Published Date: 2003-11-23 23:50:00
Subject: PRO/EDR> Mumps, increase - UK (02)
Archive Number: 20031123.2910
MUMPS, INCREASE - UK (02)
A ProMED-mail post
ProMED-mail is a program of the
International Society for Infectious Diseases
Date: Sun 23 Nov 2003
From: H.Larry Penning <email@example.com>
Source: The Independent online, Home news, Sun 23 Nov 2003 [edited]
UK (England & Wales): Mumps Cases at Highest Level for a Decade
Cases of mumps are at the highest levels for almost a decade. So far this
year, there have been more than 2000 formal notifications of the disease in
England, at least half of them thought to be positive. In Wales there have
been 323 confirmed cases, compared with just 2 in 1999.
Public health doctors have warned that in some areas, one child in 5
starting primary school this year was not protected against the disease.
The massive rise in mumps cases is a cause of huge concern for health
officials, who have seen the take-up of the triple measles, mumps and
rubella (MMR) vaccination drop alarmingly because of health scares.
Mumps can cause fever, headache and inflammation of the salivary glands,
and occasionally infection of the membrane covering the brain. The disease
can also cause permanent deafness. About one in 5 adolescent or adult males
who contracts mumps develops a painful inflammation and swelling of the
testicles, which can in a small number of cases result in infertility.
Central nervous system complications are not uncommon. Teenagers are the
group most at risk because they may have missed out on the MMR, which was
introduced in 1988. Some universities are now offering MMR vaccinations to
Latest provisional figures show that for the 2nd quarter of this year there
were 1439 notifications of mumps in England, the highest number since 1995.
In the previous quarter, there were 972 notifications, also the highest
since 1995. It is estimated that around half of those notifications are
positive. "In the 2nd quarter of this year, there were 1439 notifications
of mumps, and saliva tests were sent out and returned for 824 of those
cases, of which 47 percent were positive," said a spokesman for the Health
Protection Agency. "From that, we estimate that the number of positive
cases overall for that quarter was around 700. It is high and it is the
highest for some years." In Wales, both mumps and measles are on the
increase, and doctors are warning of outbreaks of both diseases.
"The number of mumps cases stands at 323 so far, compared to 2 in 1999,"
said a spokeswoman for the National Public Health Service for Wales. "We
are seeing cases of mumps and measles in younger children because of poor
uptake of the MMR vaccine. "Our overall uptake is 78 percent, but in some
areas it is as low as 69 percent. One in 5 children who started school in
September was not protected against mumps, measles or rubella. We are
worried and we are warning of the danger of outbreaks. "We think about 3/4
of the cases of mumps are teenagers, and the majority of these cases are
people who were born before the MMR launch in 1988. They may have had
rubella and measles vaccine, but that didn't contain mumps. Our advice is
that people who are not protected, including teenagers, should have the MMR."
There have been warnings that the fall in the take-up of the MMR, blamed on
controversial and hotly disputed links that have been made between the
vaccine and autism, will result in more outbreaks of measles and rubella.
Less attention has been paid to mumps, which is often considered a benign
illness with low mortality rates. But doctors warn that it should not be
[Similar data have been reported by the Information and Statistics Division
of the National Health Service (NHS) Scotland. Over the past 18 months the
incidences of suspected (but not necessarily confirmed) mumps rose by 27
percent, rubella by 22 percent, and measles by 18 percent in children under
15 (see: <http://news.bbc.co.uk/2/low/uk_news/scotland/3227345.stm>). New
notifications of mumps in children under 15 rose from 98 in 2001 to 124 in
2002, according to the findings, which cover the year 2002 and the first
half-year period of 2003. Notifications of rubella increased from 222 in
2001 to 270 in 2002. In Scotland take-up rates for the triple measles,
mumps and rubella (MMR) vaccine are running at their lowest levels for at
least 8 years.
A similar upsurge in mumps cases in Northern Ireland was reported in
ProMED-mail in 2001. The increase in mumps cases is occurring nationwide,
irrespective of social or local economic factors, and can be related
directly to the decline in acceptance of the MMR triple vaccine by parents.
Since replacement in September 1992 of the Urabe strain of mumps virus by
the Jeryl Lynn strain, the triple MMR vaccine has performed satisfactorily
with no serious complications, notwithstanding the subsequent finding that
the Jeryl Lynn strain of mumps virus is a mixture of 2 distinct isolates
(Afzal et al., J Gen Virol 75, 2139, 1994). The resurgence of mumps cases
and the apparent lack of protection are likely to be related to the decline
in uptake of the MMR triple vaccine in the UK as a result of adverse
publicity surrounding the unsubstantiated claim of a link between the
triple vaccine and autism. - Mod.CP]