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Current status of mumps and mumps vaccine in the United States.

Reported mumps in the United States has declined to all-time low levels following the increasingly widespread use of mumps-virus vaccine. Mumps vaccine has proven safe and effective. Its incorporation into combined live-virus vaccines, especially measles-mumps-rubella, has made mumps vaccination a practical and economically feasible component of routine immunization activities. Because of the favorable experience to date with mumps vaccine and the associated drop in mumps morbidity and mortality, mumps control programs likely will receive increasing public health attention in the coming years.

Adolescent

Transfer of measles, mumps, and rubella antibodies from mother to infant. Its effect on measles, mumps, and rubella immunization.

Sera from 42 mother-infant pairs were examined to determine the effect of passively acquired enhanced neutralizing (ENt) antibody on immunization. The ENt antibodies to measles, mumps, and rubella were greater in term newborns than in their mothers, with mean ratio of 1.8:1, 1.3:1, and 1.2:1, respectively. In 21% to 25% of the children, these antibodies persisted until 12 months of age. When immunized with trivalent measles-mumps-rubella vaccine, children who had persisting ENt measles and rubella titers had significantly lower mean antibody responses than children without detectable antibodies to the two viruses. Persisting ENt mumps antibodies did not affect the postimmunization titers. Seroconversion rates to any of the three viruses were not different in children with or without preexisting ENt antibody.

Antibodies, Viral

[Mumps meningitis and mumps vaccination (author's transl)].

Mumps meningitis (MM) is the most frequent inflammatory disease of the central nervous system in children. It occurs twice as often in boys as in girls. Usually it is mild; encephalitic signs are found only in 2-3% of the cases. Even here persistent neurological signs are rare, but psychological alterations are found in about 20% of the cases. 40% of all MM cases occur in children of school age necessitating absence from school for four weeks at last. The frequency of MM makes it a financial problem too. In Viennese hospitals 4.2 million Austrian Schillings were spent yearly for hospitalization of children with MM, on average, during the years 1971-1975. The vaccination of all Viennese children born in a single year (18,000) against mumps would require an outlay of only 2.8 million Austrian Schillings. Wide-spread routine vaccination against mumps is indicated, therefore, not only for medical, but for social and economic reasons as well.

Absenteeism

Mumps meningitis: prolonged pleocytosis and occurrence of mumps virus-specific oligoclonal IgG in the cerebrospinal fluid.

A pleocytosis of the CSF occurred in all of 10 children with mumps meningitis and persisted for weeks and months in some patients. Oligoclonal IgG proteins were detected in the cerebrospinal fluid (CSF) during the 2nd week after onset of meningitis or later in 4 out of 10 patients, and could be detected as late as 11 and 12 months after meningitis in 2 patients. Evidence is presented that the oligoclonal IgG represents mumps virus-specific antibody synthesized locally in the brain. Oligoclonal virus antibodies were demonstrated also in serum samples. The persistence for weeks and moths of pleocytosis and oligoclonal IgG virus antibody in the CSF may imply that a virus infection in some cases persists in the brain in spite of apparently complete clinical recovery.

Adolescent

[Changes on platelet adhesion, aggregation and production in course of mumps and mumps meningitis (author's transl)].

In 20 children with mumps and mumps meningitis thrombocyte functions, the thrombopoiesis and the platelet count were examinated over a four week period. The spontaneous, standardized platelet adhesion and aggregation on silikonized glass surface showed a statistically significant increase from the 5th to the 15th day of the illness. Within the first four days a decrease of the megathrombocyte portion respectively of the youngest platelet forms was noted as revealed by the platelet spreading preparations. Then the thrombopoiesis index as well as the platelet count arised from the 5th day of the illness parallel to the other platelet functions. The enhanced thrombopoiesis diminished at the end of the 3rd week of the illness but the platelet adhesion and aggregation continued to be further increased. A distinct correlation could be established between the development of the specific antibodies and increased platelet adhesion, aggregation and thrombopoiesis in epidemic parotitis. The influence of the immune complexes and of the virus itself, furthermore the occurrence of the regenerating phase as well as the effects of the possible thromboplastic activity following a tissue damage or an inflammatory reaction were discussed.

Antibodies, Viral

[Epidemiology of measles and mumps. 2nd part: mumps (author's transl)].

Similar to measles, mumps morbidity is also seen to follow an undulating course with a 2--3 years rhythm as well as having an annual peak in the second quarter. The peak of the age specific morbidity, however, is found in the 7th--8th year of life and consequently part of the infections only appear later in adulthood. Most of the infections remain subclinical and only about 12% are recorded. Morality is about 1 : 100 000, meningitis occurs in about 1,5% of the infections and is benign in most cases. Encephalitis occurs in about 0,9% of cases and frequently leads to brain damage.

Austria

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

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

History and future of the MUMPS in medical computing.

MUMPS is an integrated language and operating system. It was originally developed in the mid 60s, primarily for the interactive manipulation of text-like, hierachical data found so pervasively in medicine. This paper traces the growth in use of MUMPS. Some of the many medical application for which MUMPS is used are discussed, as are the achievements and goals of the MUMPS Users' Group, particularly in facilitating application transfer. The influence of federal funding upon the growth and use of MUMPS is noted. Of particular importance is the federal support of the MUMPS Development Committee in the standardization of MUMPS, and the MUMPS User's Group in promoting MUMPS information and application exchange.

Computers

Possible role of mumps virus in the etiology of ovarian cancer.

Eighty-four ovarian cancer (OCa) patients and 84 controls with nonmalignant conditions matched by age and ethnic origin were interviewed with regard to clinical mumps history and their sera were tested for complement fixation (CF) mumps antibodies. OCa patients differed from the controls in the response to past mumps infection in two respects: 1) They appeared to be more likely to have developed subclinical mumps as evidenced by a lower rate of clinical mumps history in the presence of serological evidence of similar infection rates among those with positive and those with negative clinical mumps history. 2) They tended to present lower persistent mumps CF antibody titers. These results may be interpreted to indicate that an immunological incompetence enables the development of OCa possibly through a direct etiologic role of mumps virus.

Adult

[Results of studying a live mumps vaccine from strain L-3 manufactured by the Moscow Research Institute of Viral Preparations. The epidemiological effectiveness of the vaccine].

A controlled experiment was carried out to study the epidemiological effectiveness of live mumps vaccine from the L-3 strain, the importance of urgent prophylaxis by vaccination in mumps foci and to evaluate the economic effectiveness of mass prophylaxis of mumps by vaccination. The observations involved 113,967 children of 1 to 12 years. Vaccinations were given to 51,701 subjects and 62,256 subjects were the control group. The groups were formed by random selection. One vaccination dose contained 10(4)HAdU50 of mumps virus. The results attest to high epidemilogical effectiveness of the mumps vaccine. The incidence of mumps among the vaccinees was 29.7-fold lower than among unvaccinated, and the coefficient of protection was 96.6%. The urgent vaccination vaccination prophylaxis carried out in children's institutions during the period of introduction of mumps arrested the outbreak within one month, nad the duration of quarantine was reduced 2-3-fold. As a result of the vaccination the economic effect of 290,000 roubles was achieved.

Child