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Yin Z, Zheng C, Fang Q, Gong X, Cao G, Li J, Xiang Z, Song W. Introduction of Two-Dose Mumps-Containing Vaccine into Routine Immunization Schedule in Quzhou, China, Using Cox-Proportional Hazard Model. J Immunol Res 2021; 2021:5990417. [PMID: 34778466 PMCID: PMC8589524 DOI: 10.1155/2021/5990417] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2021] [Revised: 10/08/2021] [Accepted: 10/13/2021] [Indexed: 12/02/2022] Open
Abstract
Mumps is a vaccine-preventable disease caused by the mumps virus, but the incidence of mumps has increased among the children who were vaccinated with one-dose measles-mumps-rubella (MMR) in recent years. In this study, we analyzed the influence of different doses of mumps-containing vaccine (MuCV) against mumps using Cox-proportional hazard model. We collected 909 mumps cases of children who were born from 2006 to 2010 and vaccinated with different doses of MuCV in Quzhou during 2006-2018, which were all clinically diagnosed. Kaplan-Meier survival methods and Cox-proportional hazard model were used to estimate the hazard probabilities. Kaplan-Meier curves showed that the cumulative hazard of male and female has no difference; lower hazards were detected among those who were vaccinated with two-dose MuCV, born in 2006, and infected after supplementary immunization activities (SIA). Cox-proportional hazard regression suggested that onset after SIA, born in 2006, and vaccinated with two-dose MuCV were protective factors against infection even after adjusting for potential confounding effects. Our study showed that it was necessary to revise the diagnostic criteria of mumps and identify RT-PCR as the standard for mumps diagnosis in China. We suggested that routine immunization schedule should introduce two doses of MMR and prevaccination screening should be performed before booster immunization in vaccinated populations.
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Affiliation(s)
- Zhiying Yin
- Quzhou Center for Disease Control and Prevention, Quzhou, 324000 Zhejiang, China
| | - Canjie Zheng
- Quzhou Center for Disease Control and Prevention, Quzhou, 324000 Zhejiang, China
| | - Quanjun Fang
- Quzhou Center for Disease Control and Prevention, Quzhou, 324000 Zhejiang, China
| | - Xiaoying Gong
- Quzhou Center for Disease Control and Prevention, Quzhou, 324000 Zhejiang, China
| | - Guoping Cao
- Quzhou Center for Disease Control and Prevention, Quzhou, 324000 Zhejiang, China
| | - Junji Li
- Quzhou Center for Disease Control and Prevention, Quzhou, 324000 Zhejiang, China
| | - Ziling Xiang
- Quzhou Center for Disease Control and Prevention, Quzhou, 324000 Zhejiang, China
| | - Wei Song
- Quzhou Women & Children's Hospital, Quzhou, 324000 Zhejiang, China
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Shah AA, Bodewes R, Reijnen L, Boelsums T, Weller CM, Fanoy EB, Veldhuijzen IK. Outbreaks of mumps genotype G viruses in the Netherlands between October 2019 and March 2020: clusters associated with multiple introductions. BMC Infect Dis 2021; 21:1035. [PMID: 34607555 PMCID: PMC8488918 DOI: 10.1186/s12879-021-06702-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Accepted: 09/10/2021] [Indexed: 11/17/2022] Open
Abstract
Background From October 2019–March 2020, several clusters of mumps cases were identified in the Netherlands. Our objective was to describe cluster-associated mumps virus transmission using epidemiological and molecular information in order to help future mumps outbreak investigation and control efforts. Methods An epidemiological cluster includes ≥ 2 mumps cases with at least an epidemiological-link to a laboratory-confirmed mumps case. A molecular group includes ≥ 2 mumps cases with identical mumps virus sequences. Cases with symptom onset date between 1 October 2019 and 31 March 2020 reported through the National Notifiable Diseases Surveillance System were included. We described epidemiological and clinical characteristics of mumps cases. Sequence data was obtained from selected regions of mumps virus genomes (2270 nucleotides). Associations between epidemiological and molecular information were investigated. Results In total, 102 mumps cases were notified (90% laboratory-confirmed, 10% epidemiologically-linked). 71 out of 102 cases were identified as part of an epidemiological cluster and/or molecular group. Twenty-one (30%) of 71 cases were identified solely from epidemiological information, 25 (35%) solely from molecular surveillance, and 25 (35%) using both. Fourteen epidemiological clusters were identified containing a total of 46 (range: 2–12, median: 3) cases. Complete sequence data was obtained from 50 mumps genotype G viruses. Twelve molecular groups were identified containing 43 (range: 2–13) cases, dispersed geographically and timewise. Combined information grouped seven epidemiological clusters into two distinct molecular groups. The first lasting for 14 weeks, the other for 6. Additionally, one molecular group was detected, linked by geography and time but without an epidemiological-link. Conclusions Combined epidemiological and molecular information indicated ongoing mumps virus transmission from multiple introductions for extended time periods. Sequence analysis provided valuable insights into epidemiological clustering. If combined information is available in a timely manner, this would improve outbreak detection, generate further insight into mumps transmission, and guide necessary control measures. Supplementary Information The online version contains supplementary material available at 10.1186/s12879-021-06702-7.
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Affiliation(s)
- Anita A Shah
- Center for Infectious Disease Control, National Institute for Public Health and Environment (RIVM), Bilthoven, The Netherlands. .,European Programme for Intervention Epidemiology Training (EPIET), European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden.
| | - Rogier Bodewes
- Center for Infectious Disease Control, National Institute for Public Health and Environment (RIVM), Bilthoven, The Netherlands
| | - Linda Reijnen
- Center for Infectious Disease Control, National Institute for Public Health and Environment (RIVM), Bilthoven, The Netherlands
| | - Timo Boelsums
- Department of Infectious Disease Control, Public Health Service Rotterdam-Rijnmond (GGD), Rotterdam, The Netherlands
| | - Claudia M Weller
- Department of Infectious Disease Control, Public Health Service Rotterdam-Rijnmond (GGD), Rotterdam, The Netherlands
| | - Ewout B Fanoy
- Department of Infectious Disease Control, Public Health Service Rotterdam-Rijnmond (GGD), Rotterdam, The Netherlands
| | - Irene K Veldhuijzen
- Center for Infectious Disease Control, National Institute for Public Health and Environment (RIVM), Bilthoven, The Netherlands
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Assessing the Changes of Mumps Characteristics with Different Vaccination Strategies Using Surveillance Data: Importance to Introduce the 2-Dose Schedule in Quzhou of China. J Immunol Res 2020; 2020:8130760. [PMID: 32300606 PMCID: PMC7140127 DOI: 10.1155/2020/8130760] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Revised: 02/20/2020] [Accepted: 03/03/2020] [Indexed: 11/18/2022] Open
Abstract
Background From 2005 to 2016, the prevention and control of mumps in China have undergone three stages of transition. These include the use of MuCV as a self-supported vaccine, the introduction of one-dose MMR to the Expanded Program on Immunization (EPI), and the administration of two-dose MuCV following supplementary immunization activities (SIAs) using MM. Here, using surveillance data, we assessed the epidemiology of mumps during the three stages. Methods Children in Quzhou of China born from 2005 to 2016 and registered in the Zhejiang Provincial Immunization Information System (ZJIIS) were included. We analyzed the epidemic data and calculated incidence and MuCV coverage via birth cohorts. Results The average incidence of mumps in 2005-2006, 2007-2010, and 2011-2016 was 51.57, 41.02, and 12.53 per 100,000 individuals, respectively. The highest incidence was in children aged 6-14 years from 2005-2016, of which the majority were school students (67.84%). Approximately 90% of the reported outbreaks occurred in school children (primary school/middle school). The seasonal characteristics of mumps were less obvious from 2011 to 2016. The coverage of one-dose MMR in the 2005 birth cohort was 71.38%. For the 2006-2010 birth cohort, the coverage of one-dose MuCV was 96.82% and the coverage of two-dose MuCV was 17.68%. The children born from 2011 to 2016 were only free vaccinated with MMR; the coverage of one-dose MuCV was 99.10%. The mumps incidence in the three birth cohorts significantly declined (X2 = 805.90, P < 0.001 for trend). Except the children less than two years old, the mumps incidence for the children born from 2006 to 2010 was higher than that for the children born from 2011 to 2016. Conclusion The mumps incidence significantly declined following the introduction of one-dose MMR. The SIA using MM led to a rapid reduction of mumps cases. Therefore, we recommend a two-dose MuCV routine immunization schedule and improved vaccination coverage.
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Barrabeig I, Antón A, Torner N, Pumarola T, Costa J, Domínguez À. Mumps: MMR vaccination and genetic diversity of mumps virus, 2007-2011 in Catalonia, Spain. BMC Infect Dis 2019; 19:954. [PMID: 31706275 PMCID: PMC6842476 DOI: 10.1186/s12879-019-4496-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2019] [Accepted: 09/23/2019] [Indexed: 11/15/2022] Open
Abstract
Background Mumps is a vaccine-preventable disease but outbreaks have been reported in persons vaccinated with two doses of MMR vaccine. The objective was to describe the demographic features, vaccination effectiveness and genetic mumps virus diversity among laboratory-confirmed cases between 2007 and 2011 in Catalonia. Methods Cases and outbreaks of mumps notified to the notifiable diseases system of Catalonia between 2007 and 2011 retrospectively registered were included. Public health care centres provided written immunization records to regional public health staff to determine the vaccination history. Saliva and serum specimens were collected from suspected cases for laboratory-confirmation using real-time reverse-transcriptase PCR (rtRT-PCR) or serological testing. Phylogenetic analysis of the complete SH gene (316 nucleotides) and complete coding HN protein (1749 nucleotides) sequences was made. Categorical variables were compared using the Chi-square or Fisher’s tests and continuous variables using the Student test. Vaccination effectiveness by number of MMR doses was estimated using the screening method. Results During the study period, 581 confirmed cases of mumps were notified (incidence rate 1.6 cases/100,000 persons-year), of which 60% were male. Three hundred sixty-four laboratory-confirmed cases were reported, of which 44% were confirmed by rtRT-PCR. Of the 289 laboratory-confirmed cases belonging to vaccination cohorts, 33.5% (97) had received one dose of MMR vaccine and 50% (145) two doses. Based on phylogenetic analyses of 316-nucleotide and 174-nucleotide SH sequences, the viruses belonging to viral genotypes were: genotype G (126), genotype D (23), genotype H (2), genotype F (2), genotype J (1), while one remained uncharacterized. Amino acid differences were detected between circulating strains and the Jeryl Lynn vaccine strains, although the majority of amino acid substitutions were genotype-specific. Fifty-one outbreaks were notified that included 324 confirmed mumps cases. Genotype G was the most frequent genotype detected. The family (35%), secondary schools (25%) and community outbreaks (18%) were the most frequent settings. Conclusions Our study shows that genotype G viruses are the most prevalent in Catalonia. Most cases occurred in people who had received two doses of MMR, suggesting inadequate effectiveness of the Jeryl Lynn vaccine strain. The possible factors related are discussed.
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Affiliation(s)
- Irene Barrabeig
- Epidemiological Surveillance and Response to Public Health Emergencies Unit in Barcelona South, Agency of Public Health of Catalonia, Generalitat of Catalonia., Hospital Universitari de Bellvitge, Edifici antiga escola d'infermeria, 3a planta, Feixa Llarga, s/n, 08907, L'Hospitalet de Llobregat, Spain. .,CIBER Epidemiología y Salud Pública, Institut of Health Carlos III, Madrid, Spain.
| | - Andrés Antón
- Virology Unit, Centre de Diagnòstic Biomèdic, Hospital Clínic, Barcelona, Spain
| | - Núria Torner
- Epidemiological Surveillance and Response to Public Health Emergencies Unit in Barcelona South, Agency of Public Health of Catalonia, Generalitat of Catalonia., Hospital Universitari de Bellvitge, Edifici antiga escola d'infermeria, 3a planta, Feixa Llarga, s/n, 08907, L'Hospitalet de Llobregat, Spain.,CIBER Epidemiología y Salud Pública, Institut of Health Carlos III, Madrid, Spain.,Department of Medicine, University of Barcelona, Barcelona, Spain
| | - Tomàs Pumarola
- Virology Unit, Centre de Diagnòstic Biomèdic, Hospital Clínic, Barcelona, Spain
| | - Josep Costa
- Virology Unit, Centre de Diagnòstic Biomèdic, Hospital Clínic, Barcelona, Spain.,CIBER Enfermedades Hepáticas y Digestivas, Institute of Health Carlos III, Madrid, Spain
| | - Àngela Domínguez
- CIBER Epidemiología y Salud Pública, Institut of Health Carlos III, Madrid, Spain.,Department of Medicine, University of Barcelona, Barcelona, Spain
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Assessment of disease specific immune responses in enteric diseases using dried blood spot (DBS). PLoS One 2019; 14:e0218353. [PMID: 31206533 PMCID: PMC6578496 DOI: 10.1371/journal.pone.0218353] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2018] [Accepted: 05/30/2019] [Indexed: 01/30/2023] Open
Abstract
BACKGROUND Blood collection, transportation and storage remain a problem in countries where infrastructure, laboratory facilities and skilled manpower are scarce. This limits evaluation of immune responses in natural infections and vaccination in field studies. We developed methods to measure antigen specific antibody responses using dried blood spot (DBS) in cholera, ETEC and typhoid fever patients as well as recipients of oral cholera vaccine (OCV). METHODOLOGY/PRINCIPLE FINDINGS We processed heparinized blood for preparing DBS and plasma specimens from patients with, cholera, ETEC and typhoid as well as OCV recipients. We optimized the conventional vibriocidal method to measure vibriocidal antibody response in DBS eluates. We measured responses in DBS samples and plasma (range of titer of 5 to 10240). Vibriocidal titer showed strong agreement between DBS eluates and plasma in cholera patients (ICC = 0.9) and in OCV recipients (ICC = 0.8) using the Bland-Altman analysis and a positive correlation was seen (r = 0.7, p = 0.02 and r = 0.6, p = 0.006, respectively). We observed a strong agreement of lipopolysaccharide (LPS) and cholera toxin B (CTB)-specific antibody responses between DBS eluates and plasma in cholera patients and OCV recipients. We also found agreement of heat labile toxin B (LTB) and membrane protein (MP)-specific antibody responses in DBS eluates and plasma specimen of ETEC and typhoid patients respectively. CONCLUSION Our results demonstrate that dried blood specimens can be used as an alternate method for preservation of samples to measure antibody responses in enteric diseases and vaccine trials and can be applied to assessment of responses in humanitarian crisis and other adverse field settings.
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López-Perea N, Masa-Calles J, Torres de Mier MDV, Fernández-García A, Echevarría JE, De Ory F, Martínez de Aragón MV. Shift within age-groups of mumps incidence, hospitalizations and severe complications in a highly vaccinated population. Spain, 1998-2014. Vaccine 2017; 35:4339-4345. [PMID: 28687402 DOI: 10.1016/j.vaccine.2017.06.075] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2017] [Revised: 06/21/2017] [Accepted: 06/23/2017] [Indexed: 11/30/2022]
Abstract
The mumps vaccine (Jeryl-Lynn-strain) was introduced in Spain in 1981, and a vaccination policy which included a second dose was added in 1995. From 1992-1999, a Rubini-strain based vaccine was administered in many regions but later withdrawn due to lack of effectiveness. Despite high levels of vaccination coverage, epidemics have continued to appear. We characterized the three epidemic waves of mumps between 1998 and 2014, identifying major changes in susceptible populations using Poisson regression. For the period 1998-2003 (P1), the most affected group was from 1 to 4years old (y) [Incidence Rate (IR)=71.7 cases/100,000 population]; in the periods 2004-2009 (P2) and 2010-2014 (P3) IR ratio (IRR) increased among 15-24y (P2=1.46; P3=2.68) and 25-34y (P2=2.17; P3=4.05). Hospitalization rate (HR), complication rate (CR) and neurological complication rate (NR) among hospitalized subjects decreased across the epidemics, except for 25-34y which increased: HR ratio (HRR) (P2=2.18; P3=2.16), CRR (P3=2.48), NRR (P3=2.41). In Spain mumps incidence increased, while an overall decrease of hospitalizations and severe complications occurred across the epidemics. Cohorts born during periods of low vaccination coverage and those vaccinated with Rubini-strain were the most affected populations, leading to a shift in mumps cases from children to adolescents and young adults; this also reveals the waning immunity provided by the mumps vaccine. Despite not preventing all mumps cases, the vaccine appears to prevent serious forms of the disease.
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Affiliation(s)
- Noemí López-Perea
- National Epidemiology Centre, Instituto de Salud Carlos III, Av. Monforte de Lemos, 5, 28029 Madrid, Spain; Centers for Biomedical Research Network (CIBER-Epidemiology and Public Health), Spain.
| | - Josefa Masa-Calles
- National Epidemiology Centre, Instituto de Salud Carlos III, Av. Monforte de Lemos, 5, 28029 Madrid, Spain; Centers for Biomedical Research Network (CIBER-Epidemiology and Public Health), Spain.
| | - María de Viarce Torres de Mier
- National Epidemiology Centre, Instituto de Salud Carlos III, Av. Monforte de Lemos, 5, 28029 Madrid, Spain; Centers for Biomedical Research Network (CIBER-Epidemiology and Public Health), Spain.
| | - Aurora Fernández-García
- National Microbiology Centre, Instituto de Salud Carlos III, Ctra. Majadahoda-Pozuelo s/n, 28220 Majadahonda, Madrid, Spain; Centers for Biomedical Research Network (CIBER-Epidemiology and Public Health), Spain.
| | - Juan E Echevarría
- National Microbiology Centre, Instituto de Salud Carlos III, Ctra. Majadahoda-Pozuelo s/n, 28220 Majadahonda, Madrid, Spain; Centers for Biomedical Research Network (CIBER-Epidemiology and Public Health), Spain.
| | - Fernando De Ory
- National Microbiology Centre, Instituto de Salud Carlos III, Ctra. Majadahoda-Pozuelo s/n, 28220 Majadahonda, Madrid, Spain; Centers for Biomedical Research Network (CIBER-Epidemiology and Public Health), Spain.
| | - María Victoria Martínez de Aragón
- National Epidemiology Centre, Instituto de Salud Carlos III, Av. Monforte de Lemos, 5, 28029 Madrid, Spain; Centers for Biomedical Research Network (CIBER-Epidemiology and Public Health), Spain.
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