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Gao BG, Huang LF, Xie P. Effectiveness and safety of a mumps containing vaccine in preventing laboratory-confirmed mumps cases from 2002 to 2017: A meta-analysis. Open Life Sci 2024; 19:20220820. [PMID: 38465337 PMCID: PMC10921504 DOI: 10.1515/biol-2022-0820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Revised: 11/22/2023] [Accepted: 12/05/2023] [Indexed: 03/12/2024] Open
Abstract
Emerging evidence has figured that serum conversion rate of mumps is a crucial link of mumps disease. Nevertheless, a rising number of mumps outbreaks caused our attention and studies examining the serum conversion cases were conducted in small samples previously; this meta-analysis was conducted to assess the immunogenicity and safety of a mumps containing vaccine (MuCV) before 2019. We identified a total of 17 studies from the year of 2002-2017. In the case-control studies, the vaccine effectiveness (VE) of MuCV in preventing laboratory-confirmed mumps was 68% (odds risk: 0.32; 95% confidence interval [CI], 0.14-0.70) while in the cohort studies and randomised control trials, 58% (relative risk [RR]: 0.42; 95% CI, 0.26-0.69). Similar intervals of effectiveness rates were found during non-outbreak periods compared with outbreak periods (VE: 66%; RR: 0.34; 95% CI, 0.18-0.68 versus VE: 49%; RR: 0.51; 95% CI, 0.21-1.27). In addition, the MuCV group with two and three doses did not show enhanced laboratory-confirmed mumps than one dose (VE: 58%; RR: 0.42; 95% CI, 0.20-0.88 versus VE: 65%, RR: 0.35; 95% CI, 0.20-0.61) for the reason of the overlap of 95% CI. MuCV had comparable effectiveness comparing non-outbreak and outbreak period, one dose, and two or three doses. MuCV displayed acceptable adverse event profiles.
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Affiliation(s)
- Bu-Gang Gao
- Rehabilitation Teaching and Research Office, Department of Medicine, ChuZhou City Vocational College, Chuzhou, Anhui Province, China
| | - Ling-feng Huang
- Department of Epidemiology and Biostatistics, School of Public Health, Guangdong Medical University, Zhanjiang, Guangdong, China
- Community Health Service Center in Nantou, Zhongshan, Guangdong Province, China
| | - Ping Xie
- Rehabilitation Teaching and Research Office, Department of Medicine, ChuZhou City Vocational College, Chuzhou, Anhui Province, China
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Franconeri L, Antona D, Cauchemez S, Lévy-Bruhl D, Paireau J. Two-dose measles vaccine effectiveness remains high over time: A French observational study, 2017-2019. Vaccine 2023; 41:5797-5804. [PMID: 37586955 DOI: 10.1016/j.vaccine.2023.08.018] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 08/07/2023] [Accepted: 08/08/2023] [Indexed: 08/18/2023]
Abstract
BACKGROUND From 2008 to 2019, France has experienced a resurgence of measles epidemics. Surveillance data have shown that the proportion of cases vaccinated with two doses of measles-containing vaccine (MCV) increased with age, raising concerns about the duration of vaccine protection. Our objectives were to investigate age-stratified vaccine effectiveness (VE) for the second dose of MCV (MCV2) and to quantify protection levels over time. METHODS We analyzed data on measles cases aged 2-31 years, reported via mandatory notification to the French measles surveillance system from October 2017 to September 2019. We estimated an age-stratified VE for MCV2 using the screening method, which compares the vaccination status of cases with that of the general population. We improved this method by accounting for natural immunity, exploring four scenarios with four possible levels of natural immunity in the population. In addition, we quantified the decay rate of protection over time, by fitting an exponential decay model among individuals vaccinated in early life. RESULTS In the baseline analysis (absence of natural immunity), VE estimates were high in all age groups and decreased with age, from 99.6 % (95 % confidence interval: 99.3-99.8) in 2-5 years old to 91.4 % (85.1-95.0) in 26-31 years old. Accounting for natural immunity increased VE in the older age group to 93.2-99.2 % depending on the scenario. We estimated that VE was slowly decreasing over time, with an exponential decay rate of 0.0022/year (0.0017-0.0028), leading to VE of 96.7 % (96.0-97.4) 16 years after MCV2 vaccination. This decline was most compatible with scenario 2, a scenario of 4.4 % naturally immunized, non-vaccinated individuals in the 26-31 years old. CONCLUSION Our study confirms the continued high effectiveness of two doses of MCV with only slight degradation, decades after immunization. These findings support the importance of achieving a very high vaccination coverage with 2 doses of MCV.
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Affiliation(s)
- Léa Franconeri
- Direction des Maladies Infectieuses, Santé publique France, 94415 Saint Maurice, France.
| | - Denise Antona
- Direction des Maladies Infectieuses, Santé publique France, 94415 Saint Maurice, France
| | - Simon Cauchemez
- Mathematical Modelling of Infectious Diseases Unit, Institut Pasteur, Université Paris Cité, CNRS UMR 2000, 75015 Paris, France
| | - Daniel Lévy-Bruhl
- Direction des Maladies Infectieuses, Santé publique France, 94415 Saint Maurice, France
| | - Juliette Paireau
- Direction des Maladies Infectieuses, Santé publique France, 94415 Saint Maurice, France; Mathematical Modelling of Infectious Diseases Unit, Institut Pasteur, Université Paris Cité, CNRS UMR 2000, 75015 Paris, France
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Hiebert J, Saboui M, Frost JR, Zubach V, Laverty M, Severini A. Mumps resurgence in a highly vaccinated population: Insights gained from surveillance in Canada, 2002-2020. Vaccine 2023:S0264-410X(23)00513-3. [PMID: 37169652 DOI: 10.1016/j.vaccine.2023.04.078] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 04/26/2023] [Accepted: 04/27/2023] [Indexed: 05/13/2023]
Abstract
Although mumps vaccination has been routine in Canada for decades, mumps cases and outbreaks continue to occur periodically. Mumps surveillance, including monitoring of the mumps virus genotype associated with disease activity, is important to document baseline activity and to advance further research into vaccine effectiveness. Here we describe a detailed analysis of mumps cases that have been detected in Canada from 2002 to 2020, with a focus on the mumps molecular epidemiology. In total, 7395 cases of mumps were reported to the surveillance system, with outbreaks occurring in the years 2007, 2010 and 2016 to 2018. Adolescents and young adults aged 15 to 29 years had the highest risk of being a case (rate ratios ranging from 1.50 to 2.29), compared to adults aged 30 to 39. Genotypes of mumps viruses were determined in 3225 specimens. Genotype G was predominantly detected (96% of genotyped specimens) and was first reported in 2005. Other genotypes were more likely to be detected in cases that also reported travel (or were linked to imported cases) than the cases with genotype G detected (p < 0.0001). The genotype G viruses had little sequence diversity in the 316 nucleotide window used for genotyping (the small hydrophobic protein gene) and mainly belonged to a single phylogenetic lineage that included the MuVi/Sheffield.GBR/1.05 reference sequence. The analysis of over ten years of data has demonstrated that mumps genotype G, specifically belonging to a single lineage, the Sheffield lineage, is the endemically circulating virus in Canada. This lineage is seen also in other countries using the genotype A vaccine. Mumps remains endemic despite high MMR vaccination coverage which has been sufficient to eliminate circulation of measles and rubella in Canada, raising the hypothesis of the evolution towards a vaccine escape mumps virus.
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Affiliation(s)
- Joanne Hiebert
- Viral Exanthemata and STD section, National Microbiology Laboratory Branch, Public Health Agency of Canada, JC Wilt Infectious Diseases Research Centre, 745 Logan Avenue, Winnipeg R3E 3L5, Canada.
| | - Myriam Saboui
- Centre for Immunization and Respiratory Infectious Diseases, Public Health Agency of Canada, Ottawa, Canada
| | - Jasmine Rae Frost
- Department of Medical Microbiology and Infectious Diseases, Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada
| | - Vanessa Zubach
- Viral Exanthemata and STD section, National Microbiology Laboratory Branch, Public Health Agency of Canada, JC Wilt Infectious Diseases Research Centre, 745 Logan Avenue, Winnipeg R3E 3L5, Canada
| | - Meghan Laverty
- Viral Exanthemata and STD section, National Microbiology Laboratory Branch, Public Health Agency of Canada, JC Wilt Infectious Diseases Research Centre, 745 Logan Avenue, Winnipeg R3E 3L5, Canada
| | - Alberto Severini
- Viral Exanthemata and STD section, National Microbiology Laboratory Branch, Public Health Agency of Canada, JC Wilt Infectious Diseases Research Centre, 745 Logan Avenue, Winnipeg R3E 3L5, Canada; Department of Medical Microbiology and Infectious Diseases, Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada
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Wen L, Yang D, Li Y, Lu D, Su H, Tang M, Song X. Spatial Effect of Ecological Environmental Factors on Mumps in China during 2014-2018. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15429. [PMID: 36497504 PMCID: PMC9735526 DOI: 10.3390/ijerph192315429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/17/2022] [Revised: 11/17/2022] [Accepted: 11/17/2022] [Indexed: 06/17/2023]
Abstract
(1) Background: although mumps vaccines have been introduced in most countries around the world in recent years, mumps outbreaks have occurred in countries with high vaccination rates. At present, China remains the focus of the global fight against mumps. This study aims to observe the epidemic characteristics and spatial clustering patterns of mumps and to investigate the potential factors affecting the disease incidence, which could provide novel ideas and avenues for future research as well as the prevention and control of mumps. (2) Methods: we used ArcGIS software to visualize the spatial distribution and variation of mumps. Spatial autocorrelation analysis was applied to detect the spatial dependence and clustering patterns of the incidence. We applied the Spatial Durbin Panel Model (SDPM) to explore the spatial associations of ecological environmental factors with mumps. (3) Results: overall, the incidence rate showed a significant upward trend from 2014 to 2018, with the highest number of cases in the 10-15-year age group and from May to June. Geographically, the high incidence clusters were concentrated in southern regions, including Hunan, Hubei, Chongqing, Guizhou, Guangdong, and Guangxi. This study also found that mumps has a positive spatial spillover effect in the study area. The average temperature and GDP of the local and adjacent areas have a significant impact on mumps. The increase in PM2.5 contributes to the rise in the incidence of mumps in this region. (4) Conclusions: these results can offer some novel ideas for policymakers and researchers. Local meteorological conditions and economic levels can extend to surrounding areas to affect the occurrence of mumps, so regional cooperation becomes particularly important. We recommend investment of public health funds in areas with a high incidence of mumps and developing economies to reduce and control the incidence of mumps.
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Affiliation(s)
- Li Wen
- Department of Biostatistics, School of Public Health, Guangxi Medical University, Nanning 530021, China
| | - Danling Yang
- Department of Biostatistics, School of Public Health, Guangxi Medical University, Nanning 530021, China
| | - Yanning Li
- Department of Biostatistics, School of Public Health, Guangxi Medical University, Nanning 530021, China
| | - Dongjia Lu
- Guangxi Key Laboratory of AIDS Prevention and Treatment, Guangxi Universities Key Laboratory of Prevention and Control of Highly Prevalent Disease, Nanning 530021, China
| | - Haixia Su
- Department of Biostatistics, School of Public Health, Guangxi Medical University, Nanning 530021, China
| | - Mengying Tang
- Department of Biostatistics, School of Public Health, Guangxi Medical University, Nanning 530021, China
| | - Xiaokun Song
- Department of Biostatistics, School of Public Health, Guangxi Medical University, Nanning 530021, 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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Kidokoro M, Shiino T, Yamaguchi T, Nariai E, Kodama H, Nakata K, Sano T, Gotou K, Kisu T, Maruyama T, Kuba Y, Sakata W, Higashi T, Kiyota N, Sakai T, Yahiro S, Nagita A, Watanabe K, Hirokawa C, Hamabata H, Fujii Y, Yamamoto M, Yokoi H, Sakamoto M, Saito H, Shibata C, Inada M, Fujitani M, Minagawa H, Ito M, Shima A, Murano K, Katoh H, Kato F, Takeda M, Suga S. Nationwide and long-term molecular epidemiologic studies of mumps viruses that circulated in Japan between 1986 and 2017. Front Microbiol 2022; 13:728831. [PMID: 36386684 PMCID: PMC9650061 DOI: 10.3389/fmicb.2022.728831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Accepted: 09/21/2022] [Indexed: 11/25/2022] Open
Abstract
In Japan, major mumps outbreaks still occur every 4–5 years because of low mumps vaccine coverage (30–40%) owing to the voluntary immunization program. Herein, to prepare for a regular immunization program, we aimed to reveal the nationwide and long-term molecular epidemiological trends of the mumps virus (MuV) in Japan. Additionally, we performed whole-genome sequencing (WGS) using next-generation sequencing to assess results from conventional genotyping using MuV sequences of the small-hydrophobic (SH) gene. We analyzed 1,064 SH gene sequences from mumps clinical samples and MuV isolates collected from 25 prefectures from 1986 to 2017. The results showed that six genotypes, namely B (110), F (1), G (900), H (3), J (41), and L (9) were identified, and the dominant genotypes changed every decade in Japan since the 1980s. Genotype G has been exclusively circulating since the early 2000s. Seven clades were identified for genotype G using SH sequence-based classification. To verify the results, we performed WGS on 77 representative isolates of genotype G using NGS and phylogenetically analyzed them. Five clades were identified with high bootstrap values and designated as Japanese clade (JPC)-1, -2, -3, -4, -5. JPC-1 and -3 accounted for over 80% of the total genotype G isolates (68.3 and 13.8%, respectively). Of these, JPC-2 and -5, were newly identified clades in Japan through this study. This is the first report describing the nationwide and long-term molecular epidemiology of MuV in Japan. The results provide information about Japanese domestic genotypes, which is essential for evaluating the mumps elimination progress in Japan after the forthcoming introduction of the mumps vaccine into Japan’s regular immunization program. Furthermore, the study shows that WGS analysis using NGS is more accurate than results obtained from conventional SH sequence-based classification and is a powerful tool for accurate molecular epidemiology studies.
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Affiliation(s)
- Minoru Kidokoro
- Department of Quality Assurance, Radiation Safety, and Information Management, National Institute of Infectious Diseases, Tokyo, Japan
- *Correspondence: Minoru Kidokoro,
| | - Teiichiro Shiino
- Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan
| | - Tomohiro Yamaguchi
- Public Hygiene Division, Gifu Prefectural Tono Region Public Health Center, Tajimi, Japan
| | - Eri Nariai
- Department of Health and Food Safety, Ishikawa Prefectural Institute of Public Health and Environmental Science, Kanazawa, Japan
| | - Hiroe Kodama
- Department of Health and Food Safety, Ishikawa Prefectural Institute of Public Health and Environmental Science, Kanazawa, Japan
| | - Keiko Nakata
- Division of Virology, Osaka Institute of Public Health, Osaka, Japan
| | - Takako Sano
- Division of Microbiology, Kanagawa Prefectural Institute of Public Health, Chigasaki, Japan
| | - Keiko Gotou
- Division of Virology, Ibaraki Prefectural Institute of Public Health, Mito, Ibaraki, Japan
| | - Tomoko Kisu
- Virus Research Center, Clinical Research Division, Sendai National Hospital, Sendai, Japan
| | - Tomomi Maruyama
- Department of Infectious Diseases, Gifu Prefectural Research Institute for Health and Environmental Sciences, Kakamigahara, Japan
| | - Yumani Kuba
- Department of Medical Microbiology and zoology, Okinawa Prefectural Institute of Health and Environment, Uruma, Japan
| | - Wakako Sakata
- Kitakyushu City Institute of Health and Environmental Sciences, Kitakyushu, Japan
| | - Teruaki Higashi
- Kitakyushu City Institute of Health and Environmental Sciences, Kitakyushu, Japan
| | - Naoko Kiyota
- Department of Microbiology, Kumamoto Prefectural Institute of Public-Health and Environmental Science, Uto, Japan
| | - Takashi Sakai
- Department of Microbiology, Kumamoto Prefectural Institute of Public-Health and Environmental Science, Uto, Japan
| | - Shunsuke Yahiro
- Department of Microbiology, Kumamoto Prefectural Institute of Public-Health and Environmental Science, Uto, Japan
| | - Akira Nagita
- Department of Pediatrics, Mizushima Central Hospital, Kurashiki, Japan
| | - Kaori Watanabe
- Virology Section, Niigata Prefectural Institute of Public Health and Environmental Sciences, Niigata, Japan
| | - Chika Hirokawa
- Virology Section, Niigata Prefectural Institute of Public Health and Environmental Sciences, Niigata, Japan
| | | | - Yoshiki Fujii
- Division of Biological Science, Hiroshima City Institute of Public Health, Hiroshima, Japan
| | - Miwako Yamamoto
- Division of Biological Science, Hiroshima City Institute of Public Health, Hiroshima, Japan
| | - Hajime Yokoi
- Health Science Division, Chiba City Institute of Health and Environment, Chiba, Japan
| | - Misako Sakamoto
- Health Science Division, Chiba City Institute of Health and Environment, Chiba, Japan
| | - Hiroyuki Saito
- Department of Microbiology, Akita Prefectural Research Center for Public Health and Environment, Akita, Japan
| | - Chihiro Shibata
- Department of Microbiology, Akita Prefectural Research Center for Public Health and Environment, Akita, Japan
| | - Machi Inada
- Virology and Epidemiology Division, Nara Prefecture Institute of Health, Sakurai, Japan
| | - Misako Fujitani
- Virology and Epidemiology Division, Nara Prefecture Institute of Health, Sakurai, Japan
| | - Hiroko Minagawa
- Laboratory of Virology, Aichi Prefectural Institute of Public Health, Nagoya, Japan
| | - Miyabi Ito
- Laboratory of Virology, Aichi Prefectural Institute of Public Health, Nagoya, Japan
| | - Akari Shima
- Microbiology Division, Saga Prefectural Institute of Public Health and Pharmaceutical Research, Saga, Japan
| | - Keiko Murano
- Department of Virology III, National Institute of Infectious Diseases, Tokyo, Japan
| | - Hiroshi Katoh
- Department of Virology III, National Institute of Infectious Diseases, Tokyo, Japan
| | - Fumihiro Kato
- Department of Virology III, National Institute of Infectious Diseases, Tokyo, Japan
| | - Makoto Takeda
- Department of Virology III, National Institute of Infectious Diseases, Tokyo, Japan
| | - Shigeru Suga
- Department of Pediatrics, National Hospital Organization Mie National Hospital, Tsu, Japan
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Fu X, Ge M, Xu W, Yu M, Ju J, Zhong Y, Huang H. Epidemiological features and sociodemographic factors associated with mumps in mainland China from 2004 to 2018. J Med Virol 2022; 94:4850-4859. [PMID: 35739613 PMCID: PMC9546204 DOI: 10.1002/jmv.27955] [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: 02/25/2022] [Revised: 06/20/2022] [Accepted: 06/21/2022] [Indexed: 11/11/2022]
Abstract
BACKGROUND Mumps is an acute infectious disease that spreads widely around the world. The aim of this study was to investigate the epidemiological features and sociodemographic factors associated with mumps in mainland China from 2004 to 2018. METHODS Incidence data for mumps during the period 2004-2018 were collected from the Public Health Sciences Data Center of China. Joinpoint regression analysis was performed to explore the trends of mumps. Space-time clustering analysis was conducted to spatial and temporal aggregation areas of mumps. A generalized linear model was used to explore sociodemographic factors associated with the incidence of mumps. RESULTS Average annual incidence of mumps was 21.44/100,000 in mainland China. It was increased dramatically during 2004-2012 (APC = 7.51, 95%CI: 2.28 to 13.00). After 2012, it remained stable, however, significantly increased in intermediately developed regions from 2015 to 2018 (APC = 25.84, 95%CI: 3.59 to 52.86). The first-level spatial and temporal aggregation areas were distributed in Xinjiang, Gansu, Qinghai, Ningxia and Shaanxi, Tibet, Sichuan, Yunnan, Chongqing, Guizhou, Guangxi, with gathering times from Jan 1, 2006 to Dec 31, 2012 (RR = 1.87, P < 0.001). The percentage of the population aged 0-14 years, number of health workers per capital, and number of passengers were found to be positively associated with the incidence of mumps. CONCLUSIONS Overall, after 2012, the incidence of mumps in mainland China remained stable. High-risk periods, clusters of regions and sociodemographic factors for mumps were identified, which will help the government develop disease- and location-specific interventive measures. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Xiaofang Fu
- Linping Campus, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Minjie Ge
- Linping Campus, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Wucheng Xu
- Linping Campus, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Min Yu
- Linping Campus, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Jiangang Ju
- Linping Campus, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Yonghong Zhong
- Linping Campus, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Huaqiong Huang
- Key Laboratory of Respiratory Disease of Zhejiang Province, Department of Respiratory and Critical Care Medicine, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
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Yin Z, Wen T, Fang Q, Zheng C, Gong X, Li J, Wang S, Xiang Z. Assessment of mumps-containing vaccine effectiveness by dose during 2006 to 2020 in Quzhou, China. Hum Vaccin Immunother 2022; 18:2086774. [PMID: 35675040 PMCID: PMC9621056 DOI: 10.1080/21645515.2022.2086774] [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: 11/21/2022] Open
Abstract
Mumps cases were reported frequently when a routine dose measles–mumps–rubella(MMR) achieved high coverage in Quzhou. The supplementary immunization activities (SIA) using measles mumps (MM) was conducted to control mumps outbreaks. The effectiveness of one and two doses of mumps-containing vaccine (MuCV) was assessed using surveillance data in this study. Mumps cases and immunization information were retrieved from the National Notifiable Disease Reporting System (NNDRS) and the Zhejiang Provincial Immunization Information System (ZJIIS), respectively. Mumps cases of children born from 2006 to 2010 were included. Vaccine effectiveness by dose was calculated using the screening method. A total of 956 mumps cases were identified, of whom 754 (78.9%) had received one dose of MuCV; 108 (11.3%) had received two doses; 94 (9.8%) were unvaccinated. The coverage of one-dose MuCV in the 2006–2010 birth cohorts ranged from 91.6% to 98.9%. Except the 2009 birth cohort in which the coverage of two doses of MuCV was 55.1%, the others were less than 10%. Vaccine effectiveness (VE) of one dose ranged from 47.4% to 86.0%, while VE of two doses ranged from 64.0% to 92.4%. The VE of one and two doses of MuCV waned over time, but the VE of two doses was consistently higher than that of one dose in the same period. The vaccine schedule with two-dose MMR should be implemented among children in Quzhou. The optimal age for the second dose needs to be further evaluated.
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Affiliation(s)
- Zhiying Yin
- Department of Immunity, Quzhou Center for Disease Control and Prevention, Quzhou, Zhejiang Province, China.,School of Public Health, Zhejiang Chinese Medical University, Hangzhou, Zhejiang Province, China
| | - Tingcui Wen
- School of Public Health, Zhejiang Chinese Medical University, Hangzhou, Zhejiang Province, China
| | - Quanjun Fang
- Department of Immunity, Quzhou Center for Disease Control and Prevention, Quzhou, Zhejiang Province, China
| | - Canjie Zheng
- Department of Immunity, Quzhou Center for Disease Control and Prevention, Quzhou, Zhejiang Province, China
| | - Xiaoying Gong
- Department of Immunity, Quzhou Center for Disease Control and Prevention, Quzhou, Zhejiang Province, China
| | - Junji Li
- Department of Immunity, Quzhou Center for Disease Control and Prevention, Quzhou, Zhejiang Province, China
| | - Shuangqing Wang
- Department of Immunity, Quzhou Center for Disease Control and Prevention, Quzhou, Zhejiang Province, China
| | - Ziling Xiang
- Department of Immunity, Quzhou Center for Disease Control and Prevention, Quzhou, Zhejiang Province, China
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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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10
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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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11
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Rudnick W, Wilson S, Majerovich JA, Haavaldsrud M, Gatali M, Matsumoto CL, Deeks S. Effectiveness of an outbreak dose of mumps-containing vaccine in two First Nations communities in Northern Ontario, Canada. Hum Vaccin Immunother 2021; 18:1870909. [PMID: 34292135 PMCID: PMC8920173 DOI: 10.1080/21645515.2020.1870909] [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: 11/30/2022] Open
Abstract
Between 18 Dec 2017 and 27 June 2018, a mumps outbreak occurred in two Canadian Indigenous communities. An outbreak dose of mumps-containing vaccine was offered as part of control measures. We conducted a cohort study and survival analysis to describe the outbreak and evaluate the outbreak dose, extracting vaccination information on all community members (n = 3,135) from vaccination records. There were 70 mumps cases; 56% had received two pre-outbreak vaccine doses. Those who received a pre-outbreak dose more distantly had higher rates of mumps compared to those with more recent doses (adjusted hazard ratio = 3.4 (95%CI: 0.7–20.6) for receipt >20 years before vs. receipt ≤3 years). During the outbreak, 33% (1,010/3,080) of eligible individuals received an outbreak dose. The adjusted hazard ratio for no outbreak dose receipt was 2.7 (95%CI: 1.0–10.1). Our results suggest that an outbreak dose of mumps-containing vaccine may be an effective public health intervention, but further study is warranted.
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Affiliation(s)
- Wallis Rudnick
- Canadian Field Epidemiology Program, Public Health Agency of Canada, Ottawa, Ontario, Canada
| | | | - Jo Ann Majerovich
- First Nations and Inuit Health - Ontario Region, Indigenous Services Canada, Ottawa, Ontario, Canada
| | - Michelle Haavaldsrud
- First Nations and Inuit Health - Ontario Region, Indigenous Services Canada, Ottawa, Ontario, Canada
| | - Marene Gatali
- First Nations and Inuit Health - Ontario Region, Indigenous Services Canada, Ottawa, Ontario, Canada
| | - Cai-Lei Matsumoto
- Sioux Lookout First Nations Health Authority, Sioux Lookout, Ontario, Canada
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12
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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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13
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Australia's notifiable disease status, 2016: Annual report of the National Notifiable Diseases Surveillance System. ACTA ACUST UNITED AC 2021; 45. [PMID: 34074234 DOI: 10.33321/cdi.2021.45.28] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Abstract In 2016, a total of 67 diseases and conditions were nationally notifiable in Australia. The states and territories reported 330,387 notifications of communicable diseases to the National Notifiable Diseases Surveillance System. Notifications have remained stable between 2015 and 2016. In 2016, the most frequently notified diseases were vaccine preventable diseases (139,687 notifications, 42% of total notifications); sexually transmissible infections (112,714 notifications, 34% of total notifications); and gastrointestinal diseases (49,885 notifications, 15% of total notifications). Additionally, there were 18,595 notifications of bloodborne diseases; 6,760 notifications of vectorborne diseases; 2,020 notifications of other bacterial infections; 725 notifications of zoonoses and one notification of a quarantinable disease.
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Affiliation(s)
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- Australian Government Department of Health
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14
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Lin S, Ruan S, Geng X, Song K, Cui L, Liu X, Zhang Y, Cao M, Zhang Y. Non-linear relationships and interactions of meteorological factors on mumps in Jinan, China. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2021; 65:555-563. [PMID: 33180186 DOI: 10.1007/s00484-020-02048-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/22/2020] [Revised: 10/02/2020] [Accepted: 11/03/2020] [Indexed: 06/11/2023]
Abstract
Although vaccination is available, mumps remains a public health concern in many countries including China. Previous studies have indicated the impact of meteorological factors and mumps, but findings vary across different regions with limited evidence to inform local public health responses. We aim to examine the impacts of meteorological variables on mumps in Jinan, a temperate city of China, and explore the interactions of temperature with humidity or wind speed. Weekly meteorological data and notified cases of mumps in Jinan were collected for 2014-2018. Regression analyses using the generalized additive model were performed with considerations of multicollinearity, lag effects, school holidays, long-term trend, and seasonality. A stratification model was applied to investigate the interaction. We found a non-linear relationship between weekly mean temperature and the number of cases. Between 1.2 and 24.5 °C, the excess risk (ER) of mumps for a 1 °C increase in weekly mean temperature was 3.08% (95% CI 1.32 to 4.87%) at 0-week lag. The lagged effects could last for 3 weeks. There were interactions between mean temperature and relative humidity or wind speed. The effect of mean temperature was enhanced in days with low relative humidity or high wind speed. This study suggests that temperature is positively associated with mumps cases with thresholds in the temperate city of China, and the effect can be modified by relative humidity and wind speed and is independent of vaccine coverage. Findings could be integrated into current early warning systems of mumps in order to protect people's health from the risk of changing climate.
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Affiliation(s)
- Shaoqian Lin
- Jinan Municipal Center for Disease Control and Prevention, 2 Weiliu Road, Huaiyin District, Jinan, 250021, China
| | - Shiman Ruan
- Jinan Municipal Center for Disease Control and Prevention, 2 Weiliu Road, Huaiyin District, Jinan, 250021, China
| | - Xingyi Geng
- Jinan Municipal Center for Disease Control and Prevention, 2 Weiliu Road, Huaiyin District, Jinan, 250021, China
| | - Kaijun Song
- Jinan Municipal Center for Disease Control and Prevention, 2 Weiliu Road, Huaiyin District, Jinan, 250021, China
| | - Liangliang Cui
- Jinan Municipal Center for Disease Control and Prevention, 2 Weiliu Road, Huaiyin District, Jinan, 250021, China
| | - Xiaoxue Liu
- Jinan Municipal Center for Disease Control and Prevention, 2 Weiliu Road, Huaiyin District, Jinan, 250021, China
| | - Yingjian Zhang
- Jinan Municipal Center for Disease Control and Prevention, 2 Weiliu Road, Huaiyin District, Jinan, 250021, China
| | - Meng Cao
- Jinan Municipal Center for Disease Control and Prevention, 2 Weiliu Road, Huaiyin District, Jinan, 250021, China
| | - Ying Zhang
- School of Public Health, Faculty of Medicine and Health, University of Sydney, Camperdown, NSW, 2006, Australia.
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Fitzpatrick T, McNally JD, Stukel TA, Kwong JC, Wilton AS, Fisman D, Guttmann A. Palivizumab's real-world effectiveness: a population-based study in Ontario, Canada, 1993-2017. Arch Dis Child 2021; 106:173-179. [PMID: 32859612 PMCID: PMC7841493 DOI: 10.1136/archdischild-2020-319472] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 07/07/2020] [Accepted: 07/19/2020] [Indexed: 11/24/2022]
Abstract
OBJECTIVE To evaluate the effectiveness of two palivizumab programmes targeting high-risk infants, defined by prematurity, diagnosis of comorbidities and geography, and assess potential disparities by neighbourhood income. DESIGN Controlled, interrupted time series. SETTING Ontario, Canada. PATIENTS We used linked health and demographic administrative databases to identify all children born in hospitals 1 January 1993 through 31 December 2016. Follow-up ended at the earliest of second birthday or 30 June 2017. INTERVENTION Palivizumab-eligibility: child was born very preterm and ≤6 months old during respiratory syncytial virus (RSV) season; <24 months old with significant chronic lung or congenital heart disease; or ≤6 months, born preterm or residents of remote regions. MAIN OUTCOME Severe RSV-related illness, defined as hospitalisation or death with a diagnosis of bronchiolitis, RSV pneumonia or RSV. RESULTS 3 million births and 87 000 RSV-related events were identified. Over the study period, rates of severe RSV-related illness declined 65.4% among the highest risk group, eligible infants <6 months (230.6 to 79.8 admissions per 1000 child-years). Relative to changes among ineligible infants <6 months, rates dropped 10.4% (95% CI -18.6% to 39.4%) among eligible infants immediately following introduction of a national palivizumab programme in 1998. Initially, rates were considerably higher among infants from low-income neighbourhoods, but income-specific rates converged over time among eligible infants <6 months; such convergence was not seen among other children. CONCLUSIONS Incidence of severe RSV-related illness declined over the study period. While we cannot attribute causality, the timing and magnitude of these declines suggest impact of palivizumab in reducing RSV burden and diminishing social inequities among palivizumab-eligible infants.
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Affiliation(s)
- Tiffany Fitzpatrick
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- ICES, Toronto, Ontario, Canada
| | - James Dayre McNally
- Children's Hospital of Eastern Ontario Research Institute, University of Ottawa, Ottawa, Ontario, Canada
- Department of Pediatrics, Children's Hospital of Eastern Ontario, University of Ottawa, Ottawa, Ontario, Canada
| | - Therese A Stukel
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- ICES, Toronto, Ontario, Canada
| | - Jeffrey C Kwong
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- ICES, Toronto, Ontario, Canada
- Public Health Ontario, Toronto, Ontario, Canada
| | | | - David Fisman
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Astrid Guttmann
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- ICES, Toronto, Ontario, Canada
- Division of Paediatric Medicine, Department of Paediatrics, The Hospital for Sick Children, Toronto, Ontario, Canada
- Leong Centre for Healthy Children, University of Toronto, Toronto, Ontario, Canada
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16
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Patel C, Beard F, Hendry A, Quinn H, Dey A, Macartney K, Hueston L, Dwyer DE, McIntyre P. Australian mumps serosurvey 2012-2013: any cause for concern? ACTA ACUST UNITED AC 2020; 44. [PMID: 32829703 DOI: 10.33321/cdi.2020.44.67] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Objectives To determine population-level immunity to mumps in Australia. Methods We tested randomly selected specimens from people aged 1-49 years using the Enzygnost anti-parotitis IgG enzyme immunoassay from an opportunistically collected serum bank in 2012-2013. Weighted estimates of the proportion seropositive and equivocal for mumps-specific IgG antibody were determined by age group and compared with two previous national serosurveys conducted in 2007-2008 and 1997-1998. Results Overall, 82.1% (95% CI 80.6-83.5%) of 2,729 specimens were positive or equivocal for mumps-specific IgG antibodies (71.1% positive [95% CI 69.4-72.9%]; 10.9% equivocal [95% CI 9.8-12.2%]). The proportion positive or equivocal was higher in 2012-2013 (82.1%) than in 2007-2008 (75.5%) and 1997-1998 (72.5%), but varied by age. The proportion positive or equivocal in 2012-2013 was above 80% for all age groups older than 1 year except for 30-34 year olds, corresponding to the 1978-1982 birth cohort previously identified as most likely to have missed out on a second MMR vaccine dose. Conclusion Seropositivity to mumps in 2012-2013 was well-maintained compared with previous serosurveys. Low mumps notifications over this period in Australia suggest an absence of community-based transmission of mumps infection in the general population, but recent outbreaks among Aboriginal adolescents and young adults in close-contact settings, despite high 2-dose MMR coverage, suggest that seroprotection may be insufficient in other similar settings in Australia.Seropositivity to mumps in 2012-2013 was well-maintained compared with previous serosurveys. Low mumps notifications over this period in Australia suggest an absence of community-based transmission of mumps infection in the general population, but recent outbreaks among Aboriginal adolescents and young adults in close-contact settings, despite high 2-dose MMR coverage, suggest that seroprotection may be insufficient in other similar settings in Australia.
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Affiliation(s)
- Cyra Patel
- National Centre for Immunisation Research and Surveillance, Children's Hospital at Westmead, Sydney, Australia
| | - Frank Beard
- National Centre for Immunisation Research and Surveillance, Children's Hospital at Westmead, Sydney, Australia; University of Sydney, Sydney, Australia
| | - Alexandra Hendry
- National Centre for Immunisation Research and Surveillance, Children's Hospital at Westmead, Sydney, Australia
| | - Helen Quinn
- National Centre for Immunisation Research and Surveillance, Children's Hospital at Westmead, Sydney, Australia; University of Sydney, Sydney, Australia
| | - Aditi Dey
- National Centre for Immunisation Research and Surveillance, Children's Hospital at Westmead, Sydney, Australia; University of Sydney, Sydney, Australia
| | - Kristine Macartney
- National Centre for Immunisation Research and Surveillance, Children's Hospital at Westmead, Sydney, Australia; University of Sydney, Sydney, Australia
| | - Linda Hueston
- Institute of Clinical Pathology and Medical Research, NSW Health Pathology, Westmead, Sydney, Australia
| | - Dominic E Dwyer
- Institute of Clinical Pathology and Medical Research, NSW Health Pathology, Westmead, Sydney, Australia
| | - Peter McIntyre
- National Centre for Immunisation Research and Surveillance, Children's Hospital at Westmead, Sydney, Australia
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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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Nielsen LE, Kelly DC, Gyorffy J, Ager EP, Markelz AE. Mumps outbreak and MMR IgG surveillance as a predictor for immunity in military trainees. Vaccine 2019; 37:6139-6143. [PMID: 31493948 DOI: 10.1016/j.vaccine.2019.08.054] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Revised: 08/19/2019] [Accepted: 08/22/2019] [Indexed: 11/30/2022]
Abstract
In 2017, a mumps outbreak occurred in a barrack holding 249 service members. Suspected cases were evaluated with a combination of mumps IgG, IgM, viral culture, PCR and sequencing. Seven cases were diagnosed in febrile patients presenting with parotitis or orchitis. Mumps infection was confirmed by IgM or positive PCR with 5/7 cases having notable IgG levels before infection. Sequencing confirmed mumps genotype G strain. Serum from all 249 service members collected prior to the outbreak was withdrawn from the Department of Defense (DoD) Serum Repository and the IgG values of measles, mumps and rubella determined with 20.2%, 12.3% and 9.7% service members being seronegative, respectively. No specific IgG seronegativity combination predicted IgG marker levels to another virus within the same vaccine. This paper provides additional evidence that mumps serology is not a reliable surrogate for mumps immunity and that we need better laboratory correlates to confirm immunity.
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Affiliation(s)
- Lindsey E Nielsen
- Department of Pathology and Area Laboratory Services, Brooke Army Medical Center, San Antonio, TX, USA; Department of Pathology and Microbiology, University of Nebraska Medical Center, Omaha, NE, USA.
| | - Devin C Kelly
- Department of Medicine, Brooke Army Medical Center, San Antonio, TX, USA; Department of Medicine, Wright Patterson Medical Center, Dayton, OH, USA
| | - Janelle Gyorffy
- Department of Medicine, Brooke Army Medical Center, San Antonio, TX, USA
| | - Edward P Ager
- Department of Pathology and Area Laboratory Services, Brooke Army Medical Center, San Antonio, TX, USA
| | - Ana E Markelz
- Department of Medicine, Brooke Army Medical Center, San Antonio, TX, USA
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19
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Decreased humoral immunity to mumps in young adults immunized with MMR vaccine in childhood. Proc Natl Acad Sci U S A 2019; 116:19071-19076. [PMID: 31481612 DOI: 10.1073/pnas.1905570116] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
In the past decade, multiple mumps outbreaks have occurred in the United States, primarily in close-contact, high-density settings such as colleges, with a high attack rate among young adults, many of whom had the recommended 2 doses of mumps-measles-rubella (MMR) vaccine. Waning humoral immunity and the circulation of divergent wild-type mumps strains have been proposed as contributing factors to mumps resurgence. Blood samples from 71 healthy 18- to 23-year-old college students living in a non-outbreak area were assayed for antibodies and memory B cells (MBCs) to mumps, measles, and rubella. Seroprevalence rates of mumps, measles, and rubella determined by IgG enzyme-linked immunosorbent assay (ELISA) were 93, 93, and 100%, respectively. The index standard ratio indicated that the concentration of IgG was significantly lower for mumps than rubella. High IgG avidity to mumps Enders strain was detected in sera of 59/71 participants who had sufficient IgG levels. The frequency of circulating mumps-specific MBCs was 5 to 10 times lower than measles and rubella, and 10% of the participants had no detectable MBCs to mumps. Geometric mean neutralizing antibody titers (GMTs) by plaque reduction neutralization to the predominant circulating wild-type mumps strain (genotype G) were 6-fold lower than the GMTs against the Jeryl Lynn vaccine strain (genotype A). The majority of the participants (80%) received their second MMR vaccine ≥10 years prior to study participation. Additional efforts are needed to fully characterize B and T cell immune responses to mumps vaccine and to develop strategies to improve the quality and durability of vaccine-induced immunity.
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20
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Stapleton PJ, Eshaghi A, Seo CY, Wilson S, Harris T, Deeks SL, Bolotin S, Goneau LW, Gubbay JB, Patel SN. Evaluating the use of whole genome sequencing for the investigation of a large mumps outbreak in Ontario, Canada. Sci Rep 2019; 9:12615. [PMID: 31471545 PMCID: PMC6717193 DOI: 10.1038/s41598-019-47740-1] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Accepted: 07/18/2019] [Indexed: 01/30/2023] Open
Abstract
In 2017 Ontario experienced the largest mumps outbreak in the province in 8 years, at a time when multiple outbreaks were occurring across North America. Of 259 reported cases, 143 occurred in Toronto, primarily among young adults. Routine genotyping of the small hydrophobic gene indicated that the outbreak was due to mumps virus genotype G. We performed a retrospective study of whole genome sequencing of 26 mumps virus isolates from early in the outbreak, using a tiling amplicon method. Results indicated that two of the cases were genetically divergent, with the remaining 24 cases belonging to two major clades and one minor clade. Phylogeographic analysis confirmed circulation of virus from each clade between Toronto and other regions in Ontario. Comparison with other genotype G strains from North America suggested that the presence of co-circulating major clades may have been due to separate importation events from outbreaks in the United States. A transmission network analysis performed with the software program TransPhylo was compared with previously collected epidemiological data. The transmission tree correlated with known epidemiological links between nine patients and identified new potential clusters with no known epidemiological links.
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Affiliation(s)
- P J Stapleton
- Laboratory Medicine & Pathobiology, University of Toronto, Toronto, ON, Canada
- Public Health Ontario Laboratory, Public Health Ontario, Toronto, ON, Canada
| | - A Eshaghi
- Public Health Ontario Laboratory, Public Health Ontario, Toronto, ON, Canada
| | - C Y Seo
- Communicable Diseases, Emergency Preparedness and Response, Public Health Ontario, Toronto, ON, Canada
| | - S Wilson
- Communicable Diseases, Emergency Preparedness and Response, Public Health Ontario, Toronto, ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - T Harris
- Communicable Diseases, Emergency Preparedness and Response, Public Health Ontario, Toronto, ON, Canada
| | - S L Deeks
- Communicable Diseases, Emergency Preparedness and Response, Public Health Ontario, Toronto, ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - S Bolotin
- Laboratory Medicine & Pathobiology, University of Toronto, Toronto, ON, Canada
- Public Health Ontario Laboratory, Public Health Ontario, Toronto, ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
- Applied Immunisation Research and Evaluation, Public Health Ontario, Toronto, ON, Canada
| | - L W Goneau
- Laboratory Medicine & Pathobiology, University of Toronto, Toronto, ON, Canada
- Public Health Ontario Laboratory, Public Health Ontario, Toronto, ON, Canada
| | - J B Gubbay
- Laboratory Medicine & Pathobiology, University of Toronto, Toronto, ON, Canada
- Public Health Ontario Laboratory, Public Health Ontario, Toronto, ON, Canada
| | - S N Patel
- Laboratory Medicine & Pathobiology, University of Toronto, Toronto, ON, Canada.
- Public Health Ontario Laboratory, Public Health Ontario, Toronto, ON, Canada.
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21
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Ioannides S, Beard F, Larter N, Clark K, Wang H, Hendry A, Hull B, Dey A, Chiu C, Brotherton J, Jayasinghe S, Macartney K, McIntyre P. Vaccine Preventable Diseases and Vaccination Coverage in Aboriginal and Torres Strait Islander People, Australia, 2011–2015. Commun Dis Intell (2018) 2019. [DOI: 10.33321/cdi.2019.43.36] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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22
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Bitzegeio J, Majowicz S, Matysiak-Klose D, Sagebiel D, Werber D. Estimating age-specific vaccine effectiveness using data from a large measles outbreak in Berlin, Germany, 2014/15: evidence for waning immunity. Euro Surveill 2019; 24:1800529. [PMID: 31039834 PMCID: PMC6628761 DOI: 10.2807/1560-7917.es.2019.24.17.1800529] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2018] [Accepted: 01/23/2019] [Indexed: 11/20/2022] Open
Abstract
BackgroundMeasles elimination is based on 95% coverage with two doses of a measles-containing vaccine (MCV2), high vaccine effectiveness (VE) and life-long vaccine-induced immunity. Longitudinal analysis of antibody titres suggests existence of waning immunity, but the relevance at the population-level is unknown.AimWe sought to assess presence of waning immunity by estimating MCV2 VE in different age groups (2-5, 6-15, 16-23, 24-30 and 31-42 years) in Berlin.MethodsWe conducted a systematic literature review on vaccination coverage and applied the screening-method using data from a large measles outbreak (2014/15) in Berlin. Uncertainty in input variables was incorporated by Monte Carlo simulation. In a scenario analysis, we estimated the proportion vaccinated with MCV2 in those 31-42 years using VE of the youngest age group, where natural immunity was deemed negligible.ResultsOf 773 measles cases (median age: 20 years), 40 had received MCV2. Average vaccine coverage per age group varied (32%-88%). Estimated median VE was > 99% (95% credible interval (CrI): 98.6-100) in the three youngest age groups, but lower (90.9%, 95% CrI: 74.1-97.6) in the oldest age group. In the scenario analysis, the estimated proportion vaccinated was 98.8% (95% CrI: 96.5-99.8).ConclusionVE for MCV2 was generally high, but lower in those aged 31-42 years old. The estimated proportion with MCV2 should have led to sufficient herd immunity in those aged 31-42 years old. Thus, lower VE cannot be fully explained by natural immunity, suggesting presence of waning immunity.
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Affiliation(s)
- Julia Bitzegeio
- State Office for Health and Social Affairs, Berlin, Germany
- Berlin School of Public Health, Berlin, Germany
| | - Shannon Majowicz
- School of Public Health and Health Systems, University of Waterloo, Waterloo, Canada
| | | | | | - Dirk Werber
- State Office for Health and Social Affairs, Berlin, Germany
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23
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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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24
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Australia’s notifiable disease status, 2015: Annual report of the National Notifiable Diseases Surveillance System. Commun Dis Intell (2018) 2019. [DOI: 10.33321/cdi.2019.43.6] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
In 2015, 67 diseases and conditions were nationally notifiable in Australia. States and territories reported a total of 320,480 notifications of communicable diseases to the National Notifiable Diseases Surveillance System, an increase of 16% on the number of notifications in 2014. In 2015, the most frequently notified diseases were vaccine preventable diseases (147,569 notifications, 46% of total notifications), sexually transmissible infections (95,468 notifications, 30% of total notifications), and gastrointestinal diseases (45,326 notifications, 14% of total notifications). There were 17,337 notifications of bloodborne diseases; 12,253 notifications of vectorborne diseases; 1,815 notifications of other bacterial infections; 710 notifications of zoonoses and 2 notifications of quarantinable diseases.
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25
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Kennedy RB, Ovsyannikova IG, Thomas A, Larrabee BR, Rubin S, Poland GA. Differential durability of immune responses to measles and mumps following MMR vaccination. Vaccine 2019; 37:1775-1784. [PMID: 30797639 DOI: 10.1016/j.vaccine.2019.02.030] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2018] [Revised: 01/28/2019] [Accepted: 02/05/2019] [Indexed: 11/30/2022]
Abstract
The development and wide-spread use of mumps vaccine resulted in a dramatic and sustained decrease in the incidence of mumps disease; however, since 2000, an increase in the size and number of mumps outbreaks in the United States and other countries has sparked renewed interest in the durability of mumps-specific immunity elicited by mumps vaccination. The most likely explanation for mumps cases in previously immunized persons may be secondary vaccine failure, or waning immunity. In the current study, we examined changes in markers of measles and mumps immunity at two timepoints, approximately 7 and 17 years after two-dose MMR-II® vaccination, in a cohort of 98 healthy adults. Our results indicate that mumps IgG titers exhibited a large and significant decline during this time period, while mumps neutralizing Ab titers were relatively stable. There was a similar discrepancy with measles-specific immune responses. For both pathogens, neutralizing antibody titers were fairly low and, given the length of time since vaccination, may have already declined. These data suggest that specific immune outcomes may wane at different rates and highlight our currently incomplete understanding of protective immune responses to mumps and measles.
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Affiliation(s)
- Richard B Kennedy
- Mayo Clinic Vaccine Research Group, Mayo Clinic, Rochester, MN 55905, USA.
| | | | - Antonia Thomas
- Center for Biologics Evaluation and Research, Food and Drug Administration, U.S. Department of Health and Human Services, Silver Spring, MD 20993, USA
| | - Beth R Larrabee
- Division of Biomedical Statistics and Informatics, Department of Health Science Research, Mayo Clinic, Rochester, MN 55905, USA
| | - Steven Rubin
- Center for Biologics Evaluation and Research, Food and Drug Administration, U.S. Department of Health and Human Services, Silver Spring, MD 20993, USA
| | - Gregory A Poland
- Mayo Clinic Vaccine Research Group, Mayo Clinic, Rochester, MN 55905, USA
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26
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Westphal DW, Eastwood A, Levy A, Davies J, Huppatz C, Gilles M, Lyttle H, Williams SA, Dowse GK. A protracted mumps outbreak in Western Australia despite high vaccine coverage: a population-based surveillance study. THE LANCET. INFECTIOUS DISEASES 2019; 19:177-184. [DOI: 10.1016/s1473-3099(18)30498-5] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/16/2018] [Revised: 07/23/2018] [Accepted: 08/01/2018] [Indexed: 10/27/2022]
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Investigation and management of a large community mumps outbreak among young adults in Toronto, Canada, January 2017-February 2018. ACTA ACUST UNITED AC 2018; 44:309-316. [PMID: 31517953 DOI: 10.14745/ccdr.v44i12a01] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Background In 2017, a mumps outbreak was identified in a cohort of 18-34 year olds in Toronto, Canada. Objective To describe a large community mumps outbreak in an urban centre from January 2017 to February 2018 among young adults. Methods A broad range of interventions were implemented in an attempt to reach the target audience; including case and contact management, vaccination clinics at schools and clinicians' offices, school exclusions, bar inspections, traditional communication strategies (including health care provider updates and posters) and newer communication strategies (including three sequential social media campaigns). Results A total of 143 cases of mumps were identified. Although cases' ages ranged from three to 72 years, most (76%) were 18-34 year olds, many of whom had frequented bars and local food establishments in downtown Toronto. 84% (n=120) of the cases were community-acquired. Only 16% (n=23) of the cases reported exposures in schools and post-secondary school institutions. Of those, 39% (n=56) of cases had an unknown vaccination history; 34% (n=49) were either not vaccinated or partially vaccinated with one dose of measles-mumps-rubella vaccine; and 27% (n=38) had received the recommended two doses of mumps vaccine. Determining vaccination status was a challenge, in part due to the lack of a registry. Vaccination was recommended when subjects were known to have had fewer than two doses of vaccine or had an unknown vaccination status. A social media campaign, emphasizing the risk of social activities if not protected from the mumps, yielded over 500,000 impressions from Facebook and Twitter messages and ads and an impressive engagement rate of between 1% and 10x%. Conclusion This was the largest mumps outbreak in Toronto in over 20 years. Among young adults, ongoing social media and traditional communication campaigns can contribute to the control of community mumps outbreaks. Encouraging vaccine uptake is desirable, but without a vaccine registry it is difficult to assess vaccination coverage among adults. Susceptible cohorts of young adults who were not adequately vaccinated pose a risk for future outbreaks. Given that almost 30% of the mumps cases were fully vaccinated with two doses of mumps-containing vaccine, even two doses may not provide complete protection.
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Abstract
The mumps vaccine is not included in the national immunisation programme (NIP) of approximately 80 countries including Japan. To investigate the vaccine's cost-effectiveness, we developed a dynamic transmission model for routine one- and two-dose mumps vaccination programs in Japan. We calculated the incremental cost-effectiveness ratio compared with a current programme over a projected 50-year period. We created a Japanese population model and performed dynamic simulation to estimate the number of patients enrolled in the current programme, the routine one-dose programme, and the routine two-dose programme over the next 50 years using the Berkeley Madonna program. We estimated the medical and social costs of natural mumps infections and vaccinations to analyse cost-effectiveness. Finally, we performed a sensitivity analysis with parameters including vaccine cost, vaccine efficacy, medical costs per case, social costs per case, incidence of adverse events and discount rate. Base case analysis showed that both the one-dose and two-dose programmes predominated and that quality-adjusted life years (QALYs) were saved, compared with the current programme. The medical costs, total cost and QALYs saved during the study period in the two-dose programme compared with the current programme were 217 billion JPY, 860 billion JPY and 184 779, respectively. The two-dose programme surpassed the one-dose programme throughout the study period. In all the scenarios of the sensitivity analysis, two-dose vaccination was better than the one-dose programme. This simulation confirmed that the routine two-dose vaccination programme was more cost-effective and QALY-saving than either the one-dose programme or the current programme. Because of the variability of the results between the various models, further simulations with different models should be conducted.
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29
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Crowcroft NS, Klein NP. A framework for research on vaccine effectiveness. Vaccine 2018; 36:7286-7293. [DOI: 10.1016/j.vaccine.2018.04.016] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2017] [Revised: 03/07/2018] [Accepted: 04/04/2018] [Indexed: 01/20/2023]
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Ramanathan R, Voigt EA, Kennedy RB, Poland GA. Knowledge gaps persist and hinder progress in eliminating mumps. Vaccine 2018; 36:3721-3726. [PMID: 29784466 PMCID: PMC6031229 DOI: 10.1016/j.vaccine.2018.05.067] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2018] [Revised: 05/10/2018] [Accepted: 05/12/2018] [Indexed: 01/27/2023]
Abstract
Mumps, a common childhood disease in the pre-vaccine era that causes swelling of the parotid salivary glands, can lead to orchitis, viral meningitis, and sensorineural deafness. While the incidence of disease decreased dramatically after the vaccine was added to standard vaccination schedules, the disease has made a substantial resurgence in recent years. As a result, it becomes critical to examine the factors involved in recurring outbreaks. Although low and incomplete vaccination coverage may be a key reason, it does not fully explain the issue due to the high rate of occurrence in populations with high vaccination coverage rates. Multiple studies suggest that waning immunity and secondary vaccine failure play a large role, the effects of which were previously masked by subclinical boosting. Significant knowledge gaps persist around the exact role and mechanism of waning immunity and demonstrate the need for more research in this area, as well as a reevaluation of mumps vaccine policy.
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Affiliation(s)
- R Ramanathan
- Mayo Vaccine Research Group, Mayo Clinic, Rochester, MN 55905, USA
| | - E A Voigt
- Mayo Vaccine Research Group, Mayo Clinic, Rochester, MN 55905, USA
| | - R B Kennedy
- Mayo Vaccine Research Group, Mayo Clinic, Rochester, MN 55905, USA
| | - G A Poland
- Mayo Vaccine Research Group, Mayo Clinic, Rochester, MN 55905, USA.
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31
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L’Huillier AG, Eshaghi A, Racey CS, Ogbulafor K, Lombos E, Higgins RR, Alexander DC, Kristjanson E, Maregmen J, Gubbay JB, Mazzulli T. Laboratory testing and phylogenetic analysis during a mumps outbreak in Ontario, Canada. Virol J 2018; 15:98. [PMID: 29866178 PMCID: PMC5987625 DOI: 10.1186/s12985-018-0996-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2018] [Accepted: 05/01/2018] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND In September 2009, a mumps outbreak originated in New York and spread to Northeastern USA and Canada. This study compares the performance of different diagnostic testing methods used in Ontario and describes molecular characteristics of the outbreak strain. METHODS Between September 2009 and February 2010, specimens from suspect cases were submitted to Public Health Ontario Laboratory for mumps serology, culture and/or real-time reverse-transcriptase PCR (rRT-PCR) testing. rRT-PCR-positive specimens underwent genotyping at Canada's National Microbiology Laboratory. Whole genome sequencing was performed on four outbreak and three sporadic viral culture isolates. RESULTS Six hundred ninety-eight patients had IgM serology testing, of which 255 (37%) had culture and rRT-PCR. Among those, 35/698 (5%) were IgM positive, 39/255 (15%) culture positive and 47/255 (18%) rRT-PCR-positive. Buccal swabs had the highest rRT-PCR positivity (21%). The outbreak isolates were identical to that in the New York outbreak occurring at the same time. Nucleotide and amino acid identity with the Jeryl Lynn vaccine strain ranged from 85.0-94.5% and 82.4-99.4%, depending on the gene and coding sequences. Homology of the HN protein, the main immunogenic mumps virus protein, was found to be 94.5 and 95.3%, when compared to Jeryl Lynn vaccine major and minor components, respectively. CONCLUSIONS Despite higher sensitivity than serology, rRT-PCR testing is underutilized. Further work is needed to better understand the suboptimal match of the HN gene between the outbreak strain and the Jeryl Lynn vaccine strain.
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Affiliation(s)
- Arnaud G. L’Huillier
- Hospital for Sick Children, 555 University Avenue, Toronto, Ontario M5G 1X8 Canada
- Public Health Ontario, 661 University Avenue, Toronto, Ontario M5G 1M1 Canada
| | - Alireza Eshaghi
- Public Health Ontario, 661 University Avenue, Toronto, Ontario M5G 1M1 Canada
| | - C. Sarai Racey
- Public Health Ontario, 661 University Avenue, Toronto, Ontario M5G 1M1 Canada
- Present address: Dalla Lana School of Public Health, 155 College Street, Toronto, Ontario M5T 3M7 Canada
| | - Katherene Ogbulafor
- Public Health Ontario, 661 University Avenue, Toronto, Ontario M5G 1M1 Canada
| | - Ernesto Lombos
- Public Health Ontario, 661 University Avenue, Toronto, Ontario M5G 1M1 Canada
| | - Rachel R. Higgins
- Public Health Ontario, 661 University Avenue, Toronto, Ontario M5G 1M1 Canada
| | - David C. Alexander
- Public Health Ontario, 661 University Avenue, Toronto, Ontario M5G 1M1 Canada
- Present address: Cadham Provincial Laboratory, Winnipeg, Manitoba R3C 3Y1 Canada
| | - Erik Kristjanson
- Public Health Ontario, 661 University Avenue, Toronto, Ontario M5G 1M1 Canada
| | - Jocelyn Maregmen
- Public Health Ontario, 661 University Avenue, Toronto, Ontario M5G 1M1 Canada
| | - Jonathan B. Gubbay
- Hospital for Sick Children, 555 University Avenue, Toronto, Ontario M5G 1X8 Canada
- Public Health Ontario, 661 University Avenue, Toronto, Ontario M5G 1M1 Canada
- University of Toronto, 27 King’s College Circle, Toronto, Ontario M5S 1A1 Canada
| | - Tony Mazzulli
- Public Health Ontario, 661 University Avenue, Toronto, Ontario M5G 1M1 Canada
- University of Toronto, 27 King’s College Circle, Toronto, Ontario M5S 1A1 Canada
- Mount Sinai Hospital, 600 University Avenue, Toronto, Ontario M5G 1X5 Canada
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Nunn A, Masud S, Krajden M, Naus M, Jassem AN. Diagnostic Yield of Laboratory Methods and Value of Viral Genotyping during an Outbreak of Mumps in a Partially Vaccinated Population in British Columbia, Canada. J Clin Microbiol 2018; 56:e01954-17. [PMID: 29491021 PMCID: PMC5925731 DOI: 10.1128/jcm.01954-17] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2017] [Accepted: 02/26/2018] [Indexed: 11/20/2022] Open
Abstract
Mumps remains endemic in North America despite routine use of the measles, mumps, and rubella (MMR) vaccine. In 2016, an outbreak of mumps in British Columbia, Canada, provided an opportunity to determine the diagnostic utility of laboratory testing methods. Specimens from patients with clinical mumps were tested for infection using a commercial enzyme-linked immunosorbent assay (ELISA) for antibody detection and an in-house reverse transcriptase PCR (RT-PCR) targeting viral fusion and small hydrophobic (SH) genes. Viral genotyping was performed by SH gene sequencing. Laboratory data was linked with epidemiologic case data. Of the 139 confirmed cases, 94 (68%) had reported or documented history of MMR vaccination. Specimens were typically collected 1 day (for buccal and IgM tests) or 2 days (for urine tests) after symptom onset. Most confirmed cases (69%) were confirmed by buccal swab RT-PCR. Among cases tested by multiple methods, the percent positivity for buccal swab RT-PCR was 90% (96/107) compared to 43% (30/69) for both IgM ELISA and urine RT-PCR. Mumps IgM detection was higher in confirmed cases with no history of vaccination than in those with history (64% versus 34%, P = 0.02). The outbreak strain was identified as genotype G related to MuVi/Sheffield.GBR/1.05 but with conserved variations in five nucleotides within the SH gene that allowed linkage of geographically distinct cases. In conclusion, RT-PCR of buccal specimens had the highest diagnostic yield during a mumps outbreak in a partially vaccinated population. To optimize mumps diagnostic potential, clinicians should collect specimens depending on when the patient presents for care and their immunization history.
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Affiliation(s)
- Alexandra Nunn
- British Columbia Centre for Disease Control, Vancouver, British Columbia, Canada
| | - Shazia Masud
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Mel Krajden
- British Columbia Centre for Disease Control, Vancouver, British Columbia, Canada
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Monika Naus
- British Columbia Centre for Disease Control, Vancouver, British Columbia, Canada
- School of Population and Public Health, University of British Columbia, Vancouver, Canada
| | - Agatha N Jassem
- British Columbia Centre for Disease Control, Vancouver, British Columbia, Canada
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, British Columbia, Canada
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Smetana J, Chlibek R, Hanovcova I, Sosovickova R, Smetanova L, Polcarova P, Gal P, Dite P. Serological survey of mumps antibodies in adults in the Czech Republic and the need for changes to the vaccination strategy. Hum Vaccin Immunother 2018; 14:887-893. [PMID: 29206078 DOI: 10.1080/21645515.2017.1412021] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
Mumps outbreaks, especially in adolescents and young adults, have been reported in the Czech Republic. The aim of the presented study was to determine the seroprevalence of specific IgG antibodies against mumps in the adult population of the Czech Republic. The study was designed as a multicenter serological survey of adults aged 18 years and over. Specific IgG antibodies against mumps were detected in blood samples using an enzyme-linked immunosorbent assay (ELISA). A total of 1,911 serum samples were examined. The overall seropositivity reached 55.3%. In individual age groups, the highest seropositivity 63% (63.5-65.2%) was recorded in adults aged 40 years and over; the lowest seropositivity was found in adults aged 18-29 years (27.4%). The difference in seropositivity rate between the 18-29 years age group and the 40 years and over age groups was statistically significant (p < 0.001). Only the 18-29 years age group included both vaccinated and unvaccinated (born in the pre-vaccine era) individuals. In vaccinated individuals, seropositivity was reported in only 19.1% of persons; in unvaccinated individuals, seropositivity reached 48.2%. Our results demonstrate the long-term persistence of antibodies following natural infection and the decrease in seropositivity that occurs after vaccination over time. This immunity waning may account for the higher susceptibility of adolescents and young adults to mumps. Therefore, the current vaccination program in the Czech Republic could be considered as less effective. It will be modified with the shifting of the second dose of vaccine from two years of age to the preschool age.
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Affiliation(s)
- Jan Smetana
- a Department of Epidemiology , Faculty of Military Health Sciences, University of Defence , Hradec Kralove , Czech Republic
| | - Roman Chlibek
- a Department of Epidemiology , Faculty of Military Health Sciences, University of Defence , Hradec Kralove , Czech Republic
| | - Irena Hanovcova
- a Department of Epidemiology , Faculty of Military Health Sciences, University of Defence , Hradec Kralove , Czech Republic
| | - Renata Sosovickova
- a Department of Epidemiology , Faculty of Military Health Sciences, University of Defence , Hradec Kralove , Czech Republic
| | - Libuse Smetanova
- b Department of Rehabilitation , University Hospital , Hradec Kralove , Czech Republic
| | - Petra Polcarova
- a Department of Epidemiology , Faculty of Military Health Sciences, University of Defence , Hradec Kralove , Czech Republic
| | - Peter Gal
- c Military Health Institute , Ceske Budejovice , Czech Republic
| | - Petr Dite
- a Department of Epidemiology , Faculty of Military Health Sciences, University of Defence , Hradec Kralove , Czech Republic.,d Military Health Institute , Brno , Czech Republic
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Standaert B, Schecroun N, Ethgen O, Topachevskyi O, Morioka Y, Van Vlaenderen I. Optimising the introduction of multiple childhood vaccines in Japan: A model proposing the introduction sequence achieving the highest health gains. Health Policy 2017; 121:1303-1312. [PMID: 29079394 DOI: 10.1016/j.healthpol.2017.08.010] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2016] [Revised: 08/01/2017] [Accepted: 08/24/2017] [Indexed: 11/25/2022]
Abstract
BACKGROUND Many countries struggle with the prioritisation of introducing new vaccines because of budget limitations and lack of focus on public health goals. A model has been developed that defines how specific health goals can be optimised through immunisation within vaccination budget constraints. METHODS Japan, as a country example, could introduce 4 new pediatric vaccines targeting influenza, rotavirus, pneumococcal disease and mumps with known burden of disease, vaccine efficacies and maximum achievable coverages. Operating under budget constraints, the Portfolio-model for the Management of Vaccines (PMV) identifies the optimal vaccine ranking and combination for achieving the maximum QALY gain over a period of 10 calendar years in children <5 years old. This vaccine strategy, of interest and helpful for a healthcare decision maker, is compared with an unranked vaccine selection process. RESULTS Results indicate that the maximum QALY gain with a fixed annual vaccination budget of 500 billion Japanese Yen over a 10-year period is 72,288 QALYs using the optimal sequence of vaccine introduction (mumps [1st], followed by influenza [2nd], rotavirus [3rd], and pneumococcal [4th]). With exactly the same budget but without vaccine ranking, the total QALY gain can be 20% lower. CONCLUSION The PMV model could be a helpful tool for decision makers in those environments with limited budget where vaccines have to be selected for trying to optimise specific health goals.
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Cardemil CV, Dahl RM, James L, Wannemuehler K, Gary HE, Shah M, Marin M, Riley J, Feikin DR, Patel M, Quinlisk P. Effectiveness of a Third Dose of MMR Vaccine for Mumps Outbreak Control. N Engl J Med 2017; 377:947-956. [PMID: 28877026 PMCID: PMC6546095 DOI: 10.1056/nejmoa1703309] [Citation(s) in RCA: 100] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
BACKGROUND The effect of a third dose of the measles-mumps-rubella (MMR) vaccine in stemming a mumps outbreak is unknown. During an outbreak among vaccinated students at the University of Iowa, health officials implemented a widespread MMR vaccine campaign. We evaluated the effectiveness of a third dose for outbreak control and assessed for waning immunity. METHODS Of 20,496 university students who were enrolled during the 2015-2016 academic year, mumps was diagnosed in 259 students. We used Fisher's exact test to compare unadjusted attack rates according to dose status and years since receipt of the second MMR vaccine dose. We used multivariable time-dependent Cox regression models to evaluate vaccine effectiveness, according to dose status (three vs. two doses and two vs. no doses) after adjustment for the number of years since the second dose. RESULTS Before the outbreak, 98.1% of the students had received at least two doses of MMR vaccine. During the outbreak, 4783 received a third dose. The attack rate was lower among the students who had received three doses than among those who had received two doses (6.7 vs. 14.5 cases per 1000 population, P<0.001). Students had more than nine times the risk of mumps if they had received the second MMR dose 13 years or more before the outbreak. At 28 days after vaccination, receipt of the third vaccine dose was associated with a 78.1% lower risk of mumps than receipt of a second dose (adjusted hazard ratio, 0.22; 95% confidence interval, 0.12 to 0.39). The vaccine effectiveness of two doses versus no doses was lower among students with more distant receipt of the second vaccine dose. CONCLUSIONS Students who had received a third dose of MMR vaccine had a lower risk of mumps than did those who had received two doses, after adjustment for the number of years since the second dose. Students who had received a second dose of MMR vaccine 13 years or more before the outbreak had an increased risk of mumps. These findings suggest that the campaign to administer a third dose of MMR vaccine improved mumps outbreak control and that waning immunity probably contributed to propagation of the outbreak. (Funded by the Centers for Disease Control and Prevention.).
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Affiliation(s)
- Cristina V Cardemil
- From the Centers for Disease Control and Prevention, Atlanta (C.V.C., K.W., H.E.G., M.S., M.M., D.R.F., M.P.); Maximus Federal, Falls Church, VA (R.M.D.); and the University of Iowa (L.J.) and Johnson County Public Health (J.R.), Iowa City, and the Iowa Department of Public Health, Des Moines (P.Q.)
| | - Rebecca M Dahl
- From the Centers for Disease Control and Prevention, Atlanta (C.V.C., K.W., H.E.G., M.S., M.M., D.R.F., M.P.); Maximus Federal, Falls Church, VA (R.M.D.); and the University of Iowa (L.J.) and Johnson County Public Health (J.R.), Iowa City, and the Iowa Department of Public Health, Des Moines (P.Q.)
| | - Lisa James
- From the Centers for Disease Control and Prevention, Atlanta (C.V.C., K.W., H.E.G., M.S., M.M., D.R.F., M.P.); Maximus Federal, Falls Church, VA (R.M.D.); and the University of Iowa (L.J.) and Johnson County Public Health (J.R.), Iowa City, and the Iowa Department of Public Health, Des Moines (P.Q.)
| | - Kathleen Wannemuehler
- From the Centers for Disease Control and Prevention, Atlanta (C.V.C., K.W., H.E.G., M.S., M.M., D.R.F., M.P.); Maximus Federal, Falls Church, VA (R.M.D.); and the University of Iowa (L.J.) and Johnson County Public Health (J.R.), Iowa City, and the Iowa Department of Public Health, Des Moines (P.Q.)
| | - Howard E Gary
- From the Centers for Disease Control and Prevention, Atlanta (C.V.C., K.W., H.E.G., M.S., M.M., D.R.F., M.P.); Maximus Federal, Falls Church, VA (R.M.D.); and the University of Iowa (L.J.) and Johnson County Public Health (J.R.), Iowa City, and the Iowa Department of Public Health, Des Moines (P.Q.)
| | - Minesh Shah
- From the Centers for Disease Control and Prevention, Atlanta (C.V.C., K.W., H.E.G., M.S., M.M., D.R.F., M.P.); Maximus Federal, Falls Church, VA (R.M.D.); and the University of Iowa (L.J.) and Johnson County Public Health (J.R.), Iowa City, and the Iowa Department of Public Health, Des Moines (P.Q.)
| | - Mona Marin
- From the Centers for Disease Control and Prevention, Atlanta (C.V.C., K.W., H.E.G., M.S., M.M., D.R.F., M.P.); Maximus Federal, Falls Church, VA (R.M.D.); and the University of Iowa (L.J.) and Johnson County Public Health (J.R.), Iowa City, and the Iowa Department of Public Health, Des Moines (P.Q.)
| | - Jacob Riley
- From the Centers for Disease Control and Prevention, Atlanta (C.V.C., K.W., H.E.G., M.S., M.M., D.R.F., M.P.); Maximus Federal, Falls Church, VA (R.M.D.); and the University of Iowa (L.J.) and Johnson County Public Health (J.R.), Iowa City, and the Iowa Department of Public Health, Des Moines (P.Q.)
| | - Daniel R Feikin
- From the Centers for Disease Control and Prevention, Atlanta (C.V.C., K.W., H.E.G., M.S., M.M., D.R.F., M.P.); Maximus Federal, Falls Church, VA (R.M.D.); and the University of Iowa (L.J.) and Johnson County Public Health (J.R.), Iowa City, and the Iowa Department of Public Health, Des Moines (P.Q.)
| | - Manisha Patel
- From the Centers for Disease Control and Prevention, Atlanta (C.V.C., K.W., H.E.G., M.S., M.M., D.R.F., M.P.); Maximus Federal, Falls Church, VA (R.M.D.); and the University of Iowa (L.J.) and Johnson County Public Health (J.R.), Iowa City, and the Iowa Department of Public Health, Des Moines (P.Q.)
| | - Patricia Quinlisk
- From the Centers for Disease Control and Prevention, Atlanta (C.V.C., K.W., H.E.G., M.S., M.M., D.R.F., M.P.); Maximus Federal, Falls Church, VA (R.M.D.); and the University of Iowa (L.J.) and Johnson County Public Health (J.R.), Iowa City, and the Iowa Department of Public Health, Des Moines (P.Q.)
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Wiggers JB, Chan T, Gold WL, MacFadden DR. Mumps in a 27-year-old man. CMAJ 2017; 189:E569-E571. [PMID: 28420681 PMCID: PMC5392118 DOI: 10.1503/cmaj.161347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Affiliation(s)
- J Brad Wiggers
- Division of Infectious Diseases, Department of Medicine, University of Toronto, Toronto, Ont
| | - Tiffany Chan
- Division of Infectious Diseases, Department of Medicine, University of Toronto, Toronto, Ont
| | - Wayne L Gold
- Division of Infectious Diseases, Department of Medicine, University of Toronto, Toronto, Ont
| | - Derek R MacFadden
- Division of Infectious Diseases, Department of Medicine, University of Toronto, Toronto, Ont.
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Gouma S, Cremer J, Parkkali S, Veldhuijzen I, van Binnendijk RS, Koopmans MPG. Mumps virus F gene and HN gene sequencing as a molecular tool to study mumps virus transmission. INFECTION GENETICS AND EVOLUTION 2016; 45:145-150. [PMID: 27590714 DOI: 10.1016/j.meegid.2016.08.033] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/16/2016] [Revised: 08/26/2016] [Accepted: 08/29/2016] [Indexed: 10/21/2022]
Abstract
Various mumps outbreaks have occurred in the Netherlands since 2004, particularly among persons who had received 2 doses of measles, mumps, and rubella (MMR) vaccination. Genomic typing of pathogens can be used to track outbreaks, but the established genotyping of mumps virus based on the small hydrophobic (SH) gene sequences did not provide sufficient resolution. Therefore, we expanded the sequencing to include fusion (F) gene and haemagglutinin-neuraminidase (HN) gene sequences in addition to the SH gene sequences from 109 mumps virus genotype G strains obtained between 2004 and mid 2015 in the Netherlands. When the molecular information from these 3 genes was combined, we were able to identify separate mumps virus clusters and track mumps virus transmission. The analyses suggested that multiple mumps virus introductions occurred in the Netherlands between 2004 and 2015 resulting in several mumps outbreaks throughout this period, whereas during some local outbreaks the molecular data pointed towards endemic circulation. Combined analysis of epidemiological data and sequence data collected in 2015 showed good support for the phylogenetic clustering.
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Affiliation(s)
- Sigrid Gouma
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), P.O. Box 1, 3720 BA, Bilthoven, The Netherlands; Department of Viroscience, Erasmus University Medical Centre, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands.
| | - Jeroen Cremer
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), P.O. Box 1, 3720 BA, Bilthoven, The Netherlands.
| | - Saara Parkkali
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), P.O. Box 1, 3720 BA, Bilthoven, The Netherlands; European Programme for Intervention Epidemiology Training, European Centre for Disease Prevention and Control, Stockholm, Sweden.
| | - Irene Veldhuijzen
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), P.O. Box 1, 3720 BA, Bilthoven, The Netherlands.
| | - Rob S van Binnendijk
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), P.O. Box 1, 3720 BA, Bilthoven, The Netherlands.
| | - Marion P G Koopmans
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), P.O. Box 1, 3720 BA, Bilthoven, The Netherlands; Department of Viroscience, Erasmus University Medical Centre, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands.
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Yung CF, Ramsay M. Estimating true hospital morbidity of complications associated with mumps outbreak, England, 2004/05. Euro Surveill 2016; 21:30320. [PMID: 27562958 PMCID: PMC4998425 DOI: 10.2807/1560-7917.es.2016.21.33.30320] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2015] [Accepted: 06/03/2016] [Indexed: 11/20/2022] Open
Abstract
Mumps outbreaks in highly vaccinated populations continue to be reported globally. Therefore, quantifying the burden of mumps morbidity accurately will be necessary to better assess the impact of mumps vaccination programmes. We aim to estimate the true morbidity resulting from mumps complications in terms of hospitalised orchitis, meningitis, oophoritis and pancreatitis in England during the outbreak in 2004/05. This outbreak in England led to a clear increase in hospitalisations coded to mumps for complications of orchitis in those born in the 1970s and 1980s and possibly for meningitis in those born in the 1980s. A simple statistical model, based on analysing time trends for diagnosed complications in hospital databases with routine laboratory surveillance data, found that the actual morbidity was much higher. There were 2.5 times (166 cases) more mumps orchitis cases in the 1970s cohort and 2.0 times (708 cases) more mumps orchitis cases in the 1980s cohort than complications coded to mumps in hospital databases. Our study demonstrated that the mumps outbreak in England 2004/05 resulted in a substantial increase in hospitalised mumps complications, and the model we used can improve the ascertainment of morbidity from a mumps outbreak.
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Affiliation(s)
- CF Yung
- Immunisation, Hepatitis and Blood Safety Department, Public Health England, London, United Kingdom
- Infectious Disease Service, Department of Paediatrics, KK Women’s and Children’s Hospital, Singapore
| | - M Ramsay
- Immunisation, Hepatitis and Blood Safety Department, Public Health England, London, United Kingdom
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Church D, Johnson S, Raman-Wilms L, Schneider E, Waite N, Pearson Sharpe J. A literature review of the impact of pharmacy students in immunization initiatives. Can Pharm J (Ott) 2016; 149:153-65. [PMID: 27212966 PMCID: PMC4860750 DOI: 10.1177/1715163516641133] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Pharmacy students can help protect the public from vaccine-preventable diseases by participating in immunization initiatives, which currently exist in some Canadian and American jurisdictions. The objective of this article is to critically review evidence of student impact on public health through their participation in vaccination efforts. METHODS PubMed, CINAHL, Cochrane Database, EMBASE, International Pharmaceutical Abstracts, Scopus and Web of Science electronic databases were searched for peer-reviewed literature on pharmacy student involvement in vaccination programs and their impact on public health. Papers were included up to November 17, 2015. Two reviewers independently screened titles and abstracts and extracted data from eligible full-text articles. RESULTS Eighteen titles met all inclusion criteria. All studies were published between 2000 and 2015, with the majority conducted in the United States (n = 12). The number of vaccine doses administered by students in community-based clinics ranged from 109 to 15,000. Increases in vaccination rates in inpatient facilities ranged from 18.5% to 68%. Across studies, student-led educational interventions improved patient knowledge of vaccines and vaccine-preventable diseases. Patient satisfaction with student immunization services was consistently very high. DISCUSSION Methodology varied considerably across studies. The literature suggests that pharmacy students can improve public health by 1) increasing the number of vaccine doses administered, 2) increasing vaccination rates, 3) increasing capacity of existing vaccination efforts, 4) providing education about vaccines and vaccine-preventable diseases and 5) providing positive immunization experiences. CONCLUSION Opportunities exist across Canada to increase pharmacy student involvement in immunization efforts and to assess the impact of their participation. Greater student involvement in immunization initiatives could boost immunization rates and help protect Canadians from vaccine-preventable diseases.
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Affiliation(s)
- Dana Church
- School of Pharmacy (Church, Johnson, Waite, Pearson-Sharpe), University of Waterloo, Kitchener
- Leslie Dan Faculty of Pharmacy (Raman-Wilms), University of Toronto, Toronto, Ontario
- School of Pharmacy (Schneider), Wingate University, Wingate, North Carolina
| | - Sarah Johnson
- School of Pharmacy (Church, Johnson, Waite, Pearson-Sharpe), University of Waterloo, Kitchener
- Leslie Dan Faculty of Pharmacy (Raman-Wilms), University of Toronto, Toronto, Ontario
- School of Pharmacy (Schneider), Wingate University, Wingate, North Carolina
| | - Lalitha Raman-Wilms
- School of Pharmacy (Church, Johnson, Waite, Pearson-Sharpe), University of Waterloo, Kitchener
- Leslie Dan Faculty of Pharmacy (Raman-Wilms), University of Toronto, Toronto, Ontario
- School of Pharmacy (Schneider), Wingate University, Wingate, North Carolina
| | - Eric Schneider
- School of Pharmacy (Church, Johnson, Waite, Pearson-Sharpe), University of Waterloo, Kitchener
- Leslie Dan Faculty of Pharmacy (Raman-Wilms), University of Toronto, Toronto, Ontario
- School of Pharmacy (Schneider), Wingate University, Wingate, North Carolina
| | | | - Jane Pearson Sharpe
- School of Pharmacy (Church, Johnson, Waite, Pearson-Sharpe), University of Waterloo, Kitchener
- Leslie Dan Faculty of Pharmacy (Raman-Wilms), University of Toronto, Toronto, Ontario
- School of Pharmacy (Schneider), Wingate University, Wingate, North Carolina
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Ho YC, Su BH, Su HJ, Chang HL, Lin CY, Chen H, Chen KT. The association between the incidence of mumps and meteorological parameters in Taiwan. Hum Vaccin Immunother 2016; 11:1406-12. [PMID: 25891825 DOI: 10.1080/21645515.2015.1029687] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Abstract
Mumps is caused by a paramyxovirus. It is an acute, but mild infectious disease. However, approximately 10% of patients with mumps can develop severe meningoencephalitis, disability, and death. Seasonal patterns in mumps vary across countries, but the reasons for this phenomenon remain unclear. The aim of this study was to assess the role of meteorological factors on mumps infection. We investigated the relationships between weather variability and the incidence of mumps in Taiwan using a Poisson regression analysis and case-crossover methodology. Between 2006 and 2011, 6,612 cases of mumps were reported to the Centers for Disease Control, Taiwan (Taiwan CDC). The incidence of mumps showed a significant seasonality in summertime (for oscillation, P < 0.001). The number of mumps started to increase at temperatures of 20°C (r(2) = 0.73, P < 0.001), and the case count of mumps began to decline when the temperatures were higher than approximately 25°C (r(2) = 0.24, p = 0.04), producing an inverted V-shaped relationship. Similarly, the number of mumps began to increase at a vapor pressure of 5-9 hPa (r(2) = 0.87, P < 0.005) and decreased at a vapor pressure higher than 25-29 hPa (r(2) = 0.21, p = 0.05). The number of mumps cases was positively associated with temperature and vapor pressure in the preceding period of the infection. In conclusion, this study showed that the occurrence of mumps is significantly associated with increasing temperature and vapor pressure in Taiwan. Therefore, these factors could be regarded as warning signals indicating the need to implement preventive measures.
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Affiliation(s)
- Yi-Chien Ho
- a Department of Cosmetic Applications and Management/Holistic Education Center; Cardinal Tien Junior College of Healthcare and Management ; Taipei , Taiwan
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Chachou MJ, Mukinda FK, Motaze V, Wiysonge CS. Electronic and postal reminders for improving immunisation coverage in children: protocol for a systematic review and meta-analysis. BMJ Open 2015; 5:e008310. [PMID: 26474937 PMCID: PMC4611186 DOI: 10.1136/bmjopen-2015-008310] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
INTRODUCTION Worldwide, suboptimal immunisation coverage causes the deaths of more than one million children under five from vaccine-preventable diseases every year. Reasons for suboptimal coverage are multifactorial, and a combination of interventions is needed to improve compliance with immunisation schedules. One intervention relies on reminders, where the health system prompts caregivers to attend immunisation appointments on time or re-engages caregivers who have defaulted on scheduled appointments. We undertake this systematic review to investigate the potential of reminders using emails, phone calls, social media, letters or postcards to improve immunisation coverage in children under five. METHODS AND ANALYSIS We will search for published and unpublished randomised controlled trials and non-randomised controlled trials in PubMed, Scopus, CINAHL, CENTRAL, Science Citation Index, WHOLIS, Clinicaltrials.gov and the WHO International Clinical Trials Platform. We will conduct screening of search results, study selection, data extraction and risk-of-bias assessment in duplicate, resolving disagreements by consensus. In addition, we will pool data from clinically homogeneous studies using random-effects meta-analysis; assess heterogeneity of effects using the χ(2) test of homogeneity; and quantify any observed heterogeneity using the I(2) statistic. ETHICS AND DISSEMINATION This protocol does not need approval by an ethics committee because we will use publicly available data, without directly involving human participants. The results will provide updated evidence on the effects of electronic and postal reminders on immunisation coverage, and we will discuss the applicability of the findings to low and middle-income countries. We plan to disseminate review findings through publication in a peer-reviewed journal and presentation at relevant conferences. In addition, we will prepare a policymaker-friendly summary using a validated format (eg, SUPPORT Summary) and disseminate this through social media and email discussion groups. REVIEW REGISTRATION NUMBER PROSPERO registration number CRD42014012888.
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Affiliation(s)
- Martel J Chachou
- Division of Community Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Fidele K Mukinda
- Division of Community Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Villyen Motaze
- Faculty of Medicine and Health Sciences, Centre for Evidence-based Health Care, Stellenbosch University, Cape Town, South Africa
| | - Charles S Wiysonge
- Division of Community Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
- Faculty of Medicine and Health Sciences, Centre for Evidence-based Health Care, Stellenbosch University, Cape Town, South Africa
- Cochrane South Africa, South African Medical Research Council, Tygerberg, South Africa
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Mankertz A, Beutel U, Schmidt FJ, Borgmann S, Wenzel JJ, Ziegler P, Weißbrich B, Santibanez S. Laboratory-based investigation of suspected mumps cases submitted to the German National Reference Centre for Measles, Mumps, and Rubella, 2008 to 2013. Int J Med Microbiol 2015; 305:619-26. [PMID: 26358914 DOI: 10.1016/j.ijmm.2015.08.011] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
From 2008 to 2013, sample sets from 534 patients displaying clinical symptoms of mumps were submitted to the German Reference Centre for Measles, Mumps and Rubella. Mumps virus infection was confirmed in 216 cases (40%) by PCR and/or serology. Confirmed cases were more frequently seen in male than in female patients (128 vs. 81); the age group predominantly affected was 15 to 29 years old (65%, median age: 26.4 years). The majority of the confirmed cases had a remote history of vaccination with one or two doses of a mumps-containing vaccine (69%). Our results indicate that mumps virus caused two outbreaks in Bavaria in 2008 and 2010/2011 and a third one in Lower Saxony in 2011. Mumps virus genotype G was preponderantly detected from 2008 to 2013. For 107 of the 216 patients with a confirmed mumps infection, we correlated the results from PCR and serology. PCR detected cases during the first week after onset of symptoms (74% positive results). PCR worked best with throat swabs and oral fluids (61% and 60% positive results, respectively). IgM was more reliable with a longer time after onset of symptoms (67%), but indirect IgM serology was of insufficient sensitivity for vaccinated mumps cases (30%); the IgM μ-capture assay detected more cases in this group. Mumps virus is able to initiate an infection in vaccinated patients (secondary vaccine failure, SVF) although it is unclear to what extent. Since SVF does occur in highly vaccinated populations and IgM will not increase to detectable levels in all SVF patients, we strongly recommend using PCR plus serology tests to avoid false-negative diagnoses in vaccinated individuals with clinical signs of mumps.
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Affiliation(s)
- Annette Mankertz
- Robert Koch-Institute, National Reference Centre Measles, Mumps, Rubella, Seestr. 10, D-13353 Berlin, Germany.
| | | | | | - Stefan Borgmann
- Klinikum Ingolstadt, Department of Clinical Infectiology and Infection Control, Ingolstadt, Germany
| | - Jürgen J Wenzel
- Institute of Clinical Microbiology and Hygiene, Regensburg University Medical Center, Regensburg, Germany
| | - Peter Ziegler
- Public Health Department Landshut, Landshut, Germany
| | - Benedikt Weißbrich
- Institute of Virology and Immunobiology, University Würzburg, Würzburg, Germany
| | - Sabine Santibanez
- Robert Koch-Institute, National Reference Centre Measles, Mumps, Rubella, Seestr. 10, D-13353 Berlin, Germany
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Chen CC, Lu CC, Su BH, Chen KT. Epidemiologic features of mumps in Taiwan from 2006 to 2011: a new challenge for public health policy. World J Pediatr 2015; 11:141-7. [PMID: 25416005 DOI: 10.1007/s12519-014-0525-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2013] [Accepted: 03/21/2014] [Indexed: 10/24/2022]
Abstract
BACKGROUND The adoption of a second dose of the measles-mumps-rubella (MMR) vaccine among Taiwanese school children began in 2001. However, during that time, mumps cases continued to occur. The purpose of the present study was to assess the epidemiology and vaccination policy for mumps in Taiwan. METHODS We examined the data on mumps cases collected by the Taiwan Centers for Disease Control (Taiwan CDC) between 2006 and 2011. RESULTS During the 6-year study period, a total of 6612 cases of mumps were reported to the Taiwan CDC. Of the patients with known vaccination status, 62% received one dose of the MMR vaccine or no vaccine. The incidence of mumps ranged from 4.18 to 5.28 per 100 000 population and peaked in 2007. Males had a higher incidence of mumps than females (5.9 vs. 3.7 per 100 000 population; P=0.024). Children between 5 and 6 years of age had the highest incidence of mumps, and those 20 years and older had the lowest incidence. Compared to those who received two doses of the MMR vaccine, patients who were not vaccinated or received a single dose of the vaccine had a higher risk of suffering from complications and/or hospitalization. CONCLUSIONS In Taiwan, more than 60% of mumps cases received either no dose or one dose of the MMR vaccine. Monitoring mumps through biological testing and instituting a second dose of the MMR vaccine for children is needed for the elimination of mumps in Taiwan.
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Affiliation(s)
- Chian-Ching Chen
- Department of Business Administration, National Taiwan University of Science and Technology, Taipei, China
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Sane J, Gouma S, Koopmans M, de Melker H, Swaan C, van Binnendijk R, Hahné S. Epidemic of mumps among vaccinated persons, The Netherlands, 2009-2012. Emerg Infect Dis 2014; 20:643-8. [PMID: 24655811 PMCID: PMC3966393 DOI: 10.3201/eid2004.131681] [Citation(s) in RCA: 70] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
To analyze the epidemiology of a nationwide mumps epidemic in the Netherlands, we reviewed 1,557 notified mumps cases in persons who had disease onset during September 1, 2009–August 31, 2012. Seasonality peaked in spring and autumn. Most case-patients were males (59%), 18–25 years of age (67.9%), and vaccinated twice with measles-mumps-rubella vaccine (67.7%). Nearly half (46.6%) of cases occurred in university students or in persons with student contacts. Receipt of 2 doses of vaccine reduced the risk for orchitis, the most frequently reported complication (vaccine effectiveness [VE] 74%, 95% CI 57%–85%); complications overall (VE 76%, 95% CI 61%–86%); and hospitalization (VE 82%, 95% CI 53%–93%). Over time, the age distribution of case-patients changed, and proportionally more cases were reported from nonuniversity cities (p<0.001). Changes in age and geographic distribution over time may reflect increased immunity among students resulting from intense exposure to circulating mumps virus.
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45
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Fiebelkorn AP, Coleman LA, Belongia EA, Freeman SK, York D, Bi D, Zhang C, Ngo L, Rubin S. Mumps antibody response in young adults after a third dose of measles-mumps-rubella vaccine. Open Forum Infect Dis 2014; 1:ofu094. [PMID: 25734162 PMCID: PMC4324223 DOI: 10.1093/ofid/ofu094] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2014] [Accepted: 09/16/2014] [Indexed: 12/05/2022] Open
Abstract
Baseline mumps antibody titers were high-seropositive for 93.4% of subjects, low-seropositive for 5.8%, and seronegative for <1%. One month after a third measles-mumps-rubella vaccine dose, mumps titers had a modest but significant increase. One year later, titers returned to near baseline. Background Mumps outbreaks in populations with high 2-dose measles-mumps-rubella (MMR) vaccine coverage raise the question whether a third dose of MMR vaccine (MMR3) is needed. However, data on the immunogenicity of MMR3 are limited. We assessed mumps virus neutralizing antibody levels pre- and post-MMR3 in a nonoutbreak setting. Methods Mumps antibody titers were assessed at baseline, 1 month, and 1 year after MMR3 in subjects aged 18–28 years. Results At baseline, 5 of 656 (0.8%) subjects had seronegative mumps neutralizing antibody titers and 38 (5.8%) had low titers. One year post-MMR3, these numbers declined to 3 (0.5%) and 16 (2.4%), respectively. Subjects with low baseline titers were more likely to have low 1-month and 1-year titers (R2 = 0.81–0.87, P < .0001). Compared to baseline, geometric mean titers were significantly higher at 1 month (P < .0001) and 1 year (P < .01) post-MMR3; however, reverse cumulative distribution curves showed only minimal shifts in mumps titers from baseline to 1 month and 1 year. Conclusions Very few subjects had negative or low baseline mumps titers. Nonetheless, mumps titers had modest but significant increases when measured 1 month and 1 year post-MMR3. This temporary increase in titers could decrease susceptibility to disease during outbreaks, but may have limited value for routine use in vaccinated populations.
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Affiliation(s)
- Amy Parker Fiebelkorn
- National Center for Immunization and Respiratory Diseases , Centers for Disease Control and Prevention , Atlanta, Georgia
| | | | | | | | - Daphne York
- Marshfield Clinic Research Foundation , Wisconsin
| | - Daoling Bi
- National Center for Immunization and Respiratory Diseases , Centers for Disease Control and Prevention , Atlanta, Georgia
| | - Cheryl Zhang
- Center for Biologics Evaluation and Research , Food and Drug Administration , Bethesda, Maryland
| | - Laurie Ngo
- Center for Biologics Evaluation and Research , Food and Drug Administration , Bethesda, Maryland
| | - Steven Rubin
- Center for Biologics Evaluation and Research , Food and Drug Administration , Bethesda, Maryland
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Braeye T, Linina I, De Roy R, Hutse V, Wauters M, Cox P, Mak R. Mumps increase in Flanders, Belgium, 2012–2013: Results from temporary mandatory notification and a cohort study among university students. Vaccine 2014; 32:4393-4398. [DOI: 10.1016/j.vaccine.2014.06.069] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2014] [Revised: 06/03/2014] [Accepted: 06/13/2014] [Indexed: 11/17/2022]
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Hoshi SL, Kondo M, Okubo I. Economic evaluation of vaccination programme of mumps vaccine to the birth cohort in Japan. Vaccine 2014; 32:4189-97. [DOI: 10.1016/j.vaccine.2014.05.020] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2013] [Revised: 04/23/2014] [Accepted: 05/01/2014] [Indexed: 10/25/2022]
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Fiebelkorn AP, Lawler J, Curns AT, Brandeburg C, Wallace GS. Mumps postexposure prophylaxis with a third dose of measles-mumps-rubella vaccine, Orange County, New York, USA. Emerg Infect Dis 2014; 19:1411-7. [PMID: 23965729 PMCID: PMC3810923 DOI: 10.3201/eid1909.130299] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Although the measles-mumps-rubella (MMR) vaccine is not recommended for mumps postexposure prophylaxis (PEP), data on its effectiveness are limited. During the 2009–2010 mumps outbreak in the northeastern United States, we assessed effectiveness of PEP with a third dose of MMR vaccine among contacts in Orthodox Jewish households who were given a third dose within 5 days of mumps onset in the household’s index patient. We compared mumps attack rates between persons who received a third MMR dose during the first incubation period after onset in the index patient and 2-dose vaccinated persons who had not. Twenty-eight (11.7%) of 239 eligible household members received a third MMR dose as PEP. Mumps attack rates were 0% among third-dose recipients versus 5.2% among 2-dose recipients without PEP (p = 0.57). Although a third MMR dose administered as PEP did not have a significant effect, it may offer some benefits in specific outbreak contexts.
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Kutty PK, Lawler J, Rausch-Phung E, Ortega-Sanchez IR, Goodell S, Schulte C, Pollock L, Valure B, Hudson J, Gallagher K, Blog D. Epidemiology and the economic assessment of a mumps outbreak in a highly vaccinated population, Orange County, New York, 2009-2010. Hum Vaccin Immunother 2014; 10:1373-81. [PMID: 24633360 PMCID: PMC4896528 DOI: 10.4161/hv.28389] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2013] [Revised: 02/19/2014] [Accepted: 02/28/2014] [Indexed: 11/19/2022] Open
Abstract
Studies assessing the economic burden of a mumps outbreak in a highly vaccinated population are limited. The Orange County Health Department (OCHD), New York State Department of Health (NYS DOH), and the Centers for Disease Control and Prevention conducted a mumps investigation in an affected village with a highly vaccinated population. To understand the epidemiology, standardized mumps case definition and active surveillance were used to identify mumps cases. In addition, an economic assessment of a combined outbreak investigation and third dose measles-mumps-rubella (MMR) vaccine intervention conducted by OCHD and NYS DOH was performed; estimated by retrospectively evaluating public health response-related activities including use of a third dose of MMR vaccine. From September 24, 2009, through June 15, 2010, 790 mumps cases were reported-64% were male and highest attack rate was among 11-17 year age group (99.1 cases per 1000 individuals). Of the 658 cases with known vaccination history, 83.6% had documentation of 2 doses of mumps containing vaccine. No deaths were reported. The 2 major exposure settings were schools (71.8%) and households (22.5%). Approximately 7736 h of public health personnel time were expended with the total approximate cost of US $463,000, including US $34,392 for MMR vaccine-the estimated cost per household was US $827. Mumps continues to be endemic in many parts of the world, resulting in importations into the United States. Large mumps outbreaks similar to this in highly vaccinated populations may require considerable investigation and control activities.
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Affiliation(s)
- Preeta Krishnan Kutty
- National Center for Immunization and Respiratory Diseases; Centers for Disease Control and Prevention; Atlanta, GA USA
| | | | | | - Ismael R Ortega-Sanchez
- National Center for Immunization and Respiratory Diseases; Centers for Disease Control and Prevention; Atlanta, GA USA
| | | | - Cynthia Schulte
- Bureau of Immunization; New York State Department of Health; Albany, NY USA
| | - Lynn Pollock
- Bureau of Immunization; New York State Department of Health; Albany, NY USA
| | | | - Jean Hudson
- Orange County Health Department; Goshen, NY USA
| | - Kathleen Gallagher
- National Center for Immunization and Respiratory Diseases; Centers for Disease Control and Prevention; Atlanta, GA USA
| | - Debra Blog
- Bureau of Immunization; New York State Department of Health; Albany, NY USA
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Liang Y, Ma J, Li C, Chen Y, Liu L, Liao Y, Zhang Y, Jiang L, Wang XY, Che Y, Deng W, Li H, Cui X, Ma N, Ding D, Xie Z, Cui P, Ji Q, Wang J, Zhao Y, Wang J, Li Q. Safety and immunogenicity of a live attenuated mumps vaccine: a phase I clinical trial. Hum Vaccin Immunother 2014; 10:1382-90. [PMID: 24614759 DOI: 10.4161/hv.28334] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Mumps, a communicable, acute and previously well-controlled disease, has had recent and occasional resurgences in some areas. METHODS A randomized, double-blind, controlled and multistep phase I study of an F-genotype attenuated mumps vaccine produced in human diploid cells was conducted. A total of 300 subjects were enrolled and divided into 4 age groups: 16-60 years, 5-16 years, 2-5 years and 8-24 months. The groups were immunized with one injection per subject. Three different doses of the F-genotype attenuated mumps vaccine, A (3.5 ± 0.25 logCCID50), B (4.25 ± 0.25 logCCID50) and C (5.0 ± 0.25 logCCID50), as well as a placebo control and a positive control of a licensed A-genotype vaccine (S79 strain) were used. The safety and immunogenicity of this vaccine were compared with those of the controls. RESULTS The safety evaluation suggested that mild adverse reactions were observed in all groups. No serious adverse event (SAE) was reported throughout the trial. The immunogenicity test showed a similar seroconversion rate of the neutralizing and ELISA antibody in the 2- to 5-year-old and 8- to 24-month-old groups compared with the seroconversion rate in the positive control. The GMT of the neutralizing anti-F-genotype virus antibodies in the vaccine groups was slightly higher than that in the positive control group. CONCLUSIONS The F-genotype attenuated mumps vaccine evaluated in this clinical trial was demonstrated to be safe and have effective immunogenicity vs. control.
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Affiliation(s)
- Yan Liang
- Institute Of Medical Biology; Chinese Academy of Medicine Science; Peking Union Medical College; Kunming, PR China
| | - Jingchen Ma
- Hebei province Center for Disease Control and Prevention; Shijiazhuang, PR China
| | - Changgui Li
- National Institutes for Food and Drug Control; Beijing, PR China
| | - Yuguo Chen
- Institute of Biological Sciences; Fudan University; Shanghai, PR China
| | - Longding Liu
- Institute Of Medical Biology; Chinese Academy of Medicine Science; Peking Union Medical College; Kunming, PR China
| | - Yun Liao
- Institute Of Medical Biology; Chinese Academy of Medicine Science; Peking Union Medical College; Kunming, PR China
| | - Ying Zhang
- Institute Of Medical Biology; Chinese Academy of Medicine Science; Peking Union Medical College; Kunming, PR China
| | - Li Jiang
- Institute Of Medical Biology; Chinese Academy of Medicine Science; Peking Union Medical College; Kunming, PR China
| | - Xuan-Yi Wang
- Institute of Biological Sciences; Fudan University; Shanghai, PR China
| | - Yanchun Che
- Institute Of Medical Biology; Chinese Academy of Medicine Science; Peking Union Medical College; Kunming, PR China
| | - Wei Deng
- Institute of Biological Sciences; Fudan University; Shanghai, PR China
| | - Hong Li
- National Institutes for Food and Drug Control; Beijing, PR China
| | - Xiaoyu Cui
- National Institutes for Food and Drug Control; Beijing, PR China
| | - Na Ma
- Institute Of Medical Biology; Chinese Academy of Medicine Science; Peking Union Medical College; Kunming, PR China
| | - Dong Ding
- Institute Of Medical Biology; Chinese Academy of Medicine Science; Peking Union Medical College; Kunming, PR China
| | - Zhongping Xie
- Institute Of Medical Biology; Chinese Academy of Medicine Science; Peking Union Medical College; Kunming, PR China
| | - Pingfang Cui
- Institute Of Medical Biology; Chinese Academy of Medicine Science; Peking Union Medical College; Kunming, PR China
| | - Qiuyan Ji
- Institute Of Medical Biology; Chinese Academy of Medicine Science; Peking Union Medical College; Kunming, PR China
| | - JingJing Wang
- Institute Of Medical Biology; Chinese Academy of Medicine Science; Peking Union Medical College; Kunming, PR China
| | - Yuliang Zhao
- Hebei province Center for Disease Control and Prevention; Shijiazhuang, PR China
| | - Junzhi Wang
- National Institutes for Food and Drug Control; Beijing, PR China
| | - Qihan Li
- Institute Of Medical Biology; Chinese Academy of Medicine Science; Peking Union Medical College; Kunming, PR China
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