title: Mumps Outbreak Among a Highly Vaccinated University Community-New York City, January-April 2014.
abstract: On 14 January 2014, a vaccinated student presented with parotitis. Mumps immunoglobulin M (IgM) testing was negative and reverse-transcription polymerase chain reaction (RT-PCR) testing was not performed, resulting in a missed diagnosis and the start of an outbreak at a New York City (NYC) university.
  
  
  
  Mumps case investigations included patient interviews, medical records review, and laboratory testing including mumps serology and RT-PCR. Case patients were considered linked to the outbreak if they attended or had epidemiologic linkage to the university. Epidemiologic, clinical, and laboratory data for outbreak cases residing in NYC were analyzed.
  
  
  
  Fifty-six NYC residents with mumps were identified with onset between 12 January and 30 April 2014. Fifty-three cases (95%) were university students, 1 (2%) was a staff member, and 2 (4%) had epidemiologic links to the university. The median age was 20 years (range 18-37 years). All cases had parotitis. Three cases were hospitalized, including 1 of 2 cases with orchitis. Fifty-four (96%) cases had received ≥1 mumps-containing vaccine, 1 (2%) was unvaccinated due to religious exemption, and 1 (2%) had unknown vaccination status. Two of the 44 (5%) cases tested by serology were mumps IgM positive, and 27 of the 40 (68%) tested by RT-PCR were positive.
  
  
  
  Mumps outbreaks can occur in highly vaccinated populations. Mumps should be considered in patients with parotitis regardless of vaccination status. RT-PCR is the preferred testing method; providers should not rely on IgM testing alone. High vaccination coverage and control measures likely limited the extent of the outbreak.
authors.affiliation: Public Health/Preventive Medicine Residency Program, Division of Epidemiology, New York City Department of Health and Mental Hygiene, Queens, NY, USA.
authors.forename: Leena N
authors.initials: LN
authors.lastname: Patel
authors.affiliation: Bureau of Immunization, New York City Department of Health and Mental Hygiene, Queens, New York, USA.|Council of State and Territorial Epidemiologists Applied Epidemiology Fellowship, Atlanta, Georgia, USA.
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Arciuolo
authors.affiliation: Public Health Laboratory, New York City Department of Health and Mental Hygiene, Queens, New York, USA.
authors.forename: Jie
authors.initials: J
authors.lastname: Fu
authors.affiliation: Public Health Laboratory, New York City Department of Health and Mental Hygiene, Queens, New York, USA.
authors.forename: Francesca R
authors.initials: FR
authors.lastname: Giancotti
authors.affiliation: Bureau of Immunization, New York City Department of Health and Mental Hygiene, Queens, New York, USA.|National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
authors.forename: Jane R
authors.initials: JR
authors.lastname: Zucker
authors.affiliation: Public Health Laboratory, New York City Department of Health and Mental Hygiene, Queens, New York, USA.
authors.forename: Jennifer L
authors.initials: JL
authors.lastname: Rakeman
authors.affiliation: Bureau of Immunization, New York City Department of Health and Mental Hygiene, Queens, New York, USA.
authors.forename: Jennifer B
authors.initials: JB
authors.lastname: Rosen
mesh_terms: D000293:Adolescent; D000328:Adult; D000914:Antibodies, Viral / Q000097:blood; D004196:Disease Outbreaks; D005260:Female; D006801:Humans; D007075:Immunoglobulin M / Q000097:blood; D008297:Male; D009107:Mumps / Q000453:epidemiology*; D009519:New York City / Q000453:epidemiology; D012367:RNA, Viral / Q000097:blood; D020133:Reverse Transcriptase Polymerase Chain Reaction; D014495:Universities; D055815:Young Adult
chemical_list: D000914:Antibodies, Viral; D007075:Immunoglobulin M; D012367:RNA, Viral
keywords: mumps; outbreak; parotitis; university; vaccination