Toon Braeye1, Indra Linina2, Rikka De Roy3, Veronik Hutse4, Magali Wauters5, Pia Cox6, Ruud Mak7. 1. Epidemiology of Infectious Diseases, Operational Directorate Public Health and Surveillance, Scientific Institute of Public Health, Julliette Wytsmanstraat 14, 1050 Brussels, Belgium. Electronic address: Toon.Braeye@wiv-isp.be. 2. Epidemiology of Infectious Diseases, Operational Directorate Public Health and Surveillance, Scientific Institute of Public Health, Julliette Wytsmanstraat 14, 1050 Brussels, Belgium; European Programme for Intervention Epidemiology Training (EPIET), European Centre for Disease Prevention and Control, Stockholm, Sweden. Electronic address: indra.linina@gmail.com. 3. Student Medical Centre, KU Leuven, Catholic University of Leuven, Van Dalecollege, Naamsestraat 80 Bus 5415, 3000 Leuven, Belgium. Electronic address: Rikka.DeRoy@dsv.kuleuven.be. 4. Virology, Operational Directorate Communicable and Infectious Diseases, Scientific Institute of Public Health, Julliette Wytsmanstraat 14, 1050 Brussels, Belgium. Electronic address: Veronik.Hutse@wiv-isp.be. 5. Flemish Agency for Care and Health, Infectious Disease Control, Koning Albert II-laan 35 Bus 33, 1030 Brussels, Belgium. Electronic address: Magali.Wauters@wiv-isp.be. 6. Flemish Agency for Care and Health, Infectious Disease Control, Koning Albert II-laan 35 Bus 33, 1030 Brussels, Belgium. Electronic address: pia.cox@wvg.vlaanderen.be. 7. Flemish Agency for Care and Health, Infectious Disease Control, Koning Albert II-laan 35 Bus 33, 1030 Brussels, Belgium. Electronic address: ruud.mak@wvg.vlaanderen.be.
Abstract
INTRODUCTION: In 2012, an increase in mumps notifications occurred in Belgium, affecting young vaccinated adults. At the end of 2012, a mumps outbreak occurred at the Catholic University of Leuven KU Leuven in Flanders. We investigated the outbreak to estimate incidence, mumps vaccine effectiveness and to detect potential risk factors for the disease. METHODS: In June 2012, we set up mandatory notification in Flanders and we collected information on circulating genotypes from the National Reference Centre. We conducted a cohort study among KU Leuven students. We defined a case as self-reported parotitis, between September 2012 and March 2013. We distributed web-based questionnaires to a random sample of students. We calculated vaccine effectiveness by comparing the risks in students vaccinated twice with those vaccinated once. We estimated risk ratios (RR) to identify risk factors. RESULTS: From 16th June 2012 to 1st April 2013, 4061 mumps cases were notified to the regional public health office (30% were vaccinated once and 69% were vaccinated twice). All 16 samples collected at the KU Leuven were genotype G5. Of 717 participants of the cohort study, 38 (5%; 95%CI 4-8%) met the case-definition. All reported being vaccinated with at least one dose of mumps-containing vaccine. The incidence of mumps was 5% among those vaccinated twice and 16% among those vaccinated once (vaccine effectiveness of two doses compared to one: 68%, 95%CI -24% to 92%). The risk of mumps was lower among those vaccinated with two doses of mumps-containing vaccine ≤10 years before (RR: 0.33, 95%CI 0.10-1.02) and higher among students working in a bar (RR: 3.6, 95%CI 1.8-7.0). CONCLUSIONS: Incomplete protection by two doses of mumps-containing vaccine, possible waning immunity and intense social contacts may have contributed to the occurrence of this outbreak in Flanders. Efforts to maintain high vaccination coverage with two doses remain essential. However, the reasons for low vaccine effectiveness must be further explored and additional immunological research for more immunogenic mumps vaccines is necessary.
INTRODUCTION: In 2012, an increase in mumps notifications occurred in Belgium, affecting young vaccinated adults. At the end of 2012, a mumps outbreak occurred at the Catholic University of Leuven KU Leuven in Flanders. We investigated the outbreak to estimate incidence, mumps vaccine effectiveness and to detect potential risk factors for the disease. METHODS: In June 2012, we set up mandatory notification in Flanders and we collected information on circulating genotypes from the National Reference Centre. We conducted a cohort study among KU Leuven students. We defined a case as self-reported parotitis, between September 2012 and March 2013. We distributed web-based questionnaires to a random sample of students. We calculated vaccine effectiveness by comparing the risks in students vaccinated twice with those vaccinated once. We estimated risk ratios (RR) to identify risk factors. RESULTS: From 16th June 2012 to 1st April 2013, 4061 mumps cases were notified to the regional public health office (30% were vaccinated once and 69% were vaccinated twice). All 16 samples collected at the KU Leuven were genotype G5. Of 717 participants of the cohort study, 38 (5%; 95%CI 4-8%) met the case-definition. All reported being vaccinated with at least one dose of mumps-containing vaccine. The incidence of mumps was 5% among those vaccinated twice and 16% among those vaccinated once (vaccine effectiveness of two doses compared to one: 68%, 95%CI -24% to 92%). The risk of mumps was lower among those vaccinated with two doses of mumps-containing vaccine ≤10 years before (RR: 0.33, 95%CI 0.10-1.02) and higher among students working in a bar (RR: 3.6, 95%CI 1.8-7.0). CONCLUSIONS: Incomplete protection by two doses of mumps-containing vaccine, possible waning immunity and intense social contacts may have contributed to the occurrence of this outbreak in Flanders. Efforts to maintain high vaccination coverage with two doses remain essential. However, the reasons for low vaccine effectiveness must be further explored and additional immunological research for more immunogenic mumps vaccines is necessary.
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Authors: Hana Orlíková; Marek Malý; Pavla Lexová; Helena Šebestová; Radomíra Limberková; Lucie Jurzykowská; Jan Kynčl Journal: BMC Public Health Date: 2016-04-01 Impact factor: 3.295