Abstract
A resurgence of the mumps epidemic in highly vaccinated populations has occurred in recent years in many countries. This study aimed to evaluate the seroprevalence to mumps in urban areas of Shanghai, where a measles-mumps-rubella (MMR) vaccination had been implemented for 20 years. Mumps IgG antibodies were tested in 2662 residual sera from all ages in an urban area of Shanghai. A linear regression method was performed to assess the persistence of mumps antibodies after MMR vaccination. A logistic regression method was used to analyze the variables associated with seronegative sera. The overall age- and gender-adjusted seroprevalence of mumps antibodies reached 90% (95% CI: 90.0–90.2). The antibody concentration declined significantly in the first eight years after the second dose of MMR. The multivariate analysis identified that males, age groups, especially 17–19 years and no dose of vaccination, as well as one dose of vaccination, as factors associated with an increased risk of seronegative sera. A high seroprevalence to mumps has been achieved in the urban areas of Shanghai. A declining antibody level of mumps after the second dose of MMR may put a potential risk of recurrence of mumps. The two-dose MMR vaccine schedule is superior to one-dose schedule for mumps control.
Highlights
Mumps is a common infectious disease in children, characterized by swelling of the salivary glands but can cause orchitis, pancreatitis, and aseptic meningitis
The seroprevalence of maternal mumps antibodies declined rapidly to 1% at age 7–11 months (Table 1 and Figure 1)
After the first MMR (MMR1) vaccination at age 18 months, the seroprevalence increased rapidly in the subsequent age groups and reached 90%
Summary
Mumps is a common infectious disease in children, characterized by swelling of the salivary glands but can cause orchitis, pancreatitis, and aseptic meningitis. Mumps cases have been frequently reported in China in school-age children younger than 15 years, aged 5–9 years [1,2]. The widespread use of mumps vaccines has decreased the incidence of the disease dramatically [3]. In 1996, Shanghai started measles-mumps-rubella (MMR) vaccination with a two-dose schedule, administered at 12–18 months and 4 years of age on a voluntary and self-paid basis. In 2008, the two-dose MMR schedule was incorporated into Shanghai immunization program and routinely offered free of charge to children aged 18 months and 4 years. During the measles catch-up supplemental immunization activities (SIAs) in China in 2010, one dose of MMR was implemented for students aged 6- to 14-year-old (born between September 1996 and August 2004) in Shanghai to achieve high levels of population immunity to measles. With a high level of the two-dose MMR coverage, the incidence of mumps in Shanghai decreased gradually from 247.57 per 100,000 population in 1990 to 10.96 per 100,000 population in 2015, resulting in 95% decline in reported mumps incidence [4]
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