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[Virological evaluation of mumps meningitis following vaccination against mumps]
1Department of Pediatrics, Tazuke Kofukai Foundation Medical Research Institute Kitano Hospital.
Abstract:
1) We report 5 cases of aseptic meningitis following vaccination against mumps. Of the 5 cases, 4 cases were diagnosed as mumps meningitis. 2 cases received monovalent mumps vaccine and the other 2 MMR vaccine. They consisted of 2 boys and 2 girls, aged 2 years and 2 months to 4 years and 5 months. The period between vaccination and symptoms ranged from 15 days to 20 days (mean 18 days). Cerebrospinal fluid of the cases contained 507 to 2688 cells/mm3. Eruption was observed in the 2 cases who received MMR vaccine, while parotid swelling was not seen in any case. 2) In all 4 cases, IgM antibody to mumps virus in the cerebrospinal fluid was detected by the ELISA or EIA methods. Causative organism of the fifth case was obscure. 3) PCR (Polymerase Chain Reaction) tests revealed that mumps virus isolated from 2 cases were of vaccine strain origin. 4) To evaluate the frequency of mumps meningitis following vaccination, it seems important to investigate carefully the number of children who received the vaccine and to exclude the cases of aseptic meningitis caused by other agents. On the other hand, cases of young infants tend to be overlooked because of atypical signs.
Insights
Five children developed aseptic meningitis, with four diagnosed with mumps meningitis, after receiving mumps vaccines. Mumps virus vaccine strains were identified in two cases, suggesting a link between vaccination and meningitis.
Area of Science:
- Virology
- Immunology
- Pediatrics
Background:
- Mumps vaccination is crucial for preventing mumps infection.
- Aseptic meningitis can be a rare complication of viral infections and vaccinations.
Observation:
- Five pediatric cases of aseptic meningitis following mumps vaccination (monovalent or MMR) were reported.
- Symptoms appeared 15-20 days post-vaccination, with cerebrospinal fluid showing high cell counts.
- Mumps virus vaccine strains were identified in two cases via PCR, and mumps-specific IgM antibodies were found in four cases.
Findings:
- The study identified a potential causal link between mumps vaccination and aseptic meningitis in children.
- Mumps virus vaccine strains were confirmed in a subset of meningitis cases.
- Clinical presentation included meningitis without parotid swelling, but with rash in MMR vaccine recipients.
Implications:
- These findings highlight the importance of monitoring for aseptic meningitis post-mumps vaccination.
- Further research is needed to determine the exact frequency and risk factors.
- Healthcare providers should consider vaccine-associated meningitis in differential diagnoses, especially in young children with atypical symptoms.