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Med Mal Infect. 2014 Dec;44(11-12):502-8. doi: 10.1016/j.medmal.2014.09.006. Epub 2014 Oct 25.

Epidemic of complicated mumps in previously vaccinated young adults in the South-West of France.

Author information

1
Service des maladies infectieuses et tropicales, groupe hospitalier Pellegrin, CHU de Bordeaux, place Amélie-Raba-Léon, 33076 Bordeaux cedex, France.
2
Laboratoire de virologie, CHU de Bordeaux, 33076 Bordeaux, France; Université de Bordeaux, CNRS UMR 5234, 33076 Bordeaux, France.
3
Service de biologie de la reproduction, CHU de Bordeaux, 33076 Bordeaux, France.
4
Département de médecine interne, CHU de Bordeaux, 33075 Bordeaux, France.
5
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.

Abstract

OBJECTIVE:

We report the features and diagnosis of complicated mumps in previously vaccinated young adults.

PATIENTS AND 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.

CONCLUSION:

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.

KEYWORDS:

Meningitis; Mumps; Méningite; Oreillons; Vaccination

PMID:
25391635
DOI:
10.1016/j.medmal.2014.09.006
[Indexed for MEDLINE]

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