Smoking and older age associated with mumps in an outbreak in a group of highly-vaccinated individuals attending a youth club party, the Netherlands, 2012.
We describe a mumps outbreak in a highly-vaccinated population attending a party at a youth club. In a retrospective cohort study with 60 of approximately 100 participants responding, vaccination status was verified for 58/59 respondents, of whom 54 were vaccinated twice and four once. The attack rate was 22% (13 cases, all vaccinated), with smoking at the party (risk ratio (RR) 3.1; 95% confidence interval (CI): 1.6–6.0, p=0.001) and age ≥21 years (RR 4.7; 95% CI: 2.1–10.2, p<0.0001) as risk factors for disease in the binominal regression analysis. Mild upper respiratory illness was also highly prevalent in those who did not meet the mumps case definition (n=46) after the party, suggesting that mumps virus infection may cause mild disease in vaccinated individuals. Our investigation adds toevidence that crowded social events and smoking may facilitate spread of mumps virus among vaccinated populations, with waning immunity playing a role. The suggestion that mumps virus infection in vaccinated individuals may manifest as mild upper respiratory illness could have implications for transmission and warrants further investigation.
Dutch National Institute for Public Health and the Environment (RIVM), Bilthoven.
G
G
Ladbury
S
S
Ostendorf
T
T
Waegemaekers
R
R
van Binnendijk
H
H
Boot
S
S
Hahne
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D016001:Confidence Intervals; D003441:Crowding; D004196:Disease Outbreaks; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009107:Mumps / Q000175:diagnosis / Q000453:epidemiology* / Q000635:transmission; D009108:Mumps Vaccine / Q000008:administration & dosage* / Q000276:immunology; D009109:Mumps virus / Q000276:immunology; D009426:Netherlands / Q000453:epidemiology; D015995:Prevalence; D012044:Regression Analysis; D012141:Respiratory Tract Infections / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors; D012907:Smoking / Q000453:epidemiology*; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D014611:Vaccination / Q000706:statistics & numerical data*; D055815:Young Adult
D009108:Mumps Vaccine