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Epidemiological trends and determinants of mumps outbreaks: a systematic review and meta-analysis

Ritik Agrawal1,2, Tanveer Rehman1,2, Deepti Sinha1

  • 1ICMR Regional Medical Research Centre, Bhubaneswar, Odisha, India.

Frontiers in Public Health
|December 22, 2025
PubMed
Abstract

Insights

Mumps outbreaks are a global concern, with adults experiencing the highest attack rates (ARs). A third MMR vaccine dose is recommended to reduce mumps incidence and complications.

Area of Science:

  • Epidemiology
  • Public Health
  • Infectious Diseases

Background:

  • Mumps outbreaks are resurging globally despite widespread vaccination.
  • This study addresses the need to understand current mumps epidemiology and outcomes.

Purpose of the Study:

  • To conduct a systematic review and meta-analysis of mumps outbreaks worldwide.
  • To assess epidemiological characteristics, attack rates (ARs), and complication rates.
  • To identify trends and risk factors associated with mumps outbreaks.

Main Methods:

  • Systematic search of MEDLINE, Embase, CINAHL, and Google Scholar for studies (2004-2024).
  • Inclusion of confirmed mumps cases meeting WHO criteria across all age groups.
  • Pooled analysis of ARs and complication rates using random-effects models; subgroup and meta-regression analyses performed.

Main Results:

  • 47 studies from 21 countries, including 71,174 mumps cases, were analyzed.
  • Pooled mumps outbreak AR was 14.5%, with adults showing the highest AR (31.8%).
  • Pooled complication rate was 10.3%, with orchitis most common (63.1%); higher ARs observed in the Americas and Eastern Mediterranean regions.

Conclusions:

  • Mumps outbreaks persist globally due to waning vaccine immunity.
  • A third Measles, Mumps, and Rubella (MMR) booster dose is recommended for vaccination schedules.
  • Booster doses are particularly important for high-risk groups to mitigate ARs and complications.
Keywords:
MMR vaccineattack ratemumpsoutbreakvaccination

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