Epidemiologic and diagnostic evaluation of a recent mumps outbreak using oral fluid samples.
OBJECTIVE
To determine the optimal strategy to investigate mumps virus infection in a partially vaccinated cohort.


METHODS
122 oral fluid and serum samples were collected in a recent outbreak in Ireland. The largest age cohort, students aged 18-21 years old attending third level institutions, were investigated using virus isolation, detection of mumps specific IgM, IgG, RT-PCR and molecular genotyping.


RESULTS
97% of patients had both detectable serum IgM and IgG. Mumps virus RNA was detected in 17 oral fluid samples and 14 of these originated from a single geographic location. Only 6 of the IgM positive samples had detectable mumps virus RNA whereas this could be detected in 11 IgM negative samples. Genotyping studies revealed that genotypes G and J were co-circulating during this outbreak.


CONCLUSIONS
The use of an oral fluid sample to detect mumps virus RNA and IgM offers a major improvement over serological diagnosis in acute infection in both non-vaccinated or partially vaccinated individuals, and has the advantage that specimens are collected non-invasively.
Reid
Fiona
F
National Virus Reference Laboratory, School of Medicine and Medical Sciences, University College Dublin, Belfield, Dublin 4, Ireland.
Hassan
Jaythoon
J
Irwin
Fiona
F
Waters
Allison
A
Hall
William
W
Connell
Jeff
J
D000293:Adolescent; D000328:Adult; D000368:Aged; D000914:Antibodies, Viral / Q000032:analysis / Q000097:blood; D002648:Child; D002675:Child, Preschool; D004196:Disease Outbreaks; D005260:Female; D005838:Genotype; D006801:Humans; D007074:Immunoglobulin G / Q000032:analysis / Q000097:blood; D007075:Immunoglobulin M / Q000032:analysis / Q000097:blood; D007223:Infant; D007494:Ireland / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D008969:Molecular Sequence Data; D009107:Mumps / Q000175:diagnosis* / Q000453:epidemiology* / Q000517:prevention & control / Q000821:virology; D009108:Mumps Vaccine / Q000008:administration & dosage; D009109:Mumps virus / Q000145:classification / Q000235:genetics / Q000276:immunology* / Q000302:isolation & purification*; D012367:RNA, Viral / Q000032:analysis / Q000097:blood; D020133:Reverse Transcriptase Polymerase Chain Reaction; D012463:Saliva / Q000276:immunology* / Q000821:virology*; D017211:Treatment Failure
D000914:Antibodies, Viral; D007074:Immunoglobulin G; D007075:Immunoglobulin M; D009108:Mumps Vaccine; D012367:RNA, Viral