Seroepidemiology of mumps in Europe (1996-2008): why do outbreaks occur in highly vaccinated populations?
Mumps outbreaks have recently been recorded in a number of highly vaccinated populations. We related seroprevalence, epidemiological and vaccination data from 18 European countries participating in The European Sero-Epidemiology Network (ESEN) to their risk of mumps outbreaks in order to inform vaccination strategies. Samples from national population serum banks were collected, tested for mumps IgG antibodies and standardized for international comparisons. A comparative analysis between countries was undertaken using age-specific mumps seroprevalence data and information on reported mumps incidence, vaccine strains, vaccination programmes and vaccine coverage 5-12 years after sera collection. Mean geometric mumps antibody titres were lower in mumps outbreak countries [odds ratio (OR) 0·09, 95% confidence interval (CI) 0·01-0·71)]. MMR1 vaccine coverage ⩾95% remained protective in a multivariable model (P < 0·001), as did an interval of 4-8 years between doses (OR 0·08, 95% CI 0·01-0·85). Preventing outbreaks and controlling mumps probably requires several elements, including high-coverage vaccination programmes with MMR vaccine with 4-8 years between doses.
European Programme for Intervention Epidemiology Training (EPIET), European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden.
J
J
Eriksen
National Institute for Health and Welfare (THL), Helsinki, Finland.
I
I
Davidkin
Health Protection Agency Health Protection Services Colindale, London, UK.
G
G
Kafatos
Health Protection Agency Health Protection Services Colindale, London, UK.
N
N
Andrews
Mater Dei Hospital, Malta.
C
C
Barbara
School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Israel.
D
D
Cohen
Laboratory of the State Agency Infection Centre, Virology Unit, Riga, Latvia.
A
A
Duks
National Public Health Surveillance Laboratory, Vilnius, Lithuania.
A
A
Griskevicius
Swedish Institute for Infectious Disease Control, Stockholm, Sweden.
K
K
Johansen
National Centre for Epidemiology, Budapest, Hungary.
K
K
Bartha
National Institute of Public Health (SZU), Prague, Czech Republic.
B
B
Kriz
Nicosia Hospital, Nicosia, Cyprus.
G
G
Mitis
Surveillance & Epidemiology of Infectious Diseases, Laboratoire National de Santé, Luxembourg.
J
J
Mossong
Health Protection Agency Health Protection Services Colindale, London, UK.
A
A
Nardone
Health Protection Surveillance Centre, Dublin, Ireland.
D
D
O'Flanagan
Centro Nacional de Microbiología, Instituto de Salud Carlos III, Majadahonda, Madrid, Spain.
F
F
DE Ory
National Centre for Communicable Diseases Surveillance and Control, National Institute of Public Health, Romania.
A
A
Pistol
Center for the Evaluation of Vaccination, Vaccine and Infectious Disease Institute (Vaxinfectio), University of Antwerp, Belgium.
H
H
Theeten
Laboratory for Virology, NPHI, Slovenia.
K
K
Prosenc
Public Health Authority of the Slovak Republic, Bratislava, Slovak Republic.
M
M
Slacikova
Health Protection Agency Health Protection Services Colindale, London, UK.
R
R
Pebody
D000293:Adolescent; D000328:Adult; D000914:Antibodies, Viral / Q000097:blood*; D002648:Child; D002675:Child, Preschool; D004196:Disease Outbreaks; D005060:Europe / Q000453:epidemiology; D005260:Female; D006801:Humans; D007115:Immunization Schedule; D015994:Incidence; D007223:Infant; D008297:Male; D008875:Middle Aged; D009107:Mumps / Q000453:epidemiology* / Q000276:immunology*; D009108:Mumps Vaccine; D009109:Mumps virus / Q000276:immunology*; D016036:Seroepidemiologic Studies; D014611:Vaccination / Q000706:statistics & numerical data*; D055815:Young Adult
D000914:Antibodies, Viral; D009108:Mumps Vaccine