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Updated: Jan 19, 2026
Immune Surveillance by NK Cells and Phagocytes
Mumps outbreak and MMR IgG surveillance as a predictor for immunity in military trainees
Lindsey E Nielsen1, Devin C Kelly2, Janelle Gyorffy3
1Department of Pathology and Area Laboratory Services, Brooke Army Medical Center, San Antonio, TX, USA; Department of Pathology and Microbiology, University of Nebraska Medical Center, Omaha, NE, USA.
Abstract:
In 2017, a mumps outbreak occurred in a barrack holding 249 service members. Suspected cases were evaluated with a combination of mumps IgG, IgM, viral culture, PCR and sequencing. Seven cases were diagnosed in febrile patients presenting with parotitis or orchitis. Mumps infection was confirmed by IgM or positive PCR with 5/7 cases having notable IgG levels before infection. Sequencing confirmed mumps genotype G strain. Serum from all 249 service members collected prior to the outbreak was withdrawn from the Department of Defense (DoD) Serum Repository and the IgG values of measles, mumps and rubella determined with 20.2%, 12.3% and 9.7% service members being seronegative, respectively. No specific IgG seronegativity combination predicted IgG marker levels to another virus within the same vaccine. This paper provides additional evidence that mumps serology is not a reliable surrogate for mumps immunity and that we need better laboratory correlates to confirm immunity.
Insights
Mumps IgG antibody levels do not reliably indicate immunity, even before infection. This study highlights the need for better laboratory tests to confirm immunity against mumps and other vaccine-preventable diseases.
Area of Science:
- Infectious Diseases
- Immunology
- Vaccinology
Background:
- Mumps outbreaks can occur in populations with presumed immunity.
- Serological markers like IgG are often used to assess vaccine-induced immunity.
- The reliability of serology for confirming immunity requires ongoing evaluation.
Purpose of the Study:
- To investigate the diagnostic utility of mumps serology during an outbreak.
- To evaluate pre-outbreak immunity levels against measles, mumps, and rubella in service members.
- To determine if serological markers can predict immunity to vaccine-preventable diseases.
Main Methods:
- Case evaluation using mumps IgG, IgM, viral culture, PCR, and sequencing.
- Analysis of pre-outbreak serum samples from the Department of Defense (DoD) Serum Repository.
- Determination of measles, mumps, and rubella IgG seronegativity rates.
Main Results:
- Seven cases of mumps infection were confirmed, with some having pre-existing IgG levels.
- Sequencing identified the mumps genotype G strain.
- Significant percentages of service members were seronegative for mumps (12.3%), measles (20.2%), and rubella (9.7%).
Conclusions:
- Mumps serology is not a reliable indicator of immunity.
- Pre-existing IgG levels do not guarantee protection against infection.
- Improved laboratory correlates are needed to accurately confirm immunity to mumps and other vaccine-preventable diseases.
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