Epidemiology of a Mumps Outbreak in a Highly Vaccinated Island Population and Use of Third Measles-Mumps-Rubella Vaccine Dose for Outbreak Control– Guam 2009—2010

Details

• Alternative Title:
  Pediatr Infect Dis J
• Personal Author:
  Nelson, George E. ; Aguon, Annette ; Valencia, Engracia Quiambao ; Oliva, Rita ; Guerrero, Michele Leon ; Reyes, Richard ; Lizama, Anna ; Diras, Daryl ; Mathew, Annakutty ; Camacho, E. Jessica ; Monforte, Moryne-Nicole ; Chen, Tai-Ho ; Mahamud, Abdirahman ; Kutty, Preeta K. ; Hickman, Carole ; Bellini, William J. ; Seward, Jane ; Gallagher, Kathleen ; Fiebelkorn, Amy Parker
• Description:
  Background
  
  Despite high two-dose measles-mumps-rubella (MMR) vaccine coverage, a large mumps outbreak occurred on the U.S. Territory of Guam during 2009–2010, primarily in school-aged children.
  
  Methods
  
  We implemented active surveillance in April 2010 during the outbreak peak and characterized the outbreak epidemiology. We administered third doses of MMR vaccine to eligible students aged 9–14 years in 7 schools with the highest attack rates (ARs) between 5/18/2010—5/21/2010. Baseline surveys, follow-up surveys, and case-reports were used to determine mumps ARs. Adverse events post-vaccination were monitored.
  
  Results
  
  Between 12/1/2009—12/31/2010, 505 mumps cases were reported. Self-reported Pohnpeians and Chuukese had the highest relative risks (54.7 and 19.7, respectively) and highest crowding indices (mean: 3.1 and 3.0 persons/bedroom, respectively). Among 287 (57%) school-aged case-patients, 270 (93%) had ≥2 MMR doses. A third MMR dose was administered to 1068 (33%) eligible students. Three-dose vaccinated students had an AR of 0.9/1000 compared to 2.4/1000 among two-dose vaccinated students >1 incubation period post-intervention, but the difference was not significant (p= 0.67). No serious adverse events were reported.
  
  Conclusions
  
  This mumps outbreak occurred in a highly vaccinated population. The highest ARs occurred in ethnic minority populations with the highest household crowding indices. After the third dose MMR intervention in highly affected schools, the AR in three-dose MMR recipients was 60% lower than two-dose vaccine recipients, but the difference was not statistically significant and the intervention occurred after the outbreak peaked. This outbreak may have persisted due to crowding at home and high student contact rates.
  
  
• Subjects:
  Adolescent Adult Aged Child Child, Preschool Crowding Disease Outbreaks Ethnicity Female Humans Infant Male Measles-Mumps-Rubella Vaccine Middle Aged Mumps Socioeconomic Factors Young Adult

  More +
• Source:
  Pediatr Infect Dis J. 32(4):374-380
• Pubmed ID:
  23099425
• Pubmed Central ID:
  PMC6893844
• Document Type:
  Journal Article
• Funding:
  CC999999/ImCDC/Intramural CDC HHS/United States ; T32 AI007291/AI/NIAID NIH HHS/United States
• Place as Subject:
  Guam
• Volume:
  32
• Issue:
  4
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:b4b703c0778be1b2e38a46f3cc5fe2b254b5333ebbd452427a094409a79d81e8
• Download URL:
  https://stacks.cdc.gov/view/cdc/83224/cdc_83224_DS1.pdf
• File Type:
  [PDF - 473.54 KB ]