Recent resurgence of mumps in the United States.
BACKGROUND
The widespread use of a second dose of mumps vaccine among U.S. schoolchildren beginning in 1990 was followed by historically low reports of mumps cases. A 2010 elimination goal was established, but in 2006 the largest mumps outbreak in two decades occurred in the United States.


METHODS
We examined national data on mumps cases reported during 2006, detailed case data from the most highly affected states, and vaccination-coverage data from three nationwide surveys.


RESULTS
A total of 6584 cases of mumps were reported in 2006, with 76% occurring between March and May. There were 85 hospitalizations, but no deaths were reported; 85% of patients lived in eight contiguous midwestern states. The national incidence of mumps was 2.2 per 100,000, with the highest incidence among persons 18 to 24 years of age (an incidence 3.7 times that of all other age groups combined). In a subgroup analysis, 83% of these patients reported current college attendance. Among patients in eight highly affected states with known vaccination status, 63% overall and 84% between the ages of 18 and 24 years had received two doses of mumps vaccine. For the 12 years preceding the outbreak, national coverage of one-dose mumps vaccination among preschoolers was 89% or more nationwide and 86% or more in highly affected states. In 2006, the national two-dose coverage among adolescents was 87%, the highest in U.S. history.


CONCLUSIONS
Despite a high coverage rate with two doses of mumps-containing vaccine, a large mumps outbreak occurred, characterized by two-dose vaccine failure, particularly among midwestern college-age adults who probably received the second dose as schoolchildren. A more effective mumps vaccine or changes in vaccine policy may be needed to avert future outbreaks and achieve the elimination of mumps.
Dayan
Gustavo H
GH
Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA.
Quinlisk
M Patricia
MP
Parker
Amy A
AA
Barskey
Albert E
AE
Harris
Meghan L
ML
Schwartz
Jennifer M Hill
JM
Hunt
Kae
K
Finley
Carol G
CG
Leschinsky
Dennis P
DP
O'Keefe
Anne L
AL
Clayton
Joshua
J
Kightlinger
Lon K
LK
Dietle
Eden G
EG
Berg
Jeffrey
J
Kenyon
Cynthia L
CL
Goldstein
Susan T
ST
Stokley
Shannon K
SK
Redd
Susan B
SB
Rota
Paul A
PA
Rota
Jennifer
J
Bi
Daoling
D
Roush
Sandra W
SW
Bridges
Carolyn B
CB
Santibanez
Tammy A
TA
Parashar
Umesh
U
Bellini
William J
WJ
Seward
Jane F
JF
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007117:Immunization, Secondary; D007223:Infant; D008297:Male; D008875:Middle Aged; D009107:Mumps / Q000453:epidemiology*; D009108:Mumps Vaccine / Q000008:administration & dosage; D009109:Mumps virus / Q000235:genetics / Q000302:isolation & purification; D016133:Polymerase Chain Reaction; D017211:Treatment Failure; D014481:United States / Q000453:epidemiology; D014611:Vaccination / Q000706:statistics & numerical data
D009108:Mumps Vaccine