A Mumps Outbreak in Vojvodina, Serbia, in 2012 Underlines the Need for Additional Vaccination Opportunities for Young Adults.

Jasminka Nedeljković,Judith M Hübschen,Vladimir Petrovic,Vesna Milošević,Claude P Muller,Zorica Šeguljev,Vesna Kovačević-Jovanović,Julian W Tang

doi:10.1371/journal.pone.0139815

Abstract

In 2012, mumps was introduced from Bosnia and Herzegovina to Vojvodina, causing an outbreak with 335 reported cases. The present manuscript analyses the epidemiological and laboratory characteristics of this outbreak, identifies its main causes and suggests potential future preventive measures. Sera of 133 patients were tested for mumps-specific antibodies by ELISA and 15 nose/throat swabs were investigated for mumps virus RNA by RT-PCR. IgG antibodies were found in 127 patients (95.5%). Mumps infection was laboratory-confirmed in 53 patients, including 44 IgM and 9 PCR positive cases. All other 282 cases were classified as epidemiologically-confirmed. More than half of the patients (n = 181, 54%) were 20–29 years old, followed by the 15–19 age bracket (n = 95, 28.4%). Twice as many males as females were affected (67% versus 33%). Disease complications were reported in 13 cases (3.9%), including 9 patients with orchitis and 4 with pancreatitis. According to medical records or anamnestic data, 190 patients (56.7%) were immunized with two doses and 35 (10.4%) with one dose of mumps-containing vaccine. The Serbian sequences corresponded to a minor genotype G variant detected during the 2011/2012 mumps outbreak in Bosnia and Herzegovina. Vaccine failures, the initial one-dose immunization policy and a vaccine shortage between 1999 and 2002 contributed to the outbreak. Additional vaccination opportunities should be offered to young adults during transition periods in their life trajectories.

Highlights

Mumps is a contagious vaccine-preventable disease, caused by mumps virus (MuV), a member of the family Paramyxoviridae
The outbreak started with two mumps cases registered in Novi Sad, Serbia on 16th January 2012 among students who had spent the Christmas and New Year holidays in Bosnia and Herzegovina, where a large outbreak of mumps was ongoing at that time [7,8]
The week after, another 15 cases who had spent their holidays in Bosnia and Herzegovina were notified

Summary

Introduction

Mumps is a contagious vaccine-preventable disease, caused by mumps virus (MuV), a member of the family Paramyxoviridae. Mumps Outbreak in Serbia in 2012 and Vaccination Needs. In Serbia, mumps has been a notifiable disease since 1978. Immunisation against mumps using measles-mumps (MM) vaccine was introduced in the childhood immunization schedule in 1986 (L-Zagreb strain; vaccine produced by the Institute of Immunology Zagreb). Since 1993 measles/mumps/rubella (MMR) vaccine, containing Urabe AM9 vaccine strain (mainly TRIMOVAX MÉRIEUX vaccine from Sanofi Pasteur), is used. An exception were the years 2001 and 2002 when the Jeryl Lynn strain in the Glaxo SmithKline MMR vaccine was applied. A two-dose schedule, with the first dose given at 12 months and the second at 12 years and no later than 14 years of age, was introduced in 1996. Since 2006, the second dose is administered at the age of 7 years [2]

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Conclusion