Mumps outbreak among vaccinated university students associated with a large party, the Netherlands, 2010

Greenland, Katie; Whelan, Jane; Fanoy, Ewout; Borgert, Marjon; Hulshof, Koen; Yap, K H; Swaan, Corien; Donker, Tjibbe; Binnendijk, Rob van; Melker, Hester E. de; Hahné, Susan

doi:10.1016/j.vaccine.2012.04.083

Cited by 67 publications

(56 citation statements)

References 23 publications

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“…[5][6][7][8][9][10][11][12][13][14] In 2009-2012, a mumps epidemic (genotype G) arose that spread across multiple locations within the Netherlands, in which also primarily vaccinated students were affected. 15 Waning of vaccine-induced immunity has been suggested to play a role in these outbreaks. [6][7][8][9][10]13,14 When compared to the other components in the MMR vaccine, the mumps component seemed to be the least effective in eliciting good (high avidity) antibody responses, which were shown to wane to lower levels and in avidity index 20 y after a second MMR vaccination.…”

Section: Introductionmentioning

confidence: 99%

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: Introductionmentioning

confidence: 99%

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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“…Similar studies also reported that mumps outbreaks among highly vaccinated populations tended to occur in highdensity settings such as universities and schools, with teenagers as the most vulnerable group. 8,10,[14][15][16]18,19 These findings indicate that among highly vaccinated populations, despite herd immunity, intense exposures to one or more mumps cases may increase the risk of transmission, even in the most recently vaccinated children. It is possible that such risk factors may overcome vaccine-induced immunity resulting in persistence of transmission of the disease.…”

Section: Discussionmentioning

confidence: 98%

“…[12][13][14][15][16] Between October 2012 and March 2013, 148 cases of mumps were notified in the Central Region of Portugal to the Regional Health Administration. In contrast, there was no evidence of outbreaks elsewhere in the country between 2009 and 2012.…”

Section: Discussionmentioning

confidence: 99%

“…17 From 2012 no official data was published. As done by others, [12][13][14][15][16] we used a case definition adapted from the European Community Case Definitions for Communicable Diseases, 9 contemplating the existence of possible cases of mumps without fever. The disease may present without fever or asymptomatic, especially in patients with some degree of immunity.…”

Section: Discussionmentioning

confidence: 99%

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Mumps Outbreak among Highly Vaccinated Teenagers and Children in the Central Region of Portugal, 2012-2013

et al. 2015

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Results: Over six months, 148 outbreak-related cases were reported: 87.8% occurred in three of the 16 affected counties and 78.4% had a known epidemiological link. Median age was 14.5 years (2-62) and 70.3% were 11-20 years old; 61.5% were male. The mean duration of disease was seven days (2-20). The disease was generally mild; 80.4% had fever and in 55.4% there was unilateral involvement of the parotid gland. Seven cases had orchitis, one oophoritis and one had nephritis. Two cases were hospitalized. School transmission predominated and class attack rates were < 30%. Most of the cases occurred in vaccinated individuals (92%) of whom 86.8% had received 2 doses; 17.7% had received one dose of the vaccine containing the Rubini strain. Mumps virus genotype G was identified in 4 cases. Discussion: This mumps outbreak among a highly vaccinated population, occurring mostly in teenagers at school, could be due to the partial effectiveness of the vaccine against the disease (particularly in the group vaccinated with Rubini strain), waning immunity overtime and genotype mismatch.Conclusions: This outbreak report shows the importance of discussion about the need of more booster dose of the actual vaccine or new vaccine including more genotypes to improve immunogenicity.

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“…The majority of mumps patients in these outbreaks were adolescents and some outbreaks were specifically associated with educational settings or student events. [6][7][8][9] The understanding of mumps virus pathogenesis and the immune responses required for protection against mumps virus infection is limited, whereas this knowledge is important for the development of new mumps vaccine strategies and outbreak control measures. Therefore, the recent outbreaks create the opportunity to gain more insights into mumps virus pathogenesis in humans, especially in relation to the vaccine-acquired immune response, as MMR vaccination does not provide lifelong sterile immunity in a significant proportion of individuals.…”

mentioning

confidence: 99%

Mumps virus pathogenesis: Insights and knowledge gaps

Gouma

Binnendijk

2016

Human Vaccines & Immunotherapeutics

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Mumps outbreak among vaccinated university students associated with a large party, the Netherlands, 2010

Cited by 67 publications

References 23 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 Outbreak among Highly Vaccinated Teenagers and Children in the Central Region of Portugal, 2012-2013

Mumps virus pathogenesis: Insights and knowledge gaps

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