Complicated mumps epidemic in young adults previously vaccinated in south-western France

Complicated mumps epidemic in young adults previously vaccinated in south-western France
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Médecine et Maladies infectieuses
M.-O. Vareil, G. Rouibi, S. Kassab, V. Soula, P. Duffaue, ME Lafon, D. Neau, C. Cazanave
2014


Abstract

Objective: We report the characteristics and diagnosis of complicated mumps in vaccinated young adults.
Patients and methods: We retrospectively studied 7 cases of complicated mumps managed during 1 year at the University Hospital of Bordeaux. The diagnosis was suggested by the clinical presentation and confirmed by specific RT-PCR.
Risultati: Five cases of meningitis, 1 of orchitis and 1 of unilateral hearing damage have been identified. Each of the 7 patients had previously been vaccinated with MMR, 4 had received 2 doses of this vaccine. IgG antibodies, generally considered sufficient for immunological protection, and each patient had at least 1 positive mumps RT-PCR test.
Conclusion: Complicated mumps outbreaks can still occur despite extensive coverage of MMR vaccination. The clinical presentation suggested mumps but the final diagnosis could be confirmed by the genomic detection of the virus. Unusual viral strains with increased neurovirulence. A full vaccination schedule of contact persons or a third injection of vaccines for those who have been vaccinated.


Conclusions

Complicated mumps outbreaks can still occur despite extensive coverage of MMR vaccination. The clinical presentation suggested mumps but the final diagnosis could only be confirmed by genomic detection of the virus. Unusual viral strains with increased neurovirulence, insufficient population coverage associated with decreased immunity over time may explain outbreaks of complicated mumps. To prevent further spread of the disease during the outbreak, a complete vaccination schedule of contact persons or a third injection of vaccine is needed for previously vaccinated people who are at risk of developing mumps.



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