Characterization of Large Mumps Outbreak among Vaccinated Palestinian Refugees

被引:24
作者
Hindiyeh, Musa Y. [1 ]
Aboudy, Yair
Wohoush, Mahmoud
Shulman, Lester M. [2 ]
Ram, Daniela
Levin, Tal
Frank, Tamar
Riccardo, Flavia
Khalili, Mohamad
Sawalha, Elias-Shlash
Obeidi, Maysoun
Sabatinelli, Guido
Grossman, Zehava [2 ]
Mendelson, Ella [3 ]
机构
[1] Chaim Sheba Med Ctr, Cent Virol Lab, Viral Real Time PCR Diag, Minist Hlth,Publ Hlth Serv, IL-52621 Tel Hashomer, Israel
[2] Tel Aviv Univ, Sackler Sch Med, Sch Publ Hlth, Dept Epidemiol & Prevent Med, IL-69978 Tel Aviv, Israel
[3] Bar Ilan Univ, Fac Life Sci, Ramat Gan, Israel
关键词
VIRUS; POPULATION; IDENTIFICATION; GENOTYPES; FAILURE; MEASLES; PREVALENCE; ANTIBODIES; EXCRETION; DURATION;
D O I
10.1128/JCM.01756-08
中图分类号
Q93 [微生物学];
学科分类号
071005 ; 100705 ;
摘要
During a large mumps virus (MuV) outbreak which occurred in the Palestinian refugee camps of the West Bank, 68.1% (2,636/3,871) of the cases were vaccinated with one dose of trivalent measles, mumps, and rubella (MMR) vaccine. Attack rates by camp ranged from less than 1 case per 1,000 people in the population to 43/1,000 (overall, 11/1,000). The outbreak lasted from December 2003 to June 2005, with two peaks, one from April to May 2004 and the other from March to April 2005. To control the outbreak, a mass MMR vaccination campaign was conducted in May 2005. Evaluation of the immune status of cases (n = 59) and healthy controls (n = 51) revealed high levels of mumps immunoglobulin G (IgG) and a low MuV-specific IgM in clinical cases indicative of a booster immune response. This suggested a secondary rather than a primary infection due to the insufficient protection conferred by the single vaccine dose included in the vaccination program. This prediction was further confirmed by the low seroprevalence (68.6%) found in the healthy control group, which was below the threshold level required for MuV herd immunity. Mumps diagnosis was established mainly by reverse transcription-PCR in clinical samples obtained within 48 h from the onset of disease. Of the parotid fluids and nasopharyngeal aspirates analyzed, 92% were positive for MuV RNA, while only 33% of the urine samples were positive. Phylogenetic analysis of the MuV SH gene identified the outbreak strain as the H genotype, which has been in circulation worldwide at least since 1989.
引用
收藏
页码:560 / 565
页数:6
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