Abstract
Detection of specific viral antibody or nucleic acid produced by infection or immunization, using oral fluid samples, offers increased potential for wider population uptake compared to blood sampling. This methodology is well established for the control of HIV and measles infections, but can also be applied to the control of other vaccine preventable infections, and this review describes the application of oral fluid assays in support of mumps, rubella and varicella national immunization programs. In England and Wales individuals with suspected mumps or rubella, based on clinical presentation, can have an oral fluid swab sample taken for case confirmation. Universal varicella immunization of children has led to a drastic reduction of chickenpox in those countries where it is used; however, in England and Wales such a policy has not been instigated. Consequently, in England and Wales most children have had chickenpox by age 10 years; however, small, but significant, numbers of adults remain susceptible. Targeted varicella zoster virus (VZV) immunization of susceptible adolescents offers the potential to reduce the pool of susceptible adults and oral fluid determination of VZV immunity in adolescents is a potential means of identifying susceptible individuals in need of VZV vaccination. The main application of oral fluid testing is in those circumstances where blood sampling is deemed not necessary, or is undesirable, and when the documented sensitivity and specificity of the oral fluid assay methodology to be used is considered sufficient for the purpose intended.
Highlights
Mumps: Mumps vaccination and Mumps Oral Fluid TestingMumps is a highly infectious, generally benign disease defined by acute onset of unilateral or bilateral tender, self-limited swelling of the parotid or other salivary glands, lasting two or more days and without other apparent cause [1]
Detection of specific viral antibody or nucleic acid produced by infection or immunization, using oral fluid samples, offers increased potential for wider population uptake compared to blood sampling
The main application of oral fluid testing is in those circumstances where blood sampling is deemed not necessary, or is undesirable, and when the documented sensitivity and specificity of the oral fluid assay methodology to be used is considered sufficient for the purpose intended
Summary
Mumps is a highly infectious, generally benign disease defined by acute onset of unilateral or bilateral tender, self-limited swelling of the parotid or other salivary glands, lasting two or more days and without other apparent cause [1]. It is a non-segmented, negative strand RNA virus comprising a helical nucleocapsid surrounded by a lipid envelope. As is known, are the only natural host of the mumps virus animal species including hamster, mouse, developing chick embryo and non-human primates can be infected [10] under laboratory conditions. Epidemic transmission in humans is by droplet spread and it has been shown by virus culture [12] that in children infected with mumps virus, who subsequently developed parotitis, that virus can be recovered from saliva on the 11th to 15th day after exposure, two to six days prior to onset of clinical signs of disease and extending up to the fourth day of illness. Children with clinically non-apparent infection shed mumps virus [12]. Using molecular techniques for detection of mumps virus following natural infection viral shedding was minimal after the first three days of symptoms [13]. The implementation of population based mumps vaccination changed all of this
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