Rate and Clinical Characteristics of Mumps Reinfection

Abstract

Mumps infection is anecdotally believed to occur only once over a lifetime. However, in recent years, it has gradually come to be recognized among pediatricians that mumps reinfection is not a rare condition, and some criteria for the mumps reinfection have been proposed. One of the widely accepted criteria is levels higher than 25.8 IU/dl of serum IgG antibodies against the mumps virus and lower than 2.0 IU/dl of serum IgM antibodies. From July 2010 to June 2011, 45 patients with acute swelling of the major salivary gland(s) were enrolled into our survey of mumps reinfection in Tsuchiura Kyodo General hospital. Serum IgG and IgM antibodies against the mumps virus were measured at the initial visit. Ten cases were diagnosed as having primary infection with the mumps virus, while the other 10 cases were diagnosed as having reinfection with the mumps virus according to the criteria. The present study suggests that mumps reinfection is a common condition in patients with acute swelling of the major salivary glands in adulthood.

Cellular and humoral immunity after vaccination or natural mumps infection

“…29 The diagnoses of the aforementioned patients without antibody or CMI were made based on the presence of high IgG antibody and high avidity of IgG antibody without demonstrable IgM antibody, which has been used to determine reinfection. 9,13,14,23,[29][30][31] Furthermore, in order to ensure the accuracy of diagnosis of reinfection, virus isolation and/or detection of the mumps virus genome 12 was added. That report showed that the viral load in reinfection was lower than in primary infection, and that reinfection was not a rare event after natural infection.…”

“…The characteristics of mumps reinfection are lower severity, less typical symptomatology, and older age compared with primary infection . The diagnoses of the aforementioned patients without antibody or CMI were made based on the presence of high IgG antibody and high avidity of IgG antibody without demonstrable IgM antibody, which has been used to determine reinfection . Furthermore, in order to ensure the accuracy of diagnosis of reinfection, virus isolation and/or detection of the mumps virus genome was added.…”

“…Under this condition, breakthrough infection after vaccination or symptomatic reinfection after natural infection of mumps has been noted in Japan. 9,[11][12][13][14] Efficacy studies regarding mumps vaccines have noted rates as low as 64% after one dose, rising to 88% after two doses, [15][16][17] although high rates (>90%) of seroconversion of the IgG antibody have been reported after mumps vaccination. 7,18 Immunogenicity studies that measure only anti-mumps specific IgG overestimate vaccine efficacy.…”

“…The vaccine coverage, however, is estimated to be approximately 30%, and thus epidemics of mumps virus infection have occurred every 4–5 years, unlike in countries that use a two‐dose schedule of MMR as a universal vaccination. Under this condition, breakthrough infection after vaccination or symptomatic reinfection after natural infection of mumps has been noted in Japan …”

Temporary Closure of Inpatient Ward due to Mumps Virus Reinfection in Elderly Patient

“…The characteristic symptoms and signs of infection with this virus comprise an ache in the parotid gland, swelling, and fever 6) . Although infection is most commonly seen during childhood, it can also occur in adults, and reinfection is sometimes observed 4) .…”