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References 1-14, 17, 21, and 43. t References 32-34. Downloaded From: http://archinte.jamanetwork.com/ by a University of Iowa User on 06/15/2015 transmission by an insect vector has received consideration,U but experimental evidence on this point is restricted to one negative study in human volunteers, using flies trapped at the site of a camp epidemic.3 It has been shown in institutional epi¬ demics # and in army 17 and in camp 28 out-\ s=dd\ References 21 and 43 ; Clark, W. : Personal communication to the authors ;Williams, H.; Drake, M. E.; Barondess, J. A.; Maley, V. ; McCroan, J.

Summary Vaccination procedures for the prevention of mumps have been evaluated in the light of results obtained with neutralization tests in chick embryos. Only 25% of individuals judged susceptible responded with neutralizing antibodies following the subcutaneous inoculation of inactivated mumps virus in contrast to the development of complement-fixing antibodies to the V antigen in 70 to 100% of the vaccinees. Production of neutralizing antibodies appeared to be closely related to immunity to mumps in an epidemic which occurred 8–11 months after vaccination while many cases were recorded in those who failed to reveal a measurable response. These data indicate that the vaccine or the method of vaccination requires improvement. The oral spraying of active attenuated virus failed to yield better responses in neutralizing antibodies as compared to subcutaneous vaccination with inactivated virus. The neutralization test did not appear superior to the complement-fixation reaction or the skin test as a method of determining susceptibility when related to the history of past mumps or subsequent incidence of mumps. On behalf of greater simplicity and speed the complement-fixation reaction and the skin test will remain useful tools in evaluating the state of immunity. A correlation of the titers in all types of sera obtained by the neutralization test, the complement fixation with the virus antigen and the hemagglutination inhibition, indicated that these three technics measured different antibodies.

Summary The results of over 1800 skin tests and over 1500 complement fixation tests have been analyzed in terms of past mumps infection, age of the individual and geographical area. Correlation between past known infection and positive complement fixation or skin tests was of the order of 70 to 80%. With the skin test it was somewhat higher in the adult than in individuals less than 18 years of age, whereas the reverse was noted with the complement fixation test. Neither a positive complement fixation reaction nor a positive skin response affords absolute assurance of resistance to mumps but the incidence of infection among such individuals was found to be less than 2%, whereas it was many times that in those giving negative reactions. Since discrepancies between the results of the 2 tests, when performed simultaneously, were not infrequent, it is obvious that both technics should be employed to attain maximal accuracy in determining the immune status of an individual.