Diagnosis of Acute Mumps Infection during an Outbreak in a Highly Vaccinated Population: Mumps RNA or Mumps IgM Detection?
DOI:
https://doi.org/10.20941/2310-6980.2018.06.1Keywords:
Mumps outbreaks, Mumps RNA, Mumps IgM, Oral fluid.Abstract
A large mumps outbreak commenced in Ireland in October 2014. The users of the National Virus Reference Laboratory were informed that oral fluid collection devices would be provided to allow the collection of oral fluid for the diagnosis of suspected acute mumps infection by RNA detection. Both mumps RNA and mumps IgM detection could be undertaken on a single oral fluid sample and hence would be more accurate in acute infection than serology alone. The aim of this study was to retrospectively assess whether changing the algorithm from serological testing for mumps IgM to molecular testing for mumps RNA in oral fluid samples was beneficial for the diagnosis of acute mumps infection during a mumps outbreak in a highly vaccinated population. A total of 1455 serum and 490 oral fluid samples were submitted for laboratory confirmation of mumps virus infection. Of the sera, 448 (30.8%) tested positive for the presence of mumps IgM. A total of 251 (51.2%) oral fluids had detectable mumps RNA. Despite the limitations of this laboratory based audit it is evident that during an outbreak, mumps RNA detection in oral fluid was beneficial for the specific, definitive diagnosis of acute mumps infection in a highly vaccinated population.
References
Reid F, Hassan J, Irwin F, Waters A, Hall W & Connell J. Epidemiologic and diagnostic evaluation of a recent mumps outbreak using oral fluid samples. J Clin Virol 2008; 41: 134- 7. https://doi.org/10.1016/j.jcv.2007.10.009
Dayan GH, Quinlisk MP, Parker AA, Barskey AE, Harris ML, Schwartz JM, Hunt K et al. Recent resurgence of mumps in the United States. N Engl J Med 2008; 358: 1580-9. https://doi.org/10.1056/NEJMoa0706589
Carr MJ, Moss E, Waters A, Dean J, Jin L, Coughlan S, Connell J et al. Molecular epidemiological evaluation of the recent resurgence in mumps virus infections in Ireland. J Clin Microbiol 2010; 48: 3288-94. https://doi.org/10.1128/JCM.00434-10
Gee, S., D. O'Flanagan, M. Fitzgerald, and S. Cotter. Mumps in Ireland, 2004-2008. Euro Surveill 2008; 13:pii18857.
Rota JS, Rosen JB, Doll MK, McNall RJ, McGrew M, Williams N, Lopareva EN et al. Comparison of the Sensitivity of Laboratory Diagnostic Methods from a Well-Characterized Outbreak of Mumps in New York City in 2009. Clinical and Vaccine Immunology 2013; 20 (3): 391-6. https://doi.org/10.1128/CVI.00660-12
Jin L, Beard S, Brown DWG. Genetic heterogeneity of mumps virus in the United Kingdom: identification of two new genotypes. J Infect Dis 1999; 180: 829-33. https://doi.org/10.1086/314957
Hassan J, Dean J, Moss E, Carr MJ, Hall WW & Connell J. Seroepidemiology of the recent mumps virus outbreaks in Ireland. J Clin Virol 2012; 53: 320-4. https://doi.org/10.1016/j.jcv.2011.12.022
Ladbury G, Ostendorf S, Waegemaekers T, Van Binnendijk R, Boot H & Hahne S. Smoking and older age associated with mumps in an outbreak in a group of highly-vaccinated individuals attending a youth club party, the Netherlands, 2012. Euro Surveill 2014; 19: 20776. https://doi.org/10.2807/1560-7917.ES2014.19.16.20776
Di Renzi M, Jackson S, Gee S, Cotter S. Increase in mumps in Ireland in late 2004. Eurosurveillance Weekly 2004; 8(52).
Principi N. & Esposito S. Mumps outbreaks: A problem in need of solutions. J Infect Dis 2018; 76: 503-6.
Cohen C, White JM, Savage EJ, Glynn JR, Choi Y, Andrews N, Brown D et al. Vaccine effectiveness estimates, 2004- 2005 mumps outbreak, England. Emerg Infect Dis 2007; 13: 12-7.
Rubin SA, Qi L, Audet SA, Sullivan B, Carbone KM, Bellini WJ, Rota PA et al. Antibody induced by immunization with the Jeryl Lynn mumps vaccine strain effectively neutralizes a heterologous wild-type mumps virus associated with a large outbreak. J Infect Dis 2008; 198: 508-15. https://doi.org/10.1086/590115
Marin M, Quinlisk P, Shimabukuro T, Sawhney C, Brown C & Lebaron CW. Mumps vaccination coverage and vaccine effectiveness in a large outbreak among college studentsIowa, 2006. Vaccine 2008; 26: 3601-7. https://doi.org/10.1016/j.vaccine.2008.04.075
Fiebelkorn AP, Coleman LA, Belongia EA, Freeman SK, York D, Bi D, Zhang C et al. Mumps antibody response in young adults after a third dose of measles-mumps-rubella vaccine. Open Forum Infect Dis 2014; 1: ofu094.
Latner DR, Fiebelkorn AP, McGrew M, Williams NJ, Coleman LA, Mclean HQ, Rubin S. et al. Mumps Virus Nucleoprotein and Hemagglutinin-Specific Antibody Response Following a Third Dose of Measles Mumps Rubella Vaccine. Open Forum Infect Dis 2017; 4: ofx263.
Shah M, Quinlisk P, Weigel A, Riley J, James L, Patterson J, Hickman C, Rota P A, Stewart R, Clemmons N, Kalas N, Cardemil C and Iowa Mumps Outbreak Response Team. Mumps Outbreak in a Highly Vaccinated University-Affiliated Setting Before and After a Measles-Mumps-Rubella Vaccination Campaign-Iowa, July 2015-May 2016. Clin Infect Dis 2018; 66: 81-8. https://doi.org/10.1093/cid/cix718
