Mumps resurgence in Denmark

St-Martin, Gry; Knudsen, Lisbet Krause; Engsig, Frederik Neess; Panum, Inge; Andersen, Peter Henrik; Rønn, Jesper; Fonager, Jannik; Fischer, Thea Kølsen

doi:10.1016/j.jcv.2014.08.013

Cited by 13 publications

(7 citation statements)

References 13 publications

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“…However, an ongoing resurgence in mumps cases began with a series of outbreaks on university campuses in 2006 (2). An older age of infection (ages 18-29y, compared to the pre-vaccine average of 5-9y) has been a defining feature these outbreaks (5), similar to recent experience in Canada, western Europe, and high-income Asian countries with routine MMR vaccination (6)(7)(8)(9).…”

Section: Introductionmentioning

confidence: 55%

Vaccine waning and mumps re-emergence in the United States

Lewnard

Grad

2017

Preprint

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One Sentence Summary: The estimated waning rate of vaccine-conferred immunity against mumps predicts observed changes in the age distribution of mumps cases in the United States since 1967.Abstract: Following decades of declining mumps incidence amid widespread vaccination, the United States and other high-income countries have experienced a resurgence in mumps cases over the last decade. Outbreaks affecting vaccinated individuals-and communities with high vaccine coverage-have prompted concerns about the effectiveness of the live attenuated vaccine currently in use: it is unclear if immune protection wanes, or if the vaccine protects inadequately against mumps virus lineages currently circulating. Synthesizing data from epidemiological studies, we estimate that vaccine-derived protection wanes at a timescale of 27 (95%CI: 16 to 51) years. After accounting for this waning, we identify no evidence of changes in vaccine effectiveness over time associated with the emergence of heterologous virus genotypes. Moreover, a mathematical model of mumps transmission validates our findings about the central role of vaccine waning in the re-emergence of cases: outbreaks from 2006 to the present among young adults, and outbreaks occurring in the late 1980s and early 1990s among adolescents, align with peaks in the susceptibility of these age groups attributable to loss of vaccine-derived protection. In contrast, evolution of mumps virus strains escaping pressure would be expected to cause a higher proportion of cases among children. Routine use of a third dose at age 18y, or booster dosing throughout adulthood, may enable mumps elimination and should be assessed in clinical trials.

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Section: Introductionmentioning

confidence: 55%

Vaccine waning and mumps re-emergence in the United States

Lewnard

Grad

2017

Preprint

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“…In Denmark, a 10-fold increase of parotitis in primarily young adults was seen from 2003 to 2013 but has since declined [22].…”

Section: Discussionmentioning

confidence: 99%

Immunity to vaccine-preventable diseases among paediatric healthcare workers in Denmark, 2019

et al. 2021

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Background Healthcare workers (HCW) have been identified as index cases in disease outbreaks of vaccine-preventable diseases (VPD) in hospitals. Aim We investigated whether Danish paediatric HCW were protected against selected serious VPD. Methods We included 90% of staff members from two paediatric departments. All 555 HCW (496 women) supplied a blood sample for serology and filled in a questionnaire. Antibodies were measured with enzyme immunoassay against measles, mumps, rubella (MMR), varicella zoster, pertussis toxin and diphtheria toxin. Results Protective levels of IgG were found for measles (90.3%), mumps (86.5%), rubella (92.3%), varicella (98.6%) and diphtheria (80.5%). We found seropositivity for all three MMR components in 421 (75.9%) HCW, lowest in those younger than 36 years (63.3%). Only 28 (5%) HCW had measurable IgG to pertussis. HCW with self-reported immunity defined as previous infection or vaccination, had protective levels of IgG against measles, mumps, rubella and varicella in 87.4–98.8% of cases, not significantly higher than in those not reporting immunity. Previous history of disease had a high positive predictive value (PPV) of 96.8–98.8%. The PPV for previous vaccination ranged from 82.5% to 90.3%. In contrast, negative predictive values of self-reported history of disease and vaccination were remarkably low for all diseases. Conclusion The immunity gaps found primarily in young HCW indicate a need for a screening and vaccination strategy for this group. Considering the poor correlation between self-reported immunity and seropositivity, efforts should be made to check HCW’s immune status in order to identify those who would benefit from vaccination.

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“…The periodicity of mumps epidemics has not been observed in highly vaccinated populations. Despite the success of mumps vaccination, there have been small and large mumps outbreaks in many countries where populations are routinely vaccinated against mumps [ 5 , 6 , 7 , 8 , 9 ]. Mumps outbreaks in the US and the UK were notable, where college students aged between 18 and 24 years were predominantly affected [ 9 , 10 ].…”

Section: The Changing Epidemiology Of Mumps In Koreamentioning

confidence: 99%

Resurgence of Mumps in Korea

Park

2015

Infect Chemother

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Routine vaccination against mumps has markedly reduced its incidence. However, the incidence of mumps continuously has increased since 2007. In 2013, a large mumps epidemic occurred in Korea, and this epidemic is still an ongoing problem. This epidemic occurred primarily in school settings and affected vaccinated adolescents, predominantly male students. The recent resurgence of mumps is caused by multiple factors: suboptimal effectiveness of the current mumps vaccines, use of the Rubini strain vaccine, waning immunity in the absence of natural boosting due to the marked reduction in the mumps incidence, genotype mismatch between the vaccine and circulating mumps virus strains, and environmental conditions that foster intense exposures. Containment of mumps outbreaks is challenging because the sensitivity of diagnostic tests is low among vaccinees and control measures are less efficient because of the inherent nature of the mumps virus. Despite the suboptimal vaccine effectiveness in outbreak settings, maintaining the high vaccine coverage is an important strategy to prevent mumps outbreaks, given that the routine use of mumps vaccines has substantially reduced the incidence of mumps and its complications as compared with that in the pre-vaccine era. In order to control the current mumps epidemic and prevent further outbreaks, we need to better understand the dynamics of mumps among vaccinated populations and the changing epidemiology in Korea. Concerted efforts should be made to systematically monitor the immunization status of the Korean population and to improve diagnosis efficiency. Furthermore, more effective mumps vaccines need to be developed in the future.

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Mumps resurgence in Denmark

Cited by 13 publications

References 13 publications

Vaccine waning and mumps re-emergence in the United States

Vaccine waning and mumps re-emergence in the United States

Immunity to vaccine-preventable diseases among paediatric healthcare workers in Denmark, 2019

Resurgence of Mumps in Korea

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