title: Factors associated with mumps meningitis and the possible impact of vaccination.
abstract: OBJECTIVE
  Mumps meningitis is a common complication of mumps infection; however, information on mumps meningitis in the postvaccine era is limited. The purpose of the present study was to determine factors associated with mumps meningitis and to discuss the effect of vaccination on this disease.
  
  
  METHODS
  We retrospectively reviewed patients younger than 19 years with mumps, diagnosed at a university hospital in Korea between 2003 and 2013. Patients were divided into groups with and without meningitis, and the clinical features of the 2 groups were compared.
  
  
  RESULTS
  The study enrolled 119 patients: 19 patients with meningitis and 100 patients without. Univariate analysis showed that older age (median: 15 years vs. 9.5 years, respectively), a longer interval from last vaccination (median: 10.2 years vs. 4.8 years, respectively), and febrile presentation (94.7% vs. 31.0%, respectively) were significantly associated with mumps meningitis. Sex, number of vaccination doses, bilateral parotitis, and the presence of complications other than meningitis did not differ between the 2 groups. In multivariate logistic regression analysis, age (odds ratio, 1.38; 95% confidence interval, 1.01-1.89; P=0.04) and fever (odds ratio, 30.46; 95% confidence interval, 3.27-283.61; P<0.01) remained independent factors for mumps meningitis.
  
  
  CONCLUSIONS
  Clinicians in the postvaccine era should be aware of the possibility of mumps meningitis in febrile cases of mumps in adolescents, regardless of the number of vaccination doses. To establish the role of vaccination in mumps meningitis, further studies will be necessary.
authors.affiliation: Department of Pediatrics, Gyeongsang National University School of Medicine, Jinju, Korea.
authors.forename: Kyuyol
authors.initials: K
authors.lastname: Rhie
authors.affiliation: Department of Pediatrics, Gyeongsang National University School of Medicine, Jinju, Korea.
authors.forename: Heung-Keun
authors.initials: HK
authors.lastname: Park
authors.affiliation: Department of Neurology, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea.
authors.forename: Young-Soo
authors.initials: YS
authors.lastname: Kim
authors.affiliation: Department of Pediatrics, Gyeongsang National University School of Medicine, Jinju, Korea.; Gyeongsang Institute of Health Science, Jinju, Korea.
authors.forename: Jung Sook
authors.initials: JS
authors.lastname: Yeom
authors.affiliation: Department of Pediatrics, Gyeongsang National University School of Medicine, Jinju, Korea.; Gyeongsang Institute of Health Science, Jinju, Korea.
authors.forename: Ji Sook
authors.initials: JS
authors.lastname: Park
authors.affiliation: Department of Pediatrics, Gyeongsang National University School of Medicine, Jinju, Korea.; Gyeongsang Institute of Health Science, Jinju, Korea.
authors.forename: Ji-Hyun
authors.initials: JH
authors.lastname: Seo
authors.affiliation: Department of Pediatrics, Gyeongsang National University School of Medicine, Jinju, Korea.; Gyeongsang Institute of Health Science, Jinju, Korea.
authors.forename: Eun Sil
authors.initials: ES
authors.lastname: Park
authors.affiliation: Department of Pediatrics, Gyeongsang National University School of Medicine, Jinju, Korea.; Gyeongsang Institute of Health Science, Jinju, Korea.
authors.forename: Jae-Young
authors.initials: JY
authors.lastname: Lim
authors.affiliation: Department of Pediatrics, Gyeongsang National University School of Medicine, Jinju, Korea.; Gyeongsang Institute of Health Science, Jinju, Korea.
authors.forename: Chan-Hoo
authors.initials: CH
authors.lastname: Park
authors.affiliation: Department of Pediatrics, Gyeongsang National University School of Medicine, Jinju, Korea.; Gyeongsang Institute of Health Science, Jinju, Korea.
authors.forename: Hyang-Ok
authors.initials: HO
authors.lastname: Woo
authors.affiliation: Department of Pediatrics, Gyeongsang National University School of Medicine, Jinju, Korea.; Gyeongsang Institute of Health Science, Jinju, Korea.
authors.forename: Hee-Shang
authors.initials: HS
authors.lastname: Youn
keywords: Child; Measles-mumps-rubella vaccine; Mumps; Viral meningitis