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Mumps outbreak in a highly vaccinated school population: assessment of secondary vaccine failure using IgG avidity
Dae Won Park1, Myung-Hyun Nam, Jung Yeon Kim
1Department of Internal Medicine, College of Medicine, Korea University, 126-1 Anam-dong 5th Str, Seongbuk-Gu, Seoul, Republic of Korea. pugae1@hanmail.net
Abstract:
From March to April 2006, an outbreak of mumps occurred in Gyeonggi, Korea. The aim of this study was to describe and discriminate between primary and secondary vaccine failure in a highly vaccinated population for mumps using IgG avidity testing. Fifteen clinical mumps cases occurred among 41 students. Among these 15 patients, 11 vaccinated patients were considered secondary vaccine failures with high IgG titers and a high avidity index (AI, > or =32%); an unvaccinated patient was considered to have primary infection with high IgG titers and low AI, and three vaccinated patients were considered as other infections with low IgG titers and low AI. Among 26 unaffected students, 5 vaccinated patients were retrospectively diagnosed as sub-clinical infection with high IgG titers and high AI; the remaining students had low IgG titers and low AI except for one previously infected student. The results of this study show that secondary vaccine failure played an important role in this mumps outbreak. Therefore, booster immunization for mumps should be considered in immunized adolescents to prevent further outbreaks.
Insights
Secondary vaccine failure was a major cause of a mumps outbreak in Korea. Booster immunization for mumps may be needed for adolescents to prevent future outbreaks.
Area of Science:
- Virology
- Immunology
- Epidemiology
Background:
- Mumps outbreaks can occur even in highly vaccinated populations.
- Distinguishing between primary and secondary vaccine failure is crucial for understanding disease transmission.
Purpose of the Study:
- To differentiate primary and secondary vaccine failure during a mumps outbreak.
- To assess the role of IgG avidity testing in identifying vaccine failure.
Main Methods:
- Analysis of 15 mumps cases and 26 unaffected students from an outbreak in Gyeonggi, Korea.
- Utilized IgG avidity testing to assess immune response in infected and unaffected individuals.
- Categorized cases into primary infection, secondary vaccine failure, and other infections based on clinical presentation and serological markers.
Main Results:
- 11 vaccinated individuals exhibited secondary vaccine failure, characterized by high IgG titers and high avidity index (AI).
- One unvaccinated individual showed primary infection with high IgG titers and low AI.
- Five vaccinated individuals had sub-clinical infections with high IgG titers and high AI.
Conclusions:
- Secondary vaccine failure significantly contributed to the mumps outbreak.
- IgG avidity testing is a valuable tool for discriminating between primary and secondary vaccine failure.
- Booster immunization for mumps should be considered for adolescents to enhance immunity and prevent outbreaks.
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