Mumps in a highly vaccinated Marshallese community in Arkansas, USA: an outbreak report.
Adolescent
Adult
Aged
Aged, 80 and over
Arkansas
/ epidemiology
Child
Child, Preschool
Disease Outbreaks
/ prevention & control
Female
Genotype
Humans
Immunogenicity, Vaccine
Incidence
Infant
Male
Measles-Mumps-Rubella Vaccine
/ immunology
Middle Aged
Mumps
/ epidemiology
Mumps virus
/ genetics
Real-Time Polymerase Chain Reaction
Serologic Tests
Treatment Outcome
Vaccination
Young Adult
Journal
The Lancet. Infectious diseases
ISSN: 1474-4457
Titre abrégé: Lancet Infect Dis
Pays: United States
ID NLM: 101130150
Informations de publication
Date de publication:
02 2019
02 2019
Historique:
received:
11
07
2018
revised:
07
09
2018
accepted:
25
09
2018
pubmed:
13
1
2019
medline:
28
5
2020
entrez:
13
1
2019
Statut:
ppublish
Résumé
During 2000-15, Arkansas Department of Health, Little Rock, AR, USA, investigated between one and six cases of mumps each year. From Aug 5, 2016, to Aug 5, 2017, the department received notification of more than 4000 suspected mumps cases in the second largest outbreak in the USA in the past 30 years. Arkansas Department of Health investigated all reported cases of mumps to ascertain exposure, travel, and vaccination histories and identify close contacts. Cases were classified as confirmed if the patient had laboratory confirmation of mumps virus or probable if they had clinical symptoms and either a positive serological test or a known epidemiological link to a confirmed case. 2954 cases of mumps related to the outbreak were identified during the outbreak period: 1665 (56%) were laboratory confirmed, 1676 (57%) were in children aged 5-17 years, and 1692 (57%) were in Marshallese people. Among the 1676 school-aged cases, 1536 (92%) had previously received at least two doses of a vaccine containing the mumps virus. Although 19 cases of orchitis were reported, severe complications were not identified. Unusual occurrences, such as recurrent parotitis and prolonged viral shedding, were observed mostly in Marshallese individuals. Viral samples were characterised as genotype G. This large-scale outbreak, primarily affecting a marginalised community with intense household crowding, highlights the need for coordinated, interdisciplinary, and non-traditional outbreak responses. This outbreak raises questions about mumps vaccine effectiveness and potential waning immunity. Council of State and Territorial Epidemiologists and US Centers for Disease Control and Prevention.
Sections du résumé
BACKGROUND
During 2000-15, Arkansas Department of Health, Little Rock, AR, USA, investigated between one and six cases of mumps each year. From Aug 5, 2016, to Aug 5, 2017, the department received notification of more than 4000 suspected mumps cases in the second largest outbreak in the USA in the past 30 years.
METHODS
Arkansas Department of Health investigated all reported cases of mumps to ascertain exposure, travel, and vaccination histories and identify close contacts. Cases were classified as confirmed if the patient had laboratory confirmation of mumps virus or probable if they had clinical symptoms and either a positive serological test or a known epidemiological link to a confirmed case.
FINDINGS
2954 cases of mumps related to the outbreak were identified during the outbreak period: 1665 (56%) were laboratory confirmed, 1676 (57%) were in children aged 5-17 years, and 1692 (57%) were in Marshallese people. Among the 1676 school-aged cases, 1536 (92%) had previously received at least two doses of a vaccine containing the mumps virus. Although 19 cases of orchitis were reported, severe complications were not identified. Unusual occurrences, such as recurrent parotitis and prolonged viral shedding, were observed mostly in Marshallese individuals. Viral samples were characterised as genotype G.
INTERPRETATION
This large-scale outbreak, primarily affecting a marginalised community with intense household crowding, highlights the need for coordinated, interdisciplinary, and non-traditional outbreak responses. This outbreak raises questions about mumps vaccine effectiveness and potential waning immunity.
FUNDING
Council of State and Territorial Epidemiologists and US Centers for Disease Control and Prevention.
Identifiants
pubmed: 30635255
pii: S1473-3099(18)30607-8
doi: 10.1016/S1473-3099(18)30607-8
pii:
doi:
Substances chimiques
Measles-Mumps-Rubella Vaccine
0
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, P.H.S.
Langues
eng
Sous-ensembles de citation
IM
Pagination
185-192Commentaires et corrections
Type : CommentIn
Type : CommentIn
Type : CommentIn
Type : CommentIn
Informations de copyright
Copyright © 2019 Elsevier Ltd. All rights reserved.