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{{Mumps}}
{{Mumps}}
{{CMG}}
{{CMG}} {{AE}} {{NRM}}
 
==Overview==
Mumps can be prevented with the [[MMR vaccine]]. The United States is replacing MMR with the [[MMRV vaccine]], which also protects against [[chickenpox]]. A single dose is on average 78% effective at preventing mumps while 2 doses is on average 88% effective. In general all age groups should receive 2 doses of MMR or MMRV vaccine unless an individual has evidence of immunity. The [[vaccine]] is contraindicated in pregnant women, individuals with egg or [[neomycin]] [[Allergy|allergies]] and immune-compromised or severely immune-suppressed individuals.


==Primary Prevention==
==Primary Prevention==
The most common preventative measure against mumps is immunization with a [[mumps vaccine]].  The vaccine may be given separately or as part of the [[MMR vaccine|MMR immunization]] vaccine which also protects against [[measles]] and [[rubella]].  In the US, MMR is now being supplanted by MMRV, which adds protection against [[Chickenpox]]. The [[World Health Organization|WHO]] recommends the use of mumps vaccines in all countries with well-functioning childhood vaccination programmes. In the United Kingdom it is routinely given to children at age 15 months. The [[American Academy of Pediatrics]] recommends the routine administration of MMR vaccine at ages 12-15 months and at 4-6 years. In some locations, the vaccine is given again between 4 to 6 years of age, or between 11 and 12 years of age if not previously given. [[Vaccine#Efficacy of vaccines|Efficacy of the vaccine]] depends on the strain of the vaccine, but is usually around 80%.<ref>{{cite journal
*Mumps can be prevented with [[MMR vaccine|MMR]] (measles-mumps-rubella) vaccine.<ref name="CDCMumps">Mumps Vaccination. Centers for Disease Control and Prevention (May 29, 2015). http://www.cdc.gov/mumps/vaccination.html Accessed March 15, 2016.</ref>
|author=Schlegel M, Osterwalder JJ, Galeazzi RL, Vernazza PL
:*2 doses of vaccine is 88% (range 66-95%) effective
|title=Comparative efficacy of three mumps vaccines during disease outbreak in Eastern Switzerland: cohort study
:*1 dose of vaccine is 78% (range 49-92%) effective
|journal=BMJ
*Multiple vaccine strains exist:<ref>{{cite journal|journal=Clin Infect Dis|year=2007|volume=45|pages=459&ndash;66|title=Mumps outbreaks in Canada and the United States: Time for new thinking on mumps vaccines|author=Peltola H, Kulkarni PS, Kapre SV, Paunio M, Jadhav SS, Dhere RM|url=http://www.journals.uchicago.edu/CID/journal/issues/v45n4/50311/50311.html}}</ref>
|year=1999
:*The Jeryl Lynn strain is most commonly used in developed countries, but has been shown to have reduced efficacy in [[epidemic]] situations.
|pages=352
:*The Leningrad-Zagreb strain is commonly used in developing countries, but appears to have superior efficacy in epidemic situations.
|volume=319
*In the US, MMR is now being supplanted by [[MMRV vaccine|MMRV]], which adds protection against [[chickenpox]].
|issue=7206
|pmid=10435956}}</ref><sup>,</sup><ref>{{cite web | title=Summary | work=WHO: Mumps vaccine | url=http://www.who.int/vaccines/en/mumps.shtml#summary] | accessdate=2006-04-18}}</ref> The Jeryl Lynn strain is most commonly used in developed countries, but has been shown to have reduced efficacy in epidemic situations.  The Leningrad-Zagreb strain is commonly used in developing countries, but appears to have superior efficacy in epidemic situations.<ref>{{cite journal|journal=Clin Infect Dis
|year=2007
|volume=45
|pages=459&ndash;66
|title=Mumps outbreaks in Canada and the United States: Time for new thinking on mumps vaccines
|author=Peltola H, Kulkarni PS, Kapre SV, Paunio M, Jadhav SS, Dhere RM
|url=http://www.journals.uchicago.edu/CID/journal/issues/v45n4/50311/50311.html}}</ref>


Some anti-vaccine activists protest against the administration of a vaccine against mumps, claiming that the attenuated vaccine strain is harmful, and/or that the wild disease is beneficial. Disagreeing, the [[WHO]], the [[American Academy of Pediatrics]], the Advisory Committee on Immunization Practices of the [[Centers for Disease Control and Prevention]], the [[American Academy of Family Physicians]], the [[British Medical Association]] and the [[Royal Pharmaceutical Society of Great Britain]] currently recommend routine vaccination of children against mumps. The British Medical Association and Royal Pharmaceutical Society of Great Britain had previously recommended against general mumps vaccination, changing that recommendation in 1987.  In 1988 it became United Kingdom government policy to introduce mass child mumps vaccination programmes with the MMR vaccine, and MMR vaccine is now routinely administered in the UK.
===Vaccine Contraindications===
*Women who are pregnant<ref name="pmid10063655">{{cite journal| author=Galazka AM, Robertson SE, Kraigher A| title=Mumps and mumps vaccine: a global review. | journal=Bull World Health Organ | year= 1999 | volume= 77 | issue= 1 | pages= 3-14 | pmid=10063655 | doi= | pmc=PMC2557572 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10063655  }} </ref>
:*Women are recommended to avoid pregnancy for 3 months after vaccination
*People with the following [[Allergy|allergies]]:
:*Sever egg allergy - children with mild egg allergies can be vaccinated but should be monitored for 20 minutes after receipt
:*[[Neomycin]]
*Children who are [[immunocompromised]] or severely [[immunosuppressed]]
:*[[HIV]]-positive children who are NOT immunocompromised should still receive MMR vaccination.


Before the introduction of the mumps vaccine, the mumps virus was the leading cause of viral meningoencephalitis in the United States.  However, encephalitis occurs rarely (less than 2 per 100,000).<ref name=PinkBook_2006>{{cite book | author = Atkinson W, Humiston S, Wolfe C, Nelson R (Editors). | title = Epidemiology and Prevention of Vaccine-Preventable Diseases | edition = 9th | publisher = Centers for Disease Control and prevention | year = 2006 | id = [http://www.cdc.gov/nip/publications/pink/def_pink_full.htm Fulltext] }}</ref> In one of the largest studies in the literature, the most common symptoms of mumps meningoencephalitis were found to be fever (97%), vomiting (94%) and headache (88.8%).<ref>{{cite journal | author=Kanra G, Isik P, Kara A, Cengiz AB, Secmeer G, Ceyhan M | title=Complementary findings in clinical and epidemiologic features of mumps and mumps meningoencephalitis in children without mumps vaccination | journal=Pediatr Int | year=2004 | pages=663-8 | volume=46 | issue=6 | id={{PMID|15660864}} }}</ref> The mumps vaccine was introduced into the United States in December 1967: since its introduction there has been a steady decrease in the incidence of mumps and mumps virus infection. There were 151,209 cases of mumps reported in 1968; in 1998 there were only 666 cases reported.
==CDC Vaccination Recommendations==
====Children====
*Children should receive 2 doses of MMR vaccine:<ref name="CDCMumps" />
:*First dose at 12 - 15 months of age
:*Second dose at 4 - 6 years of age
:*Children can receive the second dose earlier as long as it is at least 28 days after the first dose
 
====Post-High School Students====
*Students at post-high school educational institutions, such as college, trade schools, and training programs, who do not have evidence of immunity (protection) against mumps need two doses of MMR vaccine, separated by at least 28 days.
 
====Adults====
*People who are born during or after 1957 who do not have evidence of immunity against mumps should get at least one dose of MMR vaccine.
 
====International Travelers====
*Children 12 months of age or older should have two doses of MMR vaccine, separated by at least 28 days.
*Teenagers and adults without evidence of immunity to mumps should have two doses of MMR vaccine, separated by at least 28 days.
==Risk for travellers==
For non-immune travellers coming from areas without indigenous transmission, the risk of exposure to mumps virus is increased in an environment of insufficient vaccination coverage.
==Vaccine==
*Live attenuated vaccine normally in fixed combination with vaccines against [[rubella]] and [[measles]], or [[rubella]], [[measles]] and [[varicella]].
*Following primary immunization (2 doses in children aged 1-2 years) protection against mumps is likely to extend into adulthood.


==References==
==References==
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[[Category:Disease]]
[[Category:Disease]]
[[Category:Infectious disease]]
 
[[Category:Pediatrics]]
[[Category:Pediatrics]]
[[Category:Dermatology]]
[[Category:Dermatology]]

Latest revision as of 18:07, 18 September 2017

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Nate Michalak, B.A.

Overview

Mumps can be prevented with the MMR vaccine. The United States is replacing MMR with the MMRV vaccine, which also protects against chickenpox. A single dose is on average 78% effective at preventing mumps while 2 doses is on average 88% effective. In general all age groups should receive 2 doses of MMR or MMRV vaccine unless an individual has evidence of immunity. The vaccine is contraindicated in pregnant women, individuals with egg or neomycin allergies and immune-compromised or severely immune-suppressed individuals.

Primary Prevention

  • Mumps can be prevented with MMR (measles-mumps-rubella) vaccine.[1]
  • 2 doses of vaccine is 88% (range 66-95%) effective
  • 1 dose of vaccine is 78% (range 49-92%) effective
  • Multiple vaccine strains exist:[2]
  • The Jeryl Lynn strain is most commonly used in developed countries, but has been shown to have reduced efficacy in epidemic situations.
  • The Leningrad-Zagreb strain is commonly used in developing countries, but appears to have superior efficacy in epidemic situations.
  • In the US, MMR is now being supplanted by MMRV, which adds protection against chickenpox.

Vaccine Contraindications

  • Women who are pregnant[3]
  • Women are recommended to avoid pregnancy for 3 months after vaccination
  • Sever egg allergy - children with mild egg allergies can be vaccinated but should be monitored for 20 minutes after receipt
  • Neomycin
  • HIV-positive children who are NOT immunocompromised should still receive MMR vaccination.

CDC Vaccination Recommendations

Children

  • Children should receive 2 doses of MMR vaccine:[1]
  • First dose at 12 - 15 months of age
  • Second dose at 4 - 6 years of age
  • Children can receive the second dose earlier as long as it is at least 28 days after the first dose

Post-High School Students

  • Students at post-high school educational institutions, such as college, trade schools, and training programs, who do not have evidence of immunity (protection) against mumps need two doses of MMR vaccine, separated by at least 28 days.

Adults

  • People who are born during or after 1957 who do not have evidence of immunity against mumps should get at least one dose of MMR vaccine.

International Travelers

  • Children 12 months of age or older should have two doses of MMR vaccine, separated by at least 28 days.
  • Teenagers and adults without evidence of immunity to mumps should have two doses of MMR vaccine, separated by at least 28 days.

Risk for travellers

For non-immune travellers coming from areas without indigenous transmission, the risk of exposure to mumps virus is increased in an environment of insufficient vaccination coverage.

Vaccine

  • Live attenuated vaccine normally in fixed combination with vaccines against rubella and measles, or rubella, measles and varicella.
  • Following primary immunization (2 doses in children aged 1-2 years) protection against mumps is likely to extend into adulthood.

References

  1. ↑ 1.0 1.1 Mumps Vaccination. Centers for Disease Control and Prevention (May 29, 2015). http://www.cdc.gov/mumps/vaccination.html Accessed March 15, 2016.
  2. ↑ Peltola H, Kulkarni PS, Kapre SV, Paunio M, Jadhav SS, Dhere RM (2007). "Mumps outbreaks in Canada and the United States: Time for new thinking on mumps vaccines". Clin Infect Dis. 45: 459&ndash, 66.
  3. ↑ Galazka AM, Robertson SE, Kraigher A (1999). "Mumps and mumps vaccine: a global review". Bull World Health Organ. 77 (1): 3–14. PMC 2557572. PMID 10063655.


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