital of Quzhou, Quzhou, 324000 Zhejiang, China
| | - Zhiying Yin
- Department of Immunization, Quzhou Center for Disease Control and Prevention, Quzhou, 324000 Zhejiang, China
| | - Sheng Li
- Women & Children Health Care Hospital of Quzhou, Quzhou, 324000 Zhejiang, China
| | - Xiaoying Gong
- Department of Immunization, Quzhou Center for Disease Control and Prevention, Quzhou, 324000 Zhejiang, China
| | - Quanjun Fang
- Department of Immunization, Quzhou Center for Disease Control and Prevention, Quzhou, 324000 Zhejiang, China
| | - Shuangqing Wang
- Department of Immunization, Quzhou Center for Disease Control and Prevention, Quzhou, 324000 Zhejiang, China
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12
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Zhou D, Zhu MY, Wang YL, Hao XQ, Zhou DM, Liu RX, Zhang CD, Qu CF, Zhao ZY. Attenuated MuV-S79 as vector stably expressing foreign gene. World J Pediatr 2019; 15:511-515. [PMID: 31377975 DOI: 10.1007/s12519-019-00287-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Accepted: 07/02/2019] [Indexed: 01/06/2023]
Abstract
BACKGROUND To describe mumps virus (MuV) used as a vector to express enhanced green fluorescent protein (EGFP) or red fluorescent protein (RFP) genes. METHODS Molecular cloning technique was applied to establish the cDNA clones of recombinant mumps viruses (rMuVs). rMuVs were recovered based on our reverse genetic system of MuV-S79. The properties of rMuVs were determined by growth curve, plaque assay, fluorescent microscopy and determination of fluorescent intensity. RESULTS Three recombinant viruses replicated well in Vero cells and similarly as parental rMuV-S79, expressed heterologous genes in high levels, and were genetically stable in at least 15 passages. CONCLUSION rMuV-S79 is a promising platform to accommodate foreign genes like marker genes, other antigens and immunomodulators for addressing various diseases.
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Affiliation(s)
- Duo Zhou
- Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Meng-Ying Zhu
- Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Yi-Long Wang
- Department of Neurology, Children's Hospital, Zhejiang University School of Medicine, Hangzhou, 310052, China
| | - Xiao-Qiang Hao
- Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Dong-Ming Zhou
- Children's Hospital, Zhejiang University School of Medicine, Hangzhou, 310052, China
| | - Rong-Xian Liu
- Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Chu-Di Zhang
- Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Chu-Fan Qu
- Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Zheng-Yan Zhao
- Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.
- Children's Hospital, Zhejiang University School of Medicine, Hangzhou, 310052, China.
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Qin W, Wang Y, Yang T, Xu XK, Meng XM, Zhao CJ, Li SY, Xie SY, Li KC, Su H. Outbreak of mumps in a student population with high vaccination coverage in China: time for two-dose vaccination. Hum Vaccin Immunother 2019; 15:2106-2111. [PMID: 30779678 DOI: 10.1080/21645515.2019.1581526] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Abstract
In 2016, an outbreak of mumps occurred in a primary school in China with a student population having high vaccination coverage. An unmatched case-control study was performed to identify risk factors contributing to this outbreak, and a retrospective cohort study was conducted to evaluate the effectiveness of mumps-containing vaccine (MuCV). A total of 97 cases were identified during the outbreak, and the overall attack rate was 8.2%. Among students with confirmed vaccination status, 90% had received at least one dose of MuCV. Cases were more likely than non-cases to report taking the school bus during the epidemic period (adjusted OR = 2.3, 95% CI: 1.4-3.7). Vaccine effectiveness (VE) was higher for two-dose MuCV (76%, 95% CI:49â€"89%) than for one-dose MuCV (59%, 95% CI: 36â€"74%. The protection afforded by both one-dose and two-dose MuCV waned over time, from 82% among students vaccinated within 5 years to 41% among those vaccinated more than 10 years previously for one-dose VE, and from 90% to 25% over the same time period for two-dose VE. We found that outbreaks of mumps can occur in schools despite high coverage of one-dose MuCV vaccination. Although the VE of both two-dose and one-dose MuCV wanes over time, the overall VE for two-dose MuCV was superior than that of one-dose MuCV. Therefore, a two-dose MuCV schedule through routine services is likely needed in order to control mumps epidemics in China.
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Affiliation(s)
- Wei Qin
- Department of Expanded Program on Immunization, Lu'an Municipal Center for Disease Control and Prevention , Lu'an , Anhui , China.,Chinese Field Epidemiology Training Program (CFETP), Chinese Center for Disease Control and Prevention , Beijing , China.,Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University , Hefei , China
| | - Yao Wang
- Department of Expanded Program on Immunization, Lu'an Municipal Center for Disease Control and Prevention , Lu'an , Anhui , China
| | - Tao Yang
- Department of Expanded Program on Immunization, Lu'an Municipal Center for Disease Control and Prevention , Lu'an , Anhui , China
| | - Xiao-Kang Xu
- Department of Expanded Program on Immunization, Lu'an Municipal Center for Disease Control and Prevention , Lu'an , Anhui , China
| | - Xiang-Mei Meng
- Department of Expanded Program on Immunization, Lu'an Municipal Center for Disease Control and Prevention , Lu'an , Anhui , China
| | - Chang-Jun Zhao
- Department of Expanded Program on Immunization, Jin'an District Center for Disease Control and Prevention , Lu'an , Anhui , China
| | - Shao-Yi Li
- Department of Expanded Program on Immunization, Jin'an District Center for Disease Control and Prevention , Lu'an , Anhui , China
| | - Shao-Yu Xie
- Department of Expanded Program on Immunization, Lu'an Municipal Center for Disease Control and Prevention , Lu'an , Anhui , China
| | - Kai-Chun Li
- Department of Expanded Program on Immunization, Lu'an Municipal Center for Disease Control and Prevention , Lu'an , Anhui , China
| | - Hong Su
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University , Hefei , China
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Zhang L, Wang Z, Hu Y, Deng X, Guo H, Sun X, Tang F, Zhou M, Liu Y. Application of a mixture model to assess the effect of measles-mumps-rubella vaccine on the mumps epidemic in children from kindergarten to early school age in Jiangsu Province, China. Hum Vaccin Immunother 2018; 14:2654-2659. [PMID: 29792546 DOI: 10.1080/21645515.2018.1480239] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022] Open
Abstract
A single dose of the measles-mumps-rubella (MMR) vaccine has been applied in routine immunizations for children in China; however, the Immunoglobulin G (IgG) antibody level of mumps in children from kindergarten to early school age with MMR vaccine immunization history has not been elucidated. This study aimed to describe the immunity profile of children from kindergarten to early school age to identify the susceptible population. In Jiangsu Province, a cross-sectional survey of 4- to 8-year-old children who were vaccinated with at least one dose of MMR vaccine was conducted. IgG antibody results were analyzed by employing both the Enzyme-Linked Immunosorbent Assay (ELISA) cutoff values and the mixture model. A total of 7436 eligible subjects were enrolled: 3386 subjects were in kindergarten, and 4450 were in primary school. The overall seroprevalence (75.4%, 95% CI: 74.4%-76.4%) and Geometric mean concentration (GMC, 201.4U/ml, 95% CI: 194.1-209.4) of mumps antibodies in 2016 were low. The seroprevalence of children in kindergarten (78.1%, 95% CI: 76.6%-79.4%) was significantly higher than that of children in primary school (73.2%, 95% CI: 71.2%-74.6%). The GMC was negatively correlated with the time of inoculation (F = 32.17, P = 0.002). The mixture model enables a more comprehensive understanding of serological results by investigating four levels of antibody response, suggesting that there is a small fraction of the population with waning immunity. Children in kindergarten and primary school whom had received one dose of MMR vaccine were at a higher risk of mumps infection, particularly the 7-year-old group in the central region. Therefore, the single-dose MMR vaccine schedule has a limited impact on mumps control and prevention, and a two-dose MMR vaccine schedule should be introduced.
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Affiliation(s)
- Lei Zhang
- a Department of Epidemiology , School of Public Health, Nanjing Medical University , Nanjing , Jiangsu province , China
| | - Zhiguo Wang
- b Department of Expanded Program on Immunization , Jiangsu Provincial Center for Disease Control and Prevention , Nanjing , Jiangsu province , China
| | - Ying Hu
- b Department of Expanded Program on Immunization , Jiangsu Provincial Center for Disease Control and Prevention , Nanjing , Jiangsu province , China
| | - Xiuying Deng
- b Department of Expanded Program on Immunization , Jiangsu Provincial Center for Disease Control and Prevention , Nanjing , Jiangsu province , China
| | - Hongxiong Guo
- b Department of Expanded Program on Immunization , Jiangsu Provincial Center for Disease Control and Prevention , Nanjing , Jiangsu province , China
| | - Xiang Sun
- b Department of Expanded Program on Immunization , Jiangsu Provincial Center for Disease Control and Prevention , Nanjing , Jiangsu province , China
| | - Fenyang Tang
- b Department of Expanded Program on Immunization , Jiangsu Provincial Center for Disease Control and Prevention , Nanjing , Jiangsu province , China
| | - Minghao Zhou
- a Department of Epidemiology , School of Public Health, Nanjing Medical University , Nanjing , Jiangsu province , China
| | - Yuanbao Liu
- b Department of Expanded Program on Immunization , Jiangsu Provincial Center for Disease Control and Prevention , Nanjing , Jiangsu province , China
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