News Archives |
Volume 4 No 2; 15 January 2010
Laboratory confirmed number of mumps cases in England and Wales: update to end-November 2009
In the period between January and November 2009, 7,410 cases of mumps were confirmed in England and Wales from almost 19,000 notifications received (see table). The five weekly average of notified cases in 2009 (see figure) were lower than those seen during the epidemic of 2004 and 2005, but higher than the rates seen in 2007 and 2008. In 2009, notifications have been declining since the peak in week 23 (figure).
Of the 7,410 samples with onset between January and November 2009 where mumps was confirmed, 5% (389) had detectible viral RNA by PCR, 75% (5,249) IgM antibodies in oral fluid and in 15% (1,119 ) IgM was identified in serum. An additional 9% (653) of cases had samples with high IgG antibody levels and are believed to represent probable re-infection in individuals with some pre-existing immunity (either natural or vaccine acquired).
Since 2004, the majority of the confirmed cases have been linked with outbreaks in universities; the proportion of patients of university age remains high (table). Although it is recommended that new entrants to universities and colleges have had two doses of MMR before commencing their studies, many confirmed cases are still unvaccinated or have only received one dose (because these cohorts were included in the MMR catch-up campaign but were not part of the routine two-dose MMR schedule). The high proportion of confirmed cases who have received at least one dose of MMR is consistent with high vaccine coverage in individuals born after 1988. Analysis of the 2004-05 epidemic [1,2] and data from US [3] suggest that decline in protection with time (since vaccination) may also contribute to cases in university students.
January - November 2009
Age group |
|||||||||
Region |
Less than 1 |
1-4 |
5-9 |
10-14 |
15-19 |
20-24 |
25+ |
n/k |
Total |
East Mids |
- |
5 |
4 |
27 |
219 |
246 |
151 |
3 |
655 |
East of Engl'd |
2 |
3 |
15 |
27 |
190 |
194 |
114 |
- |
545 |
London |
2 |
27 |
49 |
65 |
180 |
303 |
262 |
9 |
897 |
North East |
- |
3 |
3 |
7 |
100 |
138 |
85 |
2 |
338 |
North West |
3 |
13 |
36 |
71 |
471 |
477 |
301 |
4 |
1376 |
South East |
3 |
15 |
15 |
35 |
311 |
437 |
268 |
3 |
1087 |
South West |
2 |
8 |
10 |
38 |
294 |
429 |
203 |
4 |
988 |
West Mids |
4 |
5 |
11 |
17 |
150 |
210 |
103 |
4 |
504 |
| Wales | - |
5 |
11 |
21 |
103 |
136 |
81 |
2 |
359 |
| Yorks & Humber | 1 |
5 |
19 |
27 |
206 |
267 |
133 |
3 |
661 |
| Total* | 17 |
89 |
173 |
335 |
2224 |
2837 |
2582 |
34 |
7410 |
Mumps notifications (five weekly moving averages) July-June, England and Wales
References
1. Savage E, Ramsay M, White J, Beard S, Lawson H, Hunjan R, et al. Mumps outbreaks across England and Wales in 2004: observational study. BMJ 2005; 330(7500):1119-20.
2. Cohen C, White JM, Savage EJ, Glynn JR, Choi Y, Andrews N, et al. Vaccine effectiveness estimates, 2004–2005 mumps outbreak, England. Emerg Infect Dis [serial online], 14 December 20006. Available from: http://www.cdc.gov/ncidod/EID/13/1/12.htm [accessed 15 January 2010].
3. Kyaw MH, Rue AM, Klahn J, Obrecht L, Krohn T, Rowland J, et al. Long-term persistence of mumps antibody after receipt of two measles-mumps-rubella (MMR) vaccinations and antibody response after a third MMR vaccination among a university population. J Infect Dis. 2008 June 15; 197(12):1662-8.