Epidemic of Mumps among Vaccinated Persons, the Netherlands, 2009–2012

Sane, Jussi; Gouma, Sigrid; Koopmans, Marion; Melker, Hester E. de; Swaan, Corien; Binnendijk, Rob van; Hahné, Susan

doi:10.3201/eid2004.131681

Cited by 84 publications

(85 citation statements)

References 24 publications

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“…The majority of the mumps cases was male (59%), university student (47%), 18-25 y of age (68%), and vaccinated twice with the MMR vaccine (68%). 24,25 In the present study, 2 clear response patterns in IgG and VN antibody levels against the mumps vaccine strain could be detected in consecutive blood samples obtained from mumps virus infected persons during this epidemic. In previously vaccinated mumps cases, specific IgG concentrations as well as the ND 50 values were significantly higher shortly (1-2 months) after onset of disease than at 7-10 months.…”

Section: Discussionmentioning

confidence: 81%

Dynamics of the serologic response in vaccinated and unvaccinated mumps cases during an epidemic

Kaaijk

Gouma

Hulscher

et al. 2015

Human Vaccines & Immunotherapeutics

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Abbreviations: MMR, measles mumps and rubella; ND 50 , reciprocal virus-neutralizing antibody dose; VN, virus-neutralizing antibody; RU/ml, RIVM units per ml; GMC, geometric mean concentration; 95% CI, lower and upper 95% confidence intervals of GMCIn the last decade, several mumps outbreaks were reported in various countries despite high vaccination coverage. In most cases, young adults were affected who have acquired immunity against mumps solely by vaccination and not by previous wild-type mumps virus infection. To investigate mumps-specific antibody levels, functionality and dynamics during a mumps epidemic, blood samples were obtained longitudinally from 23 clinical mumps cases, with or without a prior history of vaccination, and from 20 healthy persons with no serological evidence of recent mumps virus infection. Blood samples from mumps cases were taken 1-2 months and 7-10 months after onset of disease. Both vaccinated and unvaccinated mumps cases had significantly higher geomean concentrations of mumps-specific IgG (resp. 13,617 RU/ml (95% CI of 9,574-19,367 RU/ml) vs. 1,552 (445-5412) RU/ml at 1-2 months; and 6,514 (5,247-8,088) RU/ml vs. 1,143 (480-2,725) RU/ml at 7-10 months) than healthy controls (169 (135-210) RU/ml) (p D 0.001). Patterns in virus-neutralizing (VN) antibody responses against the mumps vaccine virus were similar, vaccinated and unvaccinated mumps cases had significantly higher ND 50 values at both time points of sampling (resp 4,695 (3,779-5,832) RU/ml vs. 1,533 (832-2,825) RU/ml at 1-2 months; 2,478 (1,968-3,122) RU/ml vs. 1,221 (1,029-1,449) RU/ml at 7-10 months) compared with (previously vaccinated) healthy controls (122 (196-76)) RU/ml) (p D 0.001) The unvaccinated mumps cases had significantly lower mumps-specific IgG and VN antibody concentrations at both sampling points compared with previously vaccinated cases, but their antibody concentrations did not differ significantly at the 2 time points. In contrast, the mumps-specific IgG and VN antibody concentrations of the previously vaccinated mumps cases were significantly higher within the first 2 months after onset of mumps and declined thereafter, characteristic for a secondary response. A moderate correlation was found between the level of mumps-specific IgG serum antibodies and VN antibodies for the mumps cases (r D 0.64; p<0.001).

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Section: Discussionmentioning

confidence: 81%

Dynamics of the serologic response in vaccinated and unvaccinated mumps cases during an epidemic

Kaaijk

Gouma

Hulscher

et al. 2015

Human Vaccines & Immunotherapeutics

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“…Most of the patients were young adults who had received 2 measles, mumps, and rubella (MMR) vaccinations during childhood at 14 months and 9 years of age, according to the Dutch national immunization program [3,4]. Similar to other recent mumps outbreaks among MMR vaccinated persons worldwide, the mumps outbreaks in the Netherlands were dominated by mumps genotype G virus strains, whereas the Jeryl Lynn mumps strain of the MMR vaccine belongs to genotype A.…”

Section: Introductionmentioning

confidence: 94%

Mumps-specific cross-neutralization by MMR vaccine-induced antibodies predicts protection against mumps virus infection

Gouma

Hulscher

Klooster

et al. 2016

Vaccine

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“…14 In a study of a recent large mumps epidemic in the Netherlands, receipt of 2 vaccine doses reduced risks for orchitis (most frequent complication), overall complications and hospitalization (VE of 74%, 76% and 82%, respectively). 20 In a smaller outbreak in Germany, VE was calculated as 91.9% for 2 vaccine doses in children (mean age: 9 y) and 50.0% for one dose in adults (mean age: 26 y). 21 This study assessed VE during a mumps outbreak, which is naturally an uncontrolled and unplanned phenomenon.…”

Section: Discussionmentioning

confidence: 99%

Characteristics of a large mumps outbreak: Clinical severity, complications and association with vaccination status of mumps outbreak cases

Stein‐Zamir

Schroeder

Shoob

et al. 2015

Human Vaccines & Immunotherapeutics

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In recent years, large mumps outbreaks, involving mainly adolescents and young adults, have re-emerged in several countries. We investigated a large mumps outbreak, evaluated the association between mumps clinical severity (complications, hospitalization) and vaccination status (number of previous measles, mumps and rubella -MMR vaccine doses), and assessed vaccine effectiveness. The first mumps cases emerged in an ultra-orthodox boys' school in Jerusalem and were epidemiologically linked to the mumps outbreak in New York. Overall, 3130 mumps cases were notified in the Jerusalem district during September 2009-August 2011 (median age 13y, 64% males). Most cases were reported from community clinics. Patients with systemic symptoms and/or complications (419, 13.4%) were either hospitalized (n D 79) or treated in an emergency medical center (n D 340). The main complications included orchitis (3.8% males> age 12y) and meningoencephalitis (0.5%). The mumps virus genotype was G5. The distribution of previous MMR vaccine doses (n D 0,1,2) was: 24.8%, 28.3% and 46.9%, respectively. The number of previous vaccine doses was inversely associated with clinical severity. Adjusted values for MMR vaccine effectiveness against complications were estimated as 52.1% (95% CI ¡4 ¡78%) for one vaccine dose and 62.7% (95% CI 25.7-81.3%) for 2 doses. The outbreak was characterized by predominance of male students; the majority of whom had been previously vaccinated. The reported complication rate was relatively low. Vaccination status was associated with age and disease severity. The combination of limited mumps vaccine effectiveness and the specific school setting (dense learning and living conditions) probably contributed to the disease spread.

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Epidemic of Mumps among Vaccinated Persons, the Netherlands, 2009–2012

Cited by 84 publications

References 24 publications

Dynamics of the serologic response in vaccinated and unvaccinated mumps cases during an epidemic

Dynamics of the serologic response in vaccinated and unvaccinated mumps cases during an epidemic

Mumps-specific cross-neutralization by MMR vaccine-induced antibodies predicts protection against mumps virus infection

Characteristics of a large mumps outbreak: Clinical severity, complications and association with vaccination status of mumps outbreak cases

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