Mumps outbreak in a tribal population from the Union Territory of Dadra and Nagar Haveli, India.

A cluster of parotitis cases (n = 13) were observed in a tribal population of Vansda village from the Union Territory of Dadra and Nagar Haveli, India between 20th and 22nd week of 2016. Primary information was received by the local Infectious Disease Surveillance Program team, and subsequently field investigations were carried out in the affected area. Active surveillance was conducted till twice the incubation period from onset of the last surveyed case. For the laboratory investigations, 19 serum samples were collected from 11-suspected cases and their close contacts (n = 8). All samples were transported within 12 h on icepacks to the main laboratory at Pune. Majority of the suspected mumps cases were children except four adults. Mumps infection was confirmed in 8 of 11 suspected cases with post-onset ranging from 28 to 43 days and none from the close contacts. Both mumps specific IgM and IgG antibodies were detected in nine cases (including one equivocal) and single contact (equivocal result). Overall, ten cases and eight contacts (including one equivocal) showed mumps specific IgG antibodies. Present investigation provides information about the characteristics of mumps outbreak in a tribal community that resides in the remote areas. In addition, introduction of mumps containing vaccine in the tribal population may have added advantages in the tribal health program.

Mumps outbreak in Orthodox Jewish communities in the United States.

BACKGROUND: By 2005, vaccination had reduced the annual incidence of mumps in the United States by more than 99%, with few outbreaks reported. However, in 2006, a large outbreak occurred among highly vaccinated populations in the United States, and similar outbreaks have been reported worldwide. The outbreak described in this report occurred among U.S. Orthodox Jewish communities during 2009 and 2010. METHODS: Cases of salivary-gland swelling and other symptoms clinically compatible with mumps were investigated, and demographic, clinical, laboratory, and vaccination data were evaluated. RESULTS: From June 28, 2009, through June 27, 2010, a total of 3502 outbreak-related cases of mumps were reported in New York City, two upstate New York counties, and one New Jersey county. Of the 1648 cases for which clinical specimens were available, 50% were laboratory-confirmed. Orthodox Jewish persons accounted for 97% of case patients. Adolescents 13 to 17 years of age (27% of all patients) and males (78% of patients in that age group) were disproportionately affected. Among case patients 13 to 17 years of age with documented vaccination status, 89% had previously received two doses of a mumps-containing vaccine, and 8% had received one dose. Transmission was focused within Jewish schools for boys, where students spend many hours daily in intense, face-to-face interaction. Orchitis was the most common complication (120 cases, 7% of male patients ≥12 years of age), with rates significantly higher among unvaccinated persons than among persons who had received two doses of vaccine. CONCLUSIONS: The epidemiologic features of this outbreak suggest that intense exposures, particularly among boys in schools, facilitated transmission and overcame vaccine-induced protection in these patients. High rates of two-dose coverage reduced the severity of the disease and the transmission to persons in settings of less intense exposure.

Seroprevalence of antibody to mumps virus in the US population, 1999-2004.

BACKGROUND: In 2006, the largest mumps outbreak in the United States in 20 years occurred. To understand prior mumps seroprevalence and factors associated with the presence of antibody to mumps virus, data from the 1999-2004 National Health and Nutrition Examination Survey (NHANES) were analyzed. METHODS: A mumps virus-specific enzyme immunoassay was used to measure the seroprevalence of serum immunoglobulin G (IgG) antibody among NHANES participants aged 6-49 years. Participants were grouped on the basis of 10-year birth cohorts, 95% confidence intervals (CIs) were calculated using SUDAAN software, and logistic regression was used to identify independent predictors. RESULTS: The overall age-adjusted seroprevalence of IgG antibody to mumps virus during 1999-2004 was 90.0% (95% CI, 88.8%-91.1%). Seroprevalence was higher among US-born non-Hispanic blacks (96.4% [95% CI, 95.5%-97.2%]) and non-US-born Mexican Americans (93.7% [95% CI, 92.0%-95.2%]). Seroprevalence was significantly lower in the 1967-1976 birth cohort (85.7% [95% CI, 83.5%-87.8%]). The variables sex, education, and race/ethnicity/birthplace were independent predictors in at least 1 of the birth cohorts. CONCLUSIONS: The overall estimate of 90.0% is at the lower end of the estimated population immunity (90%-92%) needed to achieve herd immunity. Lower seroprevalence among groups suggest that they represent populations at an increased risk. For mumps control, high vaccine coverage and high population immunity must be achieved and maintained.

Risk factors for transmission of mumps in a highly vaccinated population in Orange County, NY, 2009-2010.

BACKGROUND: In 2009-2010, we investigated a mumps outbreak among a highly vaccinated Orthodox Jewish population in a village in Orange County, NY, to identify risk factors associated with mumps transmission among persons with 2 doses of mumps-containing vaccine. METHODS: Demographic and epidemiologic characteristics were collected on students in grades 6-12 in 3 schools. A mumps case was defined as a student, who self-reported parotitis, orchitis, jaw swelling and/or a mumps-related complication or whose mumps illness was reported to the Orange County Health Department during September 1, 2009, to January 18, 2010. Log-binomial regression analyses were conducted separately for boys and girls as they attended different schools and had different hours of study. RESULTS: Of the 2503 students with 2 documented doses of mumps-containing vaccine, 320 (13%) developed mumps. Risk of mumps increased with increasing number of mumps cases in the class [≥8 vs. ≤3 cases: boys aRR = 3.1; 95% confidence interval (CI): 2.0-5.0; girls aRR = 2.6; 95% CI: 1.6-4.1] and household (>1 vs. 0 cases: boys aRR = 4.3 95% CI: 3.7-5.6; girls aRR = 10.1 95% CI: 7.1-14.3). Age at first dose, time since last dose, time between first and second dose, school, class size, number of hours at school per week and household size were not significantly associated with having mumps. CONCLUSIONS: Two doses of mumps-containing vaccine may not be as effective in outbreak settings with multiple, prolonged and intense exposure. Additional studies are required to understand why such mumps outbreaks occur and how they can be prevented in the future.

Estimating the effectiveness of early control measures through school absenteeism surveillance in observed outbreaks at rural schools in Hubei, China.

BACKGROUND: School absenteeism is a common data source in syndromic surveillance, which allows for the detection of outbreaks at an early stage. Previous studies focused on its correlation with other data sources. In this study, we evaluated the effectiveness of control measures based on early warning signals from school absenteeism surveillance in rural Chinese schools. METHODS: A school absenteeism surveillance system was established in all 17 primary schools in 3 adjacent towns in the Chinese region of Hubei. Three outbreaks (varicella, mumps, and influenza-like illness) were detected and controlled successfully from April 1, 2012, to January 15, 2014. An impulse susceptible-exposed-infectious-recovered model was used to fit the epidemics of these three outbreaks. Moreover, it simulated the potential epidemics under interventions resulting from traditional surveillance signals. The effectiveness of the absenteeism-based control measures was evaluated by comparing the simulated datasets. RESULTS: The school absenteeism system generated 52 signals. Three outbreaks were verified through epidemiological investigation. Compared to traditional surveillance, the school absenteeism system generated simultaneous signals for the varicella outbreak, but 3 days in advance for the mumps outbreak and 2-4 days in advance for the influenza-like illness outbreak. The estimated excess protection rates of control measures based on early signals were 0.0%, 19.0-44.1%, and 29.0-37.0% for the three outbreaks, respectively. CONCLUSIONS: Although not all outbreak control measures can benefit from early signals through school absenteeism surveillance, the effectiveness of early signal-based interventions is obvious. School absenteeism surveillance plays an important role in reducing outbreak spread.

Prevalence of hepatitis B markers and measles, mumps, and rubella antibodies among Jewish refugees from the former Soviet Union.

OBJECTIVE: To assess the prevalence of hepatitis B virus (HBV) infection and immunity to measles, mumps, and rubella among refugees from the former Soviet Union (FSU). DESIGN: Descriptive study. SETTING: Soviet Immigrant Health Care Program, Sinai Samaritan Hospital, Milwaukee, Wis. PATIENTS: Consecutive sample of 496 Jewish refugees from the FSU presenting for new arrival screening from December 1, 1990, through January 11, 1993. OUTCOME MEASURES: Hepatitis B surface antigen (HBsAg), hepatitis B core antibody, hepatitis B surface antibody, and measles, mumps, and rubella antibodies. RESULTS: At least one hepatitis B marker was detected in 22% of the refugees, and HBsAg was detected in 0.4%. The rate of HBV infection (any marker present) increased with increasing age, ranging from 4% among those aged 0 through 19 years to 31% among those aged 50 through 59 years (chi 2 test for trend, 13.5; P < .001). Among those aged 0 through 19 years, 19% lacked antibody to measles, 8% lacked antibody to mumps, and 13% lacked antibody to rubella. Refugees who were less than 30 years of age were more than twice as likely to lack antibodies to measles, mumps, or rubella compared with those who were 30 years of age or older (relative risk, 2.8; 95% confidence interval, 1.8 to 4.2; P < .001). CONCLUSIONS: In our sample of Jewish refugees from the FSU (primarily Ukraine, Russia, and Belorussia), the rate of HBsAg positivity was low, suggesting that routine screening for HBV infection is not needed. Seronegativity to measles, mumps, and rubella was relatively common among those less than 30 years old. Those refugees who were born after 1957 should be given combined measles, mumps, and rubella vaccine unless their written documentation indicates previous receipt of these antigens according to the immunization schedule recommended in the United States.