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Merkel Cell Polyomavirus Infection and Detection
Published on: February 7, 2019
Mumps epidemiology in Germany 2007-11.
1Immunization Unit, Robert Koch Institute, Berlin, Germany. taklaa@rki.de
Summary
Mumps remains endemic in Germany despite vaccination efforts, with official reporting significantly underestimating actual cases. Insurance data revealed higher incidences and older affected age groups in Western states compared to Eastern states.
Area of Science:
- Epidemiology
- Public Health
- Infectious Diseases
Background:
- Mumps notification in Germany was historically limited to Eastern federal states (EFS) until 2013.
- Disparities in immunization policies and vaccination coverage between former East and West Germany (WFS) complicate national incidence extrapolation.
- Established surveillance systems may underestimate the true burden of mumps in the outpatient sector.
Purpose of the Study:
- To estimate countrywide mumps incidence in Germany's outpatient sector using health insurance claims data.
- To compare insurance-based incidence estimates with official ambulatory notification data.
- To analyze age distribution and vaccination status of mumps cases.
Main Methods:
- Retrospective analysis of mumps-related International Classification of Diseases (ICD-10) diagnoses from statutory health insurance claims (2007-2011).
- Comparison of incidence rates derived from insurance data with notified case numbers from EFS and voluntary surveillance in Bavaria (WFS).
- Assessment of vaccination status and hospitalization rates among reported mumps cases.
Main Results:
- Over 32,330 outpatient mumps cases were identified through insurance claims, with annual incidence ranging from 9.3 to 11.8 per 100,000 population.
- Mumps incidence was higher in WFS than in EFS, with a notable shift towards older age groups in WFS.
- Notified case numbers were substantially lower than insurance data, underestimating incidence by 13-fold in EFS and 8-fold in Bavaria.
- High proportions of unvaccinated individuals (75.4% in EFS, 57.6% in Bavaria) and significant hospitalization rates (6.8% in EFS, 19.3% in Bavaria) were observed.
Conclusions:
- Mumps is endemic in Germany, persisting despite extensive vaccination programs.
- Current notification systems considerably underreport mumps cases in the outpatient setting.
- Insurance claims data provide a more comprehensive picture of mumps epidemiology, highlighting regional differences and the need for improved surveillance.
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