Assessing Mumps Outbreak Risk in Highly Vaccinated Populations Using Spatial Seroprevalence Data (original) (raw)
Related papers
Epidemiology and Infection, 2013
SUMMARYMumps outbreaks have recently been recorded in a number of highly vaccinated populations. We related seroprevalence, epidemiological and vaccination data from 18 European countries participating in The European Sero-Epidemiology Network (ESEN) to their risk of mumps outbreaks in order to inform vaccination strategies. Samples from national population serum banks were collected, tested for mumps IgG antibodies and standardized for international comparisons. A comparative analysis between countries was undertaken using age-specific mumps seroprevalence data and information on reported mumps incidence, vaccine strains, vaccination programmes and vaccine coverage 5-12 years after sera collection. Mean geometric mumps antibody titres were lower in mumps outbreak countries [odds ratio (OR) 0·09, 95% confidence interval (CI) 0·01-0·71)]. MMR1 vaccine coverage ⩾95% remained protective in a multivariable model (P<0·001), as did an interval of 4-8 years between doses (OR 0·08, 95% CI 0·01-0·85). Preventing outbreaks and controlling mumps probably requires several elements, including high-coverage vaccination programmes with MMR vaccine with 4-8 years between doses.
Characteristics of Large Mumps Outbreaks in the United States, July 2010–December 2015
Clinical Infectious Diseases
Background. Mumps is an acute viral illness that classically presents with parotitis. Although the United States experienced a 99% reduction in mumps cases following implementation of the 2-dose vaccination program in 1989, mumps has resurged in the past 10 years. Methods. We assessed the epidemiological characteristics of mumps outbreaks with ≥20 cases reported in the United States electronically through the National Notifiable Diseases Surveillance System and from supplemental outbreak data through direct communications with jurisdictions from July 2010 through December 2015. Mumps cases were defined using the 2012 Council of State and Territorial Epidemiologists case definition. Results. Twenty-three outbreaks with 20-485 cases per outbreak were reported in 18 jurisdictions. The duration of outbreaks ranged from 1.5 to 8.5 months (median, 3 months). All outbreaks involved close-contact settings; 18 (78%) involved universities, 16 (70%) occurred primarily among young adults (median age, 18-24 years), and 9 (39%) occurred in highly vaccinated populations (2-dose measles-mumps-rubella vaccine coverage ≥85%). Conclusions. During 2010-2015, multiple mumps outbreaks among highly vaccinated populations in close-contact settings occurred. Most cases occurred among vaccinated young adults, suggesting that waning immunity played a role. Further evaluation of risk factors associated with these outbreaks is warranted. Keywords. mumps; mumps outbreaks; MMR vaccine. METHODS Case Definitions and Reporting We conducted a detailed review of cases sent electronically through the National Notifiable Diseases Surveillance System (NNDSS), and collected supplemental outbreak data through direct communications with jurisdictions on outbreaks and outbreak-associated cases occurring from 1 July 2010 (the month after the large 2009-2010 outbreak in the northeast ended)
International Journal of Environmental Research and Public Health, 2019
Mumps vaccines have been widely used in recent years, but frequent mumps outbreaks and re-emergence around the world have not stopped. Mumps still remains a serious public health problem with a high incidence in China. The status of mumps epidemics in Chongqing, the largest city in China, is still unclear. This study aimed to investigate the epidemiological and spatiotemporal characteristics of mumps and to provide a scientific basis for formulating effective strategies for its prevention and control. Surveillance data of mumps in Chongqing from January 2004 to December 2018 were collected from the National Notifiable Diseases Reporting Information System. A descriptive analysis was conducted to understand the epidemiological characteristics. Hot spots and spatiotemporal patterns were identified by performing a spatial autocorrelation analysis, a purely spatial scan, and a spatiotemporal scan at the county level based on geographic information systems. A total of 895,429 mumps cases...
Vaccine Effectiveness Estimates, 2004–2005 Mumps Outbreak, England
Emerging Infectious Diseases, 2007
The United Kingdom and United States have recently experienced large outbreaks of mumps, which raises concerns about vaccine effectiveness. The effectiveness of the mumps component of the measles, mumps, rubella (MMR) vaccine was estimated using the screening method. In England from January 2004 through March 2005, 312 cases of mumps were reported in children eligible to have received 2 doses of MMR vaccine. Of these children, 52 (16.7%) had received 1 dose of MMR vaccine, and 97 (31.1%) had received 2 doses. Vaccine effectiveness was 88% (95% confi dence interval [CI] 83%-91%) for 1 dose and 95% (95% CI 93%-96%) for 2 doses. The effectiveness of 1 dose declined from 96% (95% CI 81%-99%) in 2-year-olds to 66% (95% CI 30%-83%) in 11-to 12-year-olds, and the effectiveness of 2 doses declined from 99% (95% CI 97%-99.5%) in 5-to 6-year-olds to 86% (95% CI 74%-93%) in 11-to 12-year-olds (p<0.001 for 1 or 2 doses). Waning immunity may contribute to mumps outbreaks in older vaccinated populations. Emerging Infectious Diseases • www.cdc.gov/eid • Vol. 13, No.
PLoS ONE, 2013
Here we present mumps virus specific antibody levels in a large cross-sectional population-based serosurveillance study performed in the Netherlands in 2006/2007 (n = 7900). Results were compared with a similar study (1995/1996) and discussed in the light of recent outbreaks. Mumps antibodies were tested using a fluorescent bead-based multiplex immunoassay. Overall seroprevalence was 90.9% with higher levels in the naturally infected cohorts compared with vaccinated cohorts. Mumps virus vaccinations at 14 months and 9 years resulted in an increased seroprevalence and antibody concentration. The second vaccination seemed to be important in acquiring stable mumps antibody levels in the long term. In conclusion, the Dutch population is well protected against mumps virus infection. However, we identified specific age-and population groups at increased risk of mumps infection. Indeed, in 2007/2008 an outbreak has occurred in the low vaccination coverage groups emphasizing the predictive value of serosurveillance studies.
Vaccine, 2017
The mumps vaccine (Jeryl-Lynn-strain) was introduced in Spain in 1981, and a vaccination policy which included a second dose was added in 1995. From 1992-1999, a Rubini-strain based vaccine was administered in many regions but later withdrawn due to lack of effectiveness. Despite high levels of vaccination coverage, epidemics have continued to appear. We characterized the three epidemic waves of mumps between 1998 and 2014, identifying major changes in susceptible populations using Poisson regression. For the period 1998-2003 (P1), the most affected group was from 1 to 4years old (y) [Incidence Rate (IR)=71.7 cases/100,000 population]; in the periods 2004-2009 (P2) and 2010-2014 (P3) IR ratio (IRR) increased among 15-24y (P2=1.46; P3=2.68) and 25-34y (P2=2.17; P3=4.05). Hospitalization rate (HR), complication rate (CR) and neurological complication rate (NR) among hospitalized subjects decreased across the epidemics, except for 25-34y which increased: HR ratio (HRR) (P2=2.18; P3=2.1...
Mumps outbreaks in highly vaccinated populations: What makes good even better?
Human vaccines, 2009
outbreak in 2006. This happened in the US despite a two-dose vaccination coverage of 87%. Moreover the majority of the cases (67%) were twice-immunised individuals. In this commentary we speculate on the factors that may be responsible for this striking difference between the US and Finland.
Sero-epidemiology of mumps in western Europe
Epidemiology and Infection, 2003
Six countries (Denmark, England and Wales, France, Germany, Italy and the Netherlands) conducted large serological surveys for mumps, in the mid-1990s, as part of the European Sero-Epidemiology Network (ESEN). The assay results were standardized and related to the schedules and coverage of the immunization programmes and the reported incidence of mumps. Low incidence of disease and few susceptibles amongst adolescents and young adults was observed in countries with high mumps vaccine coverage (e.g. the Netherlands). High disease incidence and large proportions of mumps virus antibody negative samples in adolescent and young adult age groups was noted in countries with poor vaccine coverage (e.g. Italy). The build-up of susceptibles in older children and adolescents in England and Wales, France, the former West Germany and Italy indicate the possibility of further mumps outbreaks in secondary school environments. To control mumps in western Europe, current MMR immunization programmes will need to be strengthened in a number of countries. Sero-surveillance of mumps is an important component of disease control and its usefulness will be enhanced by the development of an international mumps standard.
A Bayesian Spatial Analysis of Mumps Data in Bulgaria
2017
Bayesian spatial methods have been widely applied in different scientific areas such as epidemiological studies, image processing and many others. In this work we use Bayesian hierarchical model with Gaussian conditionally autoregressive prior to a collection of weekly mumps data from 2007 outbreak in Bulgaria. We generate a disease mapping of the crude standardized incidence ratio across all regional centers. Similar mapping is also produced for the smoothed relative risk. The combination of methods for estimates of the relative risk is a powerful tool to identify high risk regions and may be used to guide local authorities and programs.