Evaluation of Immunity for Mumps among Vaccinated Medical Students

Healthcare workers are considered at higher risk for mumps infection than the general population. Since 2017, the national immunization plan recommended the administration of a dose of measles–mumps–rubella (MMR) vaccine to the healthcare operators who are unable to demonstrate a complete vaccination history or that are seronegative for at least one of the three agents. Regarding mumps infection, based on actual concerns regarding the loss of protection over the years after vaccination, the Advisory Committee on Immunization Practices (ACIP) recommended to administer a third dose of vaccine to operators previously vaccinated with two doses of MMR vaccine who belong to a group at increased risk of mumps infection in the event of an epidemic. This guideline, however, is not currently followed in Italy, resulting in a potential risk for vaccinated operators to become unprotected from mumps over the years. The aim of our study is to evaluate the persistence of a protective antibody level for mumps among medical students vaccinated during infancy or adolescence, at the start of their hospital internship. We retrospectively evaluated mumps-specific IgG levels in a group of medical students, in the period from 1 January to 31 December 2020. We evaluated the persistence of the detectable level of mumps-specific antibodies in relation to their vaccinal status, gender and time elapsed from vaccination. We found that 17.4% (65 subjects) of our sample were seronegative for mumps. The univariate analysis showed a significant difference in serological protection between male and female gender (77.0% vs. 86.2%; p < 0.05 with chi2 test) and between age classes (86.5% vs. 76.4%; p < 0.05 for subjects aged 18–23 years and over 23 years, respectively). Female gender was significantly related to higher serological protection even after adjusting for age classes and number of vaccine doses administered in a multivariate analysis model. Our study shows a substantial percentage of subjects lacking a protective mumps titer among medical students who were vaccinated in childhood. Given the higher risk of infection among those subjects, routine pre-employment screening should be performed among those operators regardless of their vaccination history and a third dose of MMR should be offered to unprotected students.

Relationship Between Post-Pubertal Mumps Infection In Males With Infertilityand Its Effect on The Result of Seminal Fluid Analysis and Occurrence of Immunological Infertility

Background: Mumps caused by paramyxovirus in the same group as parainfluenza and Newcastle disease virus, orchitis is the widely recognized complication in post-pubertal males. Approximately 50% of patients with orchitis have some degree of testicular atrophy, but sterility is rare. Objective: To demonstrate the effect of the post-pubertal mumps infection on the result of seminal fluid analysis and to know if infection by mumps after puberty can lead to immunological infertility and production of anti-sperm antibodies. Patients and Methods: Cross-sectional study in which 300 infertile males attending microbiology laboratory in Rizgary teaching hospital in Erbil city in Iraqi Kurdistan from November 2017- September 2018. Questionnaire was prepared for each male which included: name, age, occupation, history of mumps infection after puberty. Seminal fluid collected from each patient after 3 days of abstinence and analyzed according to WHO guidelines. Seminal fluid and serum obtained from each infertile male for the detection of anti-sperm antibodies by ELISA (enzyme-linked immunosorbent assay). Results: The mean age of the participant in the study was (32.805 year) with the maximum and minimum age was (50, 18) years respectively. The incidence of post-pubertal mumps was (13.3%) and the incidence of abnormal seminal fluid analysis was (10%) and the highest abnormal seminal fluid variables among infertile males with post-pubertal mumps was oligoasthenozoospermia (43%) and the anti-sperm antibodies in the semen of infertile males with post-pubertal mumps infection was (60%) while the frequency of anti-sperm antibodies in the serum in infertile males with a history of post-pubertal mumps was (40%) which was higher than those with no history of post-pubertal mumps with highly significant relation statistically. Conclusion: Abnormal seminal fluid analysis result may be due to post-pubertal mumps and it can lead to (Asthenozoospermia, Oligospermia, and Teratozoospermia). The highest percentage of abnormal seminal fluid variables was Oligoasthenozoospermia the occurrence of anti-sperm antibodies can be the sequence of post-pubertal mumps and by itself can lead to abnormality in the seminal fluid analysis. Mumps can lead to male infertility by affecting the seminal fluid parameters and also by the production of anti-sperm antibodies which can lead to subfertility in adult males. Keywords: Paramyxovirus, post-pubertal mumps, anti-sperm antibodies

Mumps: A Rare Cause of Pancreatitis

Acute pancreatitis related to mumps infection is rarely reported. In this case report, we highlight a case of acute pancreatitis caused by mumps infection in adulthood. A 25-year old woman treated for mumps developed sudden onset of vomiting and epigastric pain. She had an elevation of serum amylase and was treated for acute pancreatitis. She showed remarkable improvement of clinical symptoms with supportive treatment and after her bilateral parotid swelling receded.International Journal of Human and Health Sciences Vol. 05 No. 02 April’21 Page: 261-263

Pancreatitis aguda asociada a infección por parotiditis (papera). Informe de un caso

Mumps are a preventable disease by vaccination, caused by a Paramyxovirus. Even though we are in the vaccination era, different phenomena as the migratory movements, are generating a new rebound of this highly transmissible viral infection. We present a female with a severe epigastric abdominal pain and elevation of alpha-amylase and triacylglycerol lipase in blood analysis, after 48 hours of mumps infection. After the exclusion of more frequent causes, the patient was diagnosed with acute pancreatitis related to mumps. This case shows that, despite it is a rare cause, acute pancreatitis should be considered in patients with mumps who present acute abdominal pain. An early diagnosis and an appropriate treatment are necessary to prevent and minimise morbi-mortality related to acute pancreatitis.

Chronic Hydrocephalus Following Mumps Encephalitis: Neuropathological Correlates and Review

Hydrocephalus is a rare and devastating complication of mumps encephalitis. The histopathological correlates of mumps infection in central nervous system tissues are not well-characterized. We present the case of a 54-year-old patient who suffered long-term neuropsychiatric sequelae and hydrocephalus as a consequence of a childhood mumps infection. Brain autopsy revealed significant dilation of the lateral and third ventricles. Aqueductal stenosis was not observed on premortem imaging or on gross examination. Histology revealed loss of ependymal epithelium throughout the aqueduct and ventricular system. Macrophage conglomerates were identified within the cerebral aqueduct at the level of the pons in addition to subjacent periaqueductal gliosis and scattered Rosenthal fibers. Together, these findings support primary ependymal injury as a pathophysiological mechanism in the development of chronic hydrocephalus following mumps infection. Finally, we review the existing literature and discuss potential mechanisms of disease.