Characteristics of the epidemiological situation of mumps in the world atthe present stage

Relevance. The socio-economic significance of mumps is determined by complications after a previous infection, affecting reproductive function, what entails economic and demographic losses. An important problem today remains the fact that despite high coverage with preventive vaccinations outbreaks of mumps are recorded among children and young adults. Aim. Analyze the epidemic situation with epidemic parotitis in the world according to various literary sources and evaluate measures to control and combat this infection. Conclusions. Outbreaks of mumps have been reported among religious and ethnic groups. Outbreaks were often recorded in organized student and military groups, mainly among persons twice vaccinated. The most affected by the mumps virus were adolescents and young adults, mostly males. Several researchers have shown the possibility of using a third dose of MMR vaccine to control an outbreak, but its short-term effect does not provide conclusive evidence for rethinking two-dose mumps immunization.

Patient Delay in Hospital Visiting and the Weekend Effect of Surveillance Report on Hand-Foot-and-Mouth Disease and Epidemic Parotitis in Hanzhong City, China

Background. We aimed at investigating the prevalence and associated factors of patient delay in hospital visiting and weekend effect of disease surveillance on hand-foot-and-mouth disease and epidemic parotitis/mumps. Methods. Daily report data on hand-foot-and-mouth disease and epidemic parotitis cases between January 1, 2014, and December 31, 2017, in Hanzhong, Shaanxi, China, were collected. The patient delay in hospital visiting was defined by the date difference between disease onset and patient’s visit to hospital. Differences of delayed durations and percentages were compared by using nonparametric or χ2 tests across gender, age, occupation, disease classification, epidemic and nonepidemic seasons, and years of disease onset. Additionally, to determine whether there existed a weekend effect of disease surveillance, the mean cases reported on weekdays and weekends were also compared. Results. A total of 14,814 patients with hand-foot-and-mouth disease and 4013 with epidemic parotitis were recorded, respectively. We found that 43.1% of the hand-foot-and-mouth disease and 36.5% of the epidemic parotitis patients had delayed visiting to hospital. All patients were reported through the online surveillance system on the day of visiting hospital. The percentage of delayed visiting to hospital differed significantly by years and epidemic and nonepidemic seasons and between children in and not in childcare center (all p values <0.05). In addition, the reported numbers of both diseases fluctuated on weekdays but obviously decreased on weekends regardless of the epidemic or nonepidemic seasons. Conclusions. The reported cases of HFMD and epidemic parotitis had an obvious weekend effect, with an increasing tendency of cases delaying in hospital visiting over the recent years in Hanzhong, China. Parents and caregivers rather than health systems should be primarily targeted for the prevention and control of infectious diseases and their local outbreaks such as community-based education on the second-dose vaccination of mumps and/or hand hygiene.

Mumps: Epidemic parotitis

Mumps is an acute, systemic, highly infectious, communicable infection of children and young adults, caused by a paramyxovirus (with an RNA genome). Transmission is by airborne droplet spread. After an incubation period of 14–18 days, typical presentation is with fever, pain near the angle of the jaw, and swelling of the parotid glands. Complications include orchitis, meningitis, and encephalitis. Diagnosis is obvious clinically in cases with a contact history and parotitis, but serological (mumps-specific IgM and IgA) and RNA-based (RT-PCR) tests are used when this is not the case (e.g. the patient presenting with meningitis). Treatment is symptomatic. Prevention is by vaccination, often given as one component of a trivalent mumps/measles/rubella vaccine at 14–16 months of age. A follow-up vaccination is now recommended at 4–5 years of age.

VACCINE PROPHYLAXIS, DIAGNOSTICS AND GENOTYPES OF MUMPS (EPIDEMIC PAROTITIS) VIRUS

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The Epidemiological Situation of Mumps in the Russian Federation in 1995 -2016

The retrospective analysis of incidence of epidemic parotitis in Russia in 1995-2016 is carried out. It is shown that growth of this infection incidence in 2016 was caused by the poor vaccination and revaccination coverage in the past, as well as the poor immunization quality (vaccination failures) and the decrease in post-vaccination immunity at some vaccinated persons due to absence of natural «booster effect» in the condition of sporadic incidence for a number of years, untimely and not in full holding the response and preventive actions in foci of the infection, and also delivery of the epidemic parotitis virus from epidemic area. Recommendations are formulated to hold actions for improvement of the epidemiological situation.