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PubMed1995

Measles, mumps, and rubella: monitoring in Switzerland through a sentinel network, 1986-94. Sentinella Arbeitsgemeinschaft.

STUDY OBJECTIVES: Since 1986, the national sentinel network in Switzerland (Sentinella) has collected reports of measles, mumps, and rubella cases in order to evaluate the impact of the Swiss MMR vaccination campaign (started in 1987) on disease frequency. DESIGN: Passive surveillance of clinical measles, mumps, and rubella cases through a voluntary physician based sentinel network in Switzerland. SETTING: Each year between June 1986 and May 1994, 150 to 200 general practitioners, specialists in internal medicine, and paediatricians in private practice covering the whole country have reported weekly numbers of consultations. PATIENTS: Every patient who fulfilled the case definition and consulted a physician participating in the Sentinella network was reported. MAIN RESULTS: Since 1986, the annual number of reported measles cases per physician has fallen--from 1.3 (95% confidence interval (CI) 1.11, 1.50) in 1986-87 to 0.4 (95% CI 0.30, 0.50) in 1993-94. A decreasing trend, although less pronounced, was also observed for rubella. An initial decrease in mumps cases was reported--from 1.8 (95% CI 1.57, 2.03) annually reported cases per physician in 1986-87 to 0.7 (95% CI 0.55, 0.83) in 1989-90. This was followed, however, by a net and sustained increase. In 1993-94, the mean annual number of reported mumps cases per practitioner reached 4.7 (95% CI 4.34, 5.01) which was the highest level since surveillance had started. Over the whole eight year period, reported mumps cases, in terms of the percentage of consultations, were four times more frequent in the French speaking part of Switzerland than in the rest of the country. The proportion of mumps cases in people reported to have been vaccinated also increased--from 10% in 1986-87 to 60% in 1993-94. CONCLUSIONS: Reductions in cases of measles and rubella but an appreciable increase in mumps cases have been observed in the past three years in Switzerland. This findings, combined with increasing vaccination coverage and the fact that 60% of mumps cases are reported in vaccinated people, suggests that the overall efficacy of the mumps vaccines used in Switzerland is probably below 80%. Under these conditions the goal of eliminating mumps will probably not be reached. Further studies are needed to evaluate the efficacy of the different mumps vaccines used.

Adolescent↗

PubMed1976

Cell-mediated immune response to mumps virus infection in man.

The antibody and cell-mediated immune response to mumps virus infection was studied in groups of subjects after natrually acquired mumps virus infection, after parenteral immunization with live attenuated mumps vaccine, and in a population of mumps seronegative subjects. The technique of neutralization of tissue culture infectivity was utilized to study mumps specific antibody. The cell-mediated immunity (CMI) was detected by specific immune release (SIR) of radioactivity by purified lymphocytes after they were reacted with radioactive chromium (51Cr) labeled human conjunctival cell cultures chronically infected with mumps virus. No SIR activity was observed in lymphocytes obtained from cord blood and young individuals seronegative for antibody to mumps virus. Detectable SIR activity was observed in a few older seronegative subjects; however, immunization with mumps vaccine in such antibody negative subjects failed to result in the development of any antibody response in the serum. High SIR activity was observed in the lymphocytes of naturally infected and vaccinated subjects. Although all naturally infected or immunized subjects had varying levels of mumps specific antibody activity in the serum, no correlation existed between the levels of antibody and SIR activity. These observations suggest the development of mumps specific in vitro correlates of CMI after naturally acquired or vaccine-induced mumps virus infection.

Adolescent↗

PubMed2006

Real-time PCR for mumps diagnosis on clinical specimens--comparison with results of conventional methods of virus detection and nested PCR.

BACKGROUND: Since November 2003, the UK has seen a dramatic rise in the number of mumps cases, resulting in increasing demands on virology laboratories to confirm mumps infection in a timely and efficient manner. Traditional mumps virus detection methods are often insensitive, lengthy, and cumbersome. Some laboratories in the UK now use molecular methods that are based on nested polymerase chain reaction (PCR). Early serological diagnosis often relies on detection of anti-mumps IgM, which may be absent in the first 10 days of illness. OBJECTIVES: We compared a one-step real-time RT-PCR with an established nested PCR (SH-PCR) and virus detection by culture and antigen detection, and assessed the clinical usefulness of mumps real-time PCR for diagnosis from CSF. STUDY DESIGN: In total, 280 clinical samples were investigated by real-time PCR, nested PCR and a combination of traditional virus detection methods (antigen detection on oral samples, cell culture on all samples). Furthermore, 88 CSF samples submitted for diagnosis of possible viral meningitis were analysed by real-time PCR. RESULTS: The real-time PCR detected the highest number of positive oral samples (119/180) compared to SH-PCR (92/180) and combined virus culture and antigen detection procedures (90/180). Sensitivity of mumps virus detection in urine was poor for all three methods: 34.0% (traditional detection), 29.8% (real-time PCR) and 2.1% (SH-PCR), respectively. Real-time PCR on 88 CSF samples identified five patients with mumps meningitis, significantly increasing viral diagnosis in this cohort. CONCLUSION: Real-time PCR on oral samples is the investigation of choice for mumps infection. Mumps virus detection in urine by any of the PCRs used was clearly less successful. Real-time PCR on CSF samples seems a promising adjunct for diagnosis of mumps meningitis, especially in an age group with high incidence of mumps.

Cohort Studies↗

PubMed2005

[Frequency of spontaneous abortion and premature birth after acute mumps infection in pregnancy].

OBJECTIVE: Since mumps infection is endemic, the occurrence of acute mumps infection during pregnancy is rare. As a result, data on the possible negative consequences of acute mumps infection on pregnancy outcome are limited. PATIENTS AND METHODS: The clinical diagnosis of acute mumps infection was serologically confirmed in 79 pregnant women between January 1985 and December 2002. Data on pregnancy outcome were obtained from the gynaecologist or obstetrician. Cord blood from 26 of the 57 live-born infants was investigated for mumps-specific IgM and IgG antibodies by enzyme-linked immunoassay. RESULTS: Sixty-two patients were prospectively followed up with respect to pregnancy outcome. Two of the 62 pregnancies were electively terminated. The overall rate of fetal loss was 6.6% (4/60). Only 2 cases of spontaneous abortion occurred during the first trimester. However, all 4 spontaneous abortions occurred in women who had contracted mumps infection during the first trimester. The time interval between mumps infection and fetal loss varied widely. The median gestational age at delivery was 40 weeks. Only 2 of the 57 live-born infants (3.5%) were delivered before completion of the 37th week of pregnancy. Mumps-specific IgM anti-bodies were not detected in any of the 26 cord blood samples tested. CONCLUSION: The lack of mumps-specific antibodies in the cord blood samples tested suggests that prenatal mumps infection did not occur. The frequency of premature birth and spontaneous abortion following mumps infection in pregnancy does not appear to be increased over normal levels.

Abortion, Spontaneous↗

PubMed1997

Mumps orchitis: report of a mini-epidemic.

PURPOSE: The incidence of mumps orchitis has declined dramatically since the introduction of vaccination. While in the past cases of mumps have only been seen occasionally at our institution, recently there has been a sharp increase in the number of confirmed cases. MATERIALS AND METHODS: Between June 1995 and April 1996, 11 patients with severe mumps orchitis were hospitalized at our clinic. Medical history, therapeutic measures and clinical outcome were recorded for each patient. RESULTS: All patients showed marked scrotal swelling with a temperature above 38.5 C. Serum C-reactive protein was significantly elevated (mean 140 mg./l.). The vaccination status of 1 of the 11 patients (9%) was unknown. Medical records from the remaining 10 patients indicated that they had not been vaccinated. Nine patients (82%) had a typical mumps parotitis preceding the orchitis. In 2 patients the clinical diagnosis of parotitis was uncertain but mumps serology was positive. None of the patients showed other manifestations of mumps. Antibodies to the mumps virus (IgG and IgM) were determined in 6 patients and positive in all cases. The average interval between parotitis and onset of orchitis was 10 days. All patients were hospitalized for an average of 6 days. Treatment included bed rest with local cooling, scrotal support and systemic treatment with nonsteroidal anti-inflammatory drugs. Ciprofloxacin or clavulanic acid/amoxicillin was administered as bacterial orchitis could not be excluded at initial presentation. The mean time to cessation of fever was 3.6 days (range 3 to 5). Antibiotics were administered for an average of 8.8 days (range 7 to 13) and anti-inflammatory drugs were given an average of 8.6 days (range 7 to 11). One patient required scrotal exploration. CONCLUSIONS: Since the introduction of a vaccine against the mumps virus there is a diminished risk for mumps and its complications. However, in case of scrotal swelling mumps orchitis should still be considered. Despite vaccination mumps has not been erradicated. Therefore, continued vaccination should be considered an important step in minimizing clinical outbreaks and working towards a possible eradication of this disease in the future.

Adolescent↗

PubMed2001

An anti-mumps IgM antibody level in the serum of idiopathic sudden sensorineural hearing loss.

PURPOSE: Measurement of anti-IgM antibody for mumps enables us to diagnose silent mumps infection. From the viewpoint of prophylactic medicine, we examined the incidence of silent mumps infection in idiopathic sudden sensorineural hearing loss (ISSNHL) by measurement of anti-mumps IgM antibody. MATERIALS AND METHODS: Serum level of anti-mumps IgM antibody was evaluated by EIA method in 69 ISSNHL cases. RESULTS: Of the 69 serum samples examined, five samples were positive, two samples were regarded as quasi-positive and other samples were negative for anti-mumps IgM antibody. The positive rate was 7.2% (5/69). The relationship of anti-mumps IgM and IgG antibody was also described. CONCLUSIONS: From the measurement of anti-IgM antibody for mumps, it was possible to diagnose silent mumps infection in ISSNHL. The positive rate of anti-IgM antibody in ISSNHL was 7.2% suggesting that the silent mumps infection could be considered as one of the causative factors of ISSNHL even though its incidence is not so high. Since mumps often occurs without clinical symptoms, it is still considered to be one of the important causes of profound hearing loss. From the viewpoint of prophylaxis of profound hearing loss and deafness, we should understand the situation of virus epidemiology and vaccination.

Adolescent↗

PubMed2006

Two successive outbreaks of mumps in Nova Scotia among vaccinated adolescents and young adults.

BACKGROUND: Before the widespread use of vaccine, mumps was the most common cause of viral meningitis (up to 10% of mumps infections). Vaccination programs have resulted in a drop of more than 99% in the number of reported mumps cases in the United States and Canada. Although rare in Canada, outbreaks have recently occurred throughout the world, including a large outbreak in the United Kingdom, where more than 56,000 cases were reported in 2004-2005. METHODS: Two recent outbreaks in Nova Scotia were investigated by public health officials. Cases were defined by laboratory confirmation of infection (i.e., isolation of mumps virus by culture) or clinical diagnosis in people epidemiologically linked to a laboratory-confirmed case. The people infected were interviewed to determine possible links and to identify contacts. Mumps virus was cultured from urine and throat specimens, identified via reverse-transcriptase polymerase chain reaction (RT-PCR) and subjected to phylogenetic analysis to identify the origin of the strain. RESULTS: The first outbreak involved 13 high-school students (median age 14 yr): 9 who had previously received 2 doses of measles-mumps-rubella vaccine (MMR) and 4 who received a single dose. The second outbreak comprised 19 cases of mumps among students and some staff at a local university (median age 23 yr), of whom 18 had received only 1 dose of MMR (the other received a second dose). The viruses identified in the outbreaks were phylogenetically similar and belonged to a genotype commonly reported in the UK. The virus from the second outbreak is identical to the strain currently circulating in the UK and United States. INTERPRETATION: The predominance in these outbreaks of infected people of university age not only highlights an environment with potential for increased transmission but also raises questions about the efficacy of the MMR vaccine. The people affected may represent a "lost cohort" who do not have immunity from natural mumps infection and were not offered a 2-dose schedule. Given the current level of mumps activity around the world, clinicians should remain vigilant for symptoms of mumps.

Adolescent↗

PubMed1996

An outbreak of mumps in a population partially vaccinated with the Rubini strain.

Since 1991, 6 years after the recommendation of universal childhood triple vaccination against measles, mumps and rubella (M + M + R), Switzerland has been confronted with an increasing number of mumps cases affecting both vaccinated and unvaccinated children. The M + M + R vaccine mainly used in the Swiss population after 1986 contains the highly attenuated Rubini strain of mumps virus. We analysed an outbreak of 102 suspected mumps cases by virus isolation, determination of IgM antibodies to mumps virus in 27 acute phase sera, and verification of vaccination histories. Mumps was confirmed by virus isolation in 88 patients, of whom 72 had previously received the Rubini vaccine strain. IgM antibodies to mumps virus were detected in 24/27 acute phase serum samples. A group of 92 subjects from the same geographic area without signs of mumps virus infection served as controls. IgG antibodies to mumps virus and vaccination status were assessed in these children. The vaccination rate in these controls was 61%, with equal seropositivity for unvaccinated and Rubini-vaccinated subjects. These data support other recent reports which indicate an insufficient protective efficacy of current mumps vaccines.

Adolescent↗

PubMed1990

Optimal age for measles and mumps vaccination in Australia.

Trivalent measles-mumps-rubella vaccine has recently replaced measles-mumps vaccine in Australia and is recommended as a single dose at the age of 12 to 15 months, with the exception of Aboriginal children in central Australia who are vaccinated at 9 months. The timing of measles vaccination has been controversial not only in Australia but also in the United States, where measles outbreaks continue to occur. This study aimed to determine seroconversion rates for measles-mumps vaccine in children aged 12 to 18 months and to make a recommendation for the timing of vaccination based on seroconversion rates and attack rates. The parents of 425 children aged 12 to 18 months gave consent for their children to have serum collected at the time of measles-mumps vaccination and three months later. The mean age at vaccination of the children who had two serum samples for measles and mumps antibody estimations was 13.9 months (mode, 13.1). The seroconversion rate for measles was 95% (314/329) (95% confidence interval (CI), 92.5% to 97.3%) and for mumps 97% (309/320) (95% CI, 93.8% to 98.1%). There were no statistically significant differences in the rates of seroconversion for measles or mumps related to age in months at the time of vaccination or in post-vaccination measles antibody titres related to age at vaccination. Post-vaccination mumps antibody titres tended to be lower in older vaccinees. None of the children who presented for vaccination had serological evidence of prior measles infection but five had evidence suggestive of prior mumps. As the seroconversion rates for measles and mumps vaccines were very high in these children it was concluded that no advantage resulted from delaying vaccination until 15 months and that the current National Health and Medical Research Council recommendations for vaccination at age 12 to 15 months should remain.

Age Factors↗

PubMed1995

Mumps outbreak in a highly vaccinated school population. Evidence for large-scale vaccination failure.

OBJECTIVES: To describe an outbreak and to identify risk factors for mumps occurring in a highly vaccinated high school population. (Note: Highly vaccinated means a population in which more than 95% have been vaccinated.) DESIGN AND PARTICIPANTS: Survey and cohort study of 307 (97%) of 318 students. OUTCOME MEASURES: Mumps was defined as an illness with 2 or more days of parotid swelling. Serologic confirmation of infection was obtained in eight cases, seven of which were evaluated for presence of IgM antibody using immunofluorescent antibodies. Vaccination records were verified for 297 (97%) students. RESULTS: Between October 3 and November 23, 1990, clinical mumps developed in 54 students (attack rate, 18%), 53 of whom had been vaccinated. Most cases (40 [77%] of 52) occurred 12 to 20 days after a school-wide pep rally. Immunofluorescent antibody testing of all seven specimens demonstrated IgM antibody to mumps. Risk factors for clinical mumps identified in multivariate analyses included female gender (odds ratio, 3.0; 95% confidence interval, 1.6 to 5.7) and source of vaccination other than the local public health clinic (students vaccinated by private providers [odds ratio, 3.0; 95% confidence interval, 1.3 to 5.2] or in other districts [odds ratio, 2.4; 95% confidence interval, 1.1 to 5.3]). CONCLUSIONS: The overall attack rate is the highest reported to date (and to our knowledge) for a population demonstrating virtually complete mumps vaccine coverage. Even verified documentation of vaccination may not be an accurate indicator of an individual's protection against mumps. Vaccination failure may play an important role in contemporary mumps outbreaks. We found no evidence to indicate that waning immunity (secondary vaccine failure) contributed significantly to this outbreak. A second dose of mumps vaccine, as recommended using measles-mumps-rubella vaccine, could potentially prevent similar outbreaks in secondary school populations in the future.

Adolescent↗

PubMed1975

Immunologic significance of the mumps virus skin test in infants, children and adults.

The biologic validity of cell-mediated immunity to mumps virus was evaluated in 395 children, adolescents and adults. The study protocol included the determination of cutaneous delayed hypersensitivity to viral and avian control antigens and in 79% of the subjects an essential double bleeding was performed before and after mumps virus skin test for assay of neutralizing antibody. Seven per cent of subjects expressed sufficient delayed hypersentitivity to the control antigen to erase an apparently positive mumps virus skin test. Anamnestic conversions from seronegativity to seropositivity, elicited by the mumps virus skin test, increased from 4% in children to 25% in adults, which suggests waning B-cell recognition of prior mumps virus infection in adults. Although pregnancy diminished the difference (p smaller than .001), adults showed greater cutaneous delayed hypersensitivity to mumps virus antigen than did children (p smaller than .001), suggesting that mumps virus reinfection or persistence induced the escalation of more sensitive T-cell recognition with increasing age. Humoral immunity, assessed by the double bleeding technique in the vast majority of individuals, rose form 16% (1-4 years), 45% (5-9 years) and 80% (10-14 years) to 94% in adolescents and adults. Ordinarily 75-95% in other age groups, the decline of correlation between mumps virus cellular and humoral immunity to 60% in school children may result from prior parainfluenza virus infection, inconsistent potency of the skin test antigen, concurrent immunosuppressive infection, and lagging induction of mumps virus cellular immunity in recently infected individuals. Immunologic study of a large colony of subhuman primates failed to establish an hierarchial antigenic interrelationship among mumps virus and two additional paramyxoviruses.

Adolescent↗

PubMed1980

Enzyme-linked immunosorbent assay for mumps and parainfluenza type 1 immunoglobulin G and immunoglobulin M antibodies.

A solid-phase enzyme-linked immunosorbent assay (ELISA) for detection of mumps and parainfluenza type 1 antibodies (immunoglobulin G [IgG] and IgM classes) is described and compared with the conventional complement fixation (CF) test. A highly positive correlation was found between mumps IgG ELISA and the mumps CF test, whereas parainfluenza type 1 IgG ELISA had only a moderate positive correlation with the respective CF test. Mumps IgM antibodies could be demonstrated in all patients with serologically verified and clinically typical (parotitis, meningitis, or orchitis) mumps virus infection, but not in patients with rises in parainfluenza CF titers. Mumps IgM was already present in the acute-phase sera if they were not taken during the first 2 days after onset of disease. Mumps IgM was also found in some paired sera that were taken too late to demonstrate any significant increase in the antibody titers by CF. Therefore, mumps IgM ELISA provides an improvement over the conventional laboratory diagnosis of mumps infection, since the measurement of specific IgM antibodies in a single serum by ELISA is diagnostic, rather than the identification of a fourfold or greater rise in CF antibody titer. An unexpected finding was that parainfluenza type 1 IgM antibodies could not be demonstrated by ELISA in paired sera with rises in parainfluenza CF titers, suggesting a different antibody response from that occurring in mumps infection.

Antibodies, Viral↗

PubMed1998

Comparison of the neurovirulence of a vaccine and a wild-type mumps virus strain in the developing rat brain.

Prior to the adoption of widespread vaccination programs, mumps virus was the leading cause of virus-induced central nervous system (CNS) disease. Mumps virus-associated CNS complications in vaccinees continue to be reported; outside the United States, some of these complications have been attributed to vaccination with insufficiently attenuated neurovirulent vaccine strains. The development of potentially neurovirulent, live, attenuated mumps virus vaccines stems largely from the lack of an animal model that can reliably predict the neurovirulence of mumps virus vaccine candidates in humans. The lack of an effective safety test with which to measure mumps virus neurovirulence has also hindered analysis of the neuropathogenesis of mumps virus infection and the identification of molecular determinants of neurovirulence. In this report we show, for the first time, that mumps virus infection of the neonatal rat leads to developmental abnormalities in the cerebellum due to cerebellar granule cell migration defects. The incidence of the cerebellar abnormalities and other neuropathological and clinical outcomes of mumps virus infection of the neonatal rat brain demonstrated the ability of this model to distinguish neurovirulent (Kilham) from nonneurovirulent (Jeryl Lynn) mumps virus strains. Thus, this neonatal rat model may prove useful in evaluating the neurovirulence potential of new live, attenuated vaccine strains and may also be of value in elucidating the molecular basis of mumps virus neurovirulence.

Animals↗

PubMedDate not supplied

Age-specific mumps seroprevalence of an unvaccinated population of adolescents in Ankara, Turkey.

This study aimed to detect the age-specific mumps seroprevalence of an unvaccinated population of adolescents in Ankara, Turkey and to compare the prevaccination epidemiology of mumps with those of some other countries. Four hundred and forty adolescents (227 females, 213 males) aged 9 - 16 years who were admitted to the Adolescent Unit were included in this study. For each participant, a questionnaire was completed and mumps-specific IgG antibodies were screened quantitatively by enzyme-linked fluorescent assay. Of the 440 patients screened for mumps antibodies, 48 (10.9%) were seronegative. Mumps seronegativity according to sex and age groups were 13.6, 9.9, and 10.4% in females and 18, 10.2, and 6.2% in males in the age groups of 9 - 10, 11 - 13, and 14 - 16, respectively. Mumps immunization models similar to those of European countries might be acceptable for Turkey, but since a low vaccination coverage may shift mumps infection to older ages, mumps immunization of adolescents is important until a national mumps vaccination program with a high coverage could be sustained. The routine health supervision visit at ages 11 to 12 years is an ideal time to immunize unvaccinated adolescents.

Adolescent↗

PubMed1986

Effect of simultaneous administration of live measles vaccine on the "take rate" of live mumps vaccine.

During the course of clinical studies to develop a new bivalent measles-mumps vaccine, it was established that simultaneous administration of live measles and mumps vaccines at doses contained in the monovalent vaccines resulted in a reduced seroconversion rate against mumps but not against measles. This one-way interference was resolved by increasing the dose of the mumps component in the bivalent measles-mumps and the trivalent measles-mumps-rubella vaccines above that in the monovalent mumps vaccine. On the other hand, it was not necessary to adjust the doses of the measles and rubella components in the combined vaccines. This observation requires that not only the titres of vaccine viruses must be carefully adjusted in combined live mumps vaccines but also that the heat-stability of each component in such vaccines be carefully determined to ensure that interference is not a problem during the complete shelf-life of the product. The relative doses at release of combined mumps vaccines using the Urabe Am 9 strain and the heat-stability characteristics of these products will be presented and discussed.

Antibodies, Viral↗

PubMed2001

Efficient isolation of mumps virus from a community outbreak using the marmoset lymphoblastoid cell line B95a.

The incidence of mumps infection in the UK was reduced greatly by vaccination as a component of MMR vaccine, but cases and outbreaks continue to occur. Although in specialised laboratories RT-PCR is available for detection of mumps virus RNA in clinical samples, in routine laboratories virus isolation remains a standard method for diagnosing mumps virus infection. Furthermore, isolation of mumps virus strains circulating currently is important for monitoring the ability of vaccine-induced antibody to neutralise any genotypes recognised recently and to detect any changes in phenotype. In this study we compared rhesus monkey kidney (RMK) cells with the cell line B95a for mumps virus isolation from twenty throat swabs collected during a mumps outbreak in a religious community with low MMR coverage. Mumps virus was isolated from eight cases (40%), six were positive in both cell cultures and two in only one, all positive samples being collected within 2 days of onset. Virus growth in B95a cells was detected by the production of a syncytial cytopathic effect, and confirmed by an indirect fluorescent antibody test using a mumps monoclonal antibody. The B95a cell line was found to be equally as sensitive for mumps isolation as RMK cells, which are regarded as the 'gold standard', thus providing an alternative to the use of primary animal cell culture.

Animals↗

PubMed1989

The epidemiology of mumps in southern Alberta 1980-1982.

The full spectrum of mumps in Southern Alberta was studied over the years 1980-1982. In the community, a random sample of 3,497 children was tested for prevalence of immunity to mumps. The 1,816 who were not immune were retested after one year. The incidence of new immunity was 16.5%. Most seroconverters had no illness suggestive of mumps. History of previous mumps or immunization were found to be unreliable predictors of serologic immune status. In the family study, information was obtained on 342 cases diagnosed as mumps by family physician recorders. The overall complication rate was 10.8% and the secondary attack rate within families was 11.7%. Hospital records of all 25 patients admitted in Calgary with mumps during the same period were analyzed. Estimated costs of unopposed mumps over 20 years compared with the estimated costs of vaccination showed that a vaccination program could give a benefit-cost ratio between 6.4 and 247. These studies show that mumps is a mild disease with relatively few serious complications or sequelae. Even so, there would be definite medical and economic benefit with immunization. A low-cost addition of mumps vaccine to the immunization program would be justified.

Adolescent↗

PubMed1999

Experimental mumps virus-induced hydrocephalus: viral neurotropism and neuronal maturity.

In order to elucidate the relationship between virus neurotropism and neuronal maturity, two experiments were performed. First, mumps virus infectivity was compared among the different developmental stages of hamster brains inoculated with mumps virus by examining the immunohistochemical distribution of mumps virus antigen. Second, brain lesions resulting from mumps virus infection during the period of neuronal migration were histologically and ultrastructurally analyzed. Three groups of Syrian hamsters, Group E12 (fetuses on the 12th day of gestation), and Groups P2 and P30 (2 and 30 days old, respectively), were injected with mumps virus intraplacentally or intracerebrally. In Group P30, mumps virus antigen was observed specifically in ependymal cells and the choroid plexus. In addition to these areas, in Group P2, some neurons in layers II and III of the cerebral cortex also showed virus antigen immunoreactivity. In Group E12, mumps virus antigen accumulated primarily in the neuroepithelial cells within the ventricular zone. Neither specific intranuclear changes related to viral replication nor the formation of complete virions and nucleocapsids was observed. We conclude that mumps virus neurotropism to hamster brains is dependent on the degree of neuronal maturity and that mumps virus can induce an abortive infection and resultant neuronal cell necrosis in the immature developing hamster brain.

Aging↗