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Third dose of MMR helpful during outbreaks of mumps
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A third dose of measles-mumps-rubella vaccine helped to quell two separate outbreaks of mumps in New York and Guam last year, according to researchers.
Kathleen Gallagher, DSc, MPH, of the CDC’s Division of Notifiable Disease Surveillance and Healthcare Information, discussed the 2009 outbreak of mumps, which led to about 3,500 cases in Orange County, New York. The outbreak started in school-aged children living in a largely Orthodox Jewish community in that state. The students reportedly spent up to 12 hours a day in religious study in crowded conditions, Gallagher said.
Many of the students had already been fully vaccinated with two doses of measles-mumps-rubella vaccine (M-M-R II, Merck), so the goal of the study was to assess the impact of adding an additional dose of vaccine for sixth- to 12th-grade students who had no prior history of mumps. Eighty-three percent of 2,255 students received the third dose, and Gallagher and colleagues said cases decreased from an average of 20.8 in 1,000 students to 0.7 in 1,000 students.
“This is first study to assess impact of the third dose of MMR on transmission of mumps in outbreaks,” Gallagher said during her presentation. “Preliminary data suggest that the third dose of MMR vaccine given during this outbreak was effective in reducing further transmission of mumps.”
The second study, led by George Nelson, MD, epidemic intelligence service officer at the CDC, concluded that among the 30% of children in eligible schools in Guam who received the third MMR dose, mumps rates declined by 93% (1.1/1,000).
“This was the largest outbreak in Guam in 52 years,” Nelson said, adding that active surveillance for mumps cases should begin immediately to prevent additional outbreaks.
Gallagher said a third dose of MMR during times of outbreak may have an effect in controlling these types of outbreaks, but more studies are needed to determine the third dose’s true effect.
For more information:
- Gallagher K. #25450. Nelson G. #25454.
Disclosures: Drs. Gallagher and Nelson report no relevant financial disclosures.
This third dose of MMR may be applicable in exposed, smaller, closed populations, but in larger metro areas with diversity, it may be very impractical and economically unfeasible. It is an important approach to consider, however, if an epidemic occurs.
— Stan L. Block, MD
Infectious Diseases in Children Editorial Board member
Disclosure: Dr. Block reports no relevant financial disclosures.