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ACIP discusses factors leading to mumps outbreak in the Northeast
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The number of cases linked to a June mumps outbreak at a New York summer camp has climbed to 2,336, CDC officials reported during the Advisory Committee on Immunziation Practices’ meeting this week.
After initial spread into other populations throughout the state and areas of New Jersey, CDC epidemiologist Kathleen Gallagher, DSc, MPH, said the disease has now been exported to Connecticut, Quebec and Israel.
Incidence remains highest among boys in the Hasidic community because they usually spend longer hours at private schools, Gallagher said, mostly around other people belonging to this population. In addition to day students, these schools also board students from a variety of other regions and states. Therefore, boys potentially exposed to mumps may inadvertently spread the disease among other communities when they return home for holidays, emphasizing the importance of up-to-date, two-dose vaccinations in this age group.
The potential for a three-dose measles-mumps-rubella vaccine (M-M-R II, Merck) was also a focal point at the meeting. Currently, officials in Orange County, New York have tried administering a third dose to children in efforts to control the outbreak. Although little data are available, Gallagher said studies to evaluate the efficacy of a three-dose vaccine regimen are ongoing.
Additional discussion addressed the genotype responsible for the outbreak, as well as the current vaccine’s ability to effectively prevent the spread of disease. Officials have identified genotype G from the United Kingdom, which was also present in the 2006 mumps outbreak, as the culprit for the current outbreak. Gallagher noted that there was “nothing special” about genotype G, and the MMRV may develop antibodies to this strain.
Nevertheless, other committee members said the mumps component of the MMRV has always been less effective than the measles and rubella components, and some attributed this to the strain contained in the vaccine.
“It’s a complex situation that we have, but as I’ve said to my colleagues from Merck, we do need a better mumps strain than we currently have,” Stanley A. Plotkin, MD, of Sanofi-Pasteur, said. “Even though we have a number of [mumps strains], none of them are perfect.” – by Melissa Foster
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