Mumps Outbreak among Highly Vaccinated Teenagers and Children in the Central Region of Portugal, 2012-2013

Authors

  • Eugénio Cordeiro Departamento de Saúde Pública. Administração Regional de Saúde do Centro. Coimbra. Portugal.
  • Muriel Ferreira Unidade de Infeciologia. Serviço de Urgência. Hospital Pediátrico. Centro Hospitalar e Universitário de Coimbra. Coimbra. Portugal.
  • Fernanda Rodrigues Unidade de Infeciologia. Serviço de Urgência. Hospital Pediátrico. Centro Hospitalar e Universitário de Coimbra. Coimbra. Portugal.
  • Paula Palminha Departamento de Saúde Pública. Instituto Nacional de Saúde Dr. Ricardo Jorge. Lisboa. Portugal.
  • Elsa Vinagre Departamento de Saúde Pública. Instituto Nacional de Saúde Dr. Ricardo Jorge. Lisboa. Portugal.
  • João Pedro Pimentel Departamento de Saúde Pública. Administração Regional de Saúde do Centro. Coimbra. Portugal.

DOI:

https://doi.org/10.20344/amp.5756

Keywords:

Adolescent, Child, Disease Outbreaks, Measles-Mumps-Rubella Vaccine, Mumps, Portugal.

Abstract

Introduction: Mumps vaccine was introduced in the National Immunization Program in Portugal in 1987, rapidly reaching a national coverage > 92%, with important reduction in the annual incidence of the disease. We report a mumps outbreak in the Central Region of Portugal, occurred in the winter 2012-13.
Material and Methods: Cases of salivary-gland swelling and other symptoms compatible with mumps were investigated. Geodemographics, clinical, laboratory and vaccination data were analyzed.
Results: Over six months, 148 outbreak-related cases were reported: 87.8% occurred in three of the 16 affected counties and 78.4% had a known epidemiological link. Median age was 14.5 years (2-62) and 70.3% were 11-20 years old; 61.5% were male. The mean duration of disease was seven days (2-20). The disease was generally mild; 80.4% had fever and in 55.4% there was unilateral involvement of the parotid gland. Seven cases had orchitis, one oophoritis and one had nephritis. Two cases were hospitalized. School transmission predominated and class attack rates were < 30%. Most of the cases occurred in vaccinated individuals (92%) of whom 86.8% had received 2 doses; 17.7% had received one dose of the vaccine containing the Rubini strain. Mumps virus genotype G was identified in 4 cases.
Discussion: This mumps outbreak among a highly vaccinated population, occurring mostly in teenagers at school, could be due to the partial effectiveness of the vaccine against the disease (particularly in the group vaccinated with Rubini strain), waning immunity overtime and genotype mismatch.
Conclusions: This outbreak report shows the importance of discussion about the need of more booster dose of the actual vaccine or new vaccine including more genotypes to improve immunogenicity.

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Published

2015-08-31

How to Cite

1.
Cordeiro E, Ferreira M, Rodrigues F, Palminha P, Vinagre E, Pimentel JP. Mumps Outbreak among Highly Vaccinated Teenagers and Children in the Central Region of Portugal, 2012-2013. Acta Med Port [Internet]. 2015 Aug. 31 [cited 2023 Feb. 9];28(4):435-41. Available from: https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/5756