Epidemic of complicated mumps in previously vaccinated young adults in the South-West of France.
OBJECTIVE
We report the features and diagnosis of complicated mumps in previously vaccinated young adults.


METHODS
We retrospectively studied 7 cases of complicated mumps managed during 1 year at the Bordeaux University Hospital. The diagnosis was suggested by the clinical presentation and confirmed using specific RT-PCR.


RESULTS
Five cases of meningitis, 1 of orchitis, and 1 of unilateral hearing impairment were identified. Each of the 7 patients had been previously vaccinated with MMR, 4 had received 2 doses of this vaccine. Blood tests revealed high rates of IgG antibodies, usually considered as sufficient for immunological protection, and every patient had at least 1 positive RT-PCR test for mumps.


CONCLUSIONS
Outbreaks of complicated mumps may still occur despite a broad coverage of MMR vaccination. The clinical presentation suggested mumps but the final diagnosis could only be confirmed by genomic detection of the virus. Unusual viral strains with increased neurovirulence, insufficient population coverage associated with immunity decrease over time may explain outbreaks of complicated mumps. A full vaccine scheme of contact people or a third injection of vaccine for previously vaccinated people who are at risk of developing mumps are required to prevent further spreading of the disease during the outbreak.
Service des maladies infectieuses et tropicales, groupe hospitalier Pellegrin, CHU de Bordeaux, place Amélie-Raba-Léon, 33076 Bordeaux cedex, France.
M-O
MO
Vareil
Service des maladies infectieuses et tropicales, groupe hospitalier Pellegrin, CHU de Bordeaux, place Amélie-Raba-Léon, 33076 Bordeaux cedex, France.
G
G
Rouibi
Laboratoire de virologie, CHU de Bordeaux, 33076 Bordeaux, France; Université de Bordeaux, CNRS UMR 5234, 33076 Bordeaux, France.
S
S
Kassab
Service de biologie de la reproduction, CHU de Bordeaux, 33076 Bordeaux, France.
V
V
Soula
Département de médecine interne, CHU de Bordeaux, 33075 Bordeaux, France.
P
P
Duffau
Laboratoire de virologie, CHU de Bordeaux, 33076 Bordeaux, France; Université de Bordeaux, CNRS UMR 5234, 33076 Bordeaux, France.
M-E
ME
Lafon
Service des maladies infectieuses et tropicales, groupe hospitalier Pellegrin, CHU de Bordeaux, place Amélie-Raba-Léon, 33076 Bordeaux cedex, France.
D
D
Neau
Service des maladies infectieuses et tropicales, groupe hospitalier Pellegrin, CHU de Bordeaux, place Amélie-Raba-Léon, 33076 Bordeaux cedex, France; Université de Bordeaux, USC EA 3671, infections humaines à mycoplasmes et à chlamydiae, 33076 Bordeaux, France; Inra, USC EA3671, infections humaines à mycoplasmes et à chlamydiae, 33076 Bordeaux, France. Electronic address: charles.cazanave@chu-bordeaux.fr.
C
C
Cazanave
D000293:Adolescent; D000328:Adult; D000914:Antibodies, Viral / Q000097:blood; D004196:Disease Outbreaks; D005260:Female; D005602:France / Q000453:epidemiology; D046088:Hearing Loss, Unilateral / Q000453:epidemiology / Q000821:virology; D006801:Humans; D007117:Immunization, Secondary; D007074:Immunoglobulin G / Q000097:blood; D007075:Immunoglobulin M / Q000097:blood; D008297:Male; D022542:Measles-Mumps-Rubella Vaccine; D008587:Meningitis, Viral / Q000453:epidemiology* / Q000821:virology; D009107:Mumps / Q000134:cerebrospinal fluid / Q000175:diagnosis / Q000453:epidemiology* / Q000821:virology; D009109:Mumps virus / Q000276:immunology / Q000302:isolation & purification; D009920:Orchitis / Q000453:epidemiology* / Q000821:virology; D012189:Retrospective Studies; D012306:Risk; D014611:Vaccination; D064166:Vaccine Potency; D055815:Young Adult
D000914:Antibodies, Viral; D007074:Immunoglobulin G; D007075:Immunoglobulin M; D022542:Measles-Mumps-Rubella Vaccine
Meningitis; Mumps; Méningite; Oreillons; Vaccination