Brotes epidémicos de parotiditis, revisión de la literatura / Mumps outbreaks, literature review

La parotiditis es un infección viral producida por el virus parotídeo. Clínicamente se caracteriza por aumento de volumen de la glándula parótida generalmente bilateral. La estrategia que ha mostrado ser más eficaz para la prevención de esta infección ha sido la implementación de la vacuna tres vírica en los programas de inmunización. En países con población altamente inmunizada como Chile, se logró una importante disminución de la incidencia de esta enfermedad. Sin embargo, a pesar de la efectividad de la vacuna se siguen reportando brotes en todo el mundo, evidenciándose un cambio epidemiológico, trasladándose la edad de presentación clínica desde la niñez y adolescencia hacia los adultos jóvenes. Este aumento en el número de casos ha sido estudiado, determinando que el efecto protector inmunitario de la vacuna decaería con el transcurso del tiempo, contribuyendo a la propagación de los brotes. Con respecto a posibles estrategias para el manejo de los brotes la aplicación de una dosis adicional de la vacunas tres vírica en población expuesta sería una medida que mejoraría el control de los brotes.

Mumps is a viral infection caused by mumps virus. Clinically, it is characterized by increased parotid volume. The most effective strategy for preventing this infection, has been the implementation of measles-mumps-rubella (MMR) vaccine in the national immunization program. Among countries with a highly immunized population, like Chile, there has been an important reduction in the incidence of this disease. Nevertheless, despite the effectivity of the MMR, there are reports of outbreaks worldwide, with an epidemiological change, from clinical presentation in childhood, to adolescents and adults. This outbreaks have been studied, and it has been determined that they are due to the waning of vaccine-derived immunity. Regarding strategies for the management of new outbreaks, the administration of an additional dose of MMR, would be an alternative.

Meningitis aguda posterior a vacuna tresvírica / Acute meningitis following mumps vaccine

Resumen En Chile, la cepa del virus parotídeo utilizada en la vacuna es Leningrad-Zagreb (L-Z). Aunque la relación entre meningitis y la cepa L-Z sigue siendo controvertida, la mayoría de los casos reportados han presentado un cuadro de curso benigno y sin secuelas neurológicas. Presentamos el caso de una paciente que tres semanas post-inmunización con la vacuna tresvírica evolucionó con una meningitis aséptica de predominio mononuclear, con serología para IgM positiva contra el virus parotídeo. En este caso clínico, existió una relación temporal entre la vacunación, el inicio del cuadro parotídeo y posteriormente el meníngeo; la curva de inmunoglobulinas demostró una infección aguda posterior a la vacuna. Si bien no se logró aislar el virus en LCR, es razonable atribuir el cuadro a una infección post-vacunal.

In Chile, the strain of the mumps virus used in the vaccine is Leningrad-Zagreb (L-Z). Although the relationship between meningitis and the L-Z strain remains controversial, most of the reported cases have shown a benign course without permanent neurological sequelae. We present a case of a patient who presented an aseptic meningitis three weeks after immunization with a mumps vaccine; and laboratory confirmation showed positive serum mumps IgM antibody. In this clinical case, there was a temporal relationship between vaccination and the onset of the mumps and subsequently the meningeal involvement; the immunoglobulin curve demonstrates acute infection after vaccination. Although it was not possible to isolate the virus in CSF, it is reasonable to attribute the picture to a post-vaccinal infection.

Epidemiological characteristics of mumps in mainland China from 2004 to 2018 and key population for prevention and control / 中国当代儿科杂志

OBJECTIVE@#To investigate the epidemiological characteristics of mumps in mainland China from 2004 to 2018, and to provide data for the key population for prevention and control of mumps.@*METHODS@#The epidemiological characteristics of mumps were analyzed with reference to the data of the cases of mumps reported in the National Scientific Data Sharing Platform for Population and Health and Disease Prevention and Control Bureau of National Health Commission of the People's Republic of China. Descriptive epidemiology was used to analyze the epidemiological characteristics of mumps.@*RESULTS@#A total of 4 272 368 cases of mumps were reported in China during 2004-2018, with an average annual reported incidence rate of 21.44/100 000. A single dose of mumps-containing vaccine was added to the national Expanded Program of Immunization in 2008, but the annual incidence rate ranged from 12.84/100 000 to 35.59/100 000. The second dose of measles, mumps and rubella combined attenuated live vaccine was included in the routine immunization in Beijing, Tianjin and Shanghai, and then the average incidence rate of mumps reported in these three regions dropped to about 10/100 000. From 2004 to 2016, the population aged 3-14 years accounted for 81.16% of all patients with mumps. The children aged 6 years had the highest incidence rate of mumps during 2004-2013.@*CONCLUSIONS@#A single dose of mumps-containing vaccine has no obvious effect on the incidence rate of mumps. Children aged 6 years have the highest incidence rate of mumps. A booster dose of mumps-containing vaccine should be given to preschool children.

Parotiditis reemergente: un nuevo brote epidémico / Reemergent parotitis: A new epidemic outbreak

Antecedentes. La parotiditis epidémica es una infección viral aguda que produce la inlamación de una o más glándulas salivales, fundamentalmente, la parótida. Es considerada una enfermedad altamente infecto-contagiosa, pero que habitualmente es benigna. con brotes epidémicos que ocurren cada 2, 3 a 7 años en poblaciones no vacunadas. En países sin programas nacionales de vacunación, la incidencia general calculada es de 100 a 1,000 casos por cada 100,000 habitantes. Objetivo. Realizar una búsqueda exhaustiva mediante una revisión sistemática y actualizada de la Parotiditis, para obtener información reciente y estandarizada en el manejo de casos posibles, sospechosos y conirmados. Métodos. Se realizó una búsqueda de artículos originales, revisiones sistemáticas, y artículos de revisión bibliográica en bases de datos indexadas PUBMED, HINARI, SCOPUS, SCIELO, LILACS desde 2012 a 2018. Desarrollo y conclusión. Las parotiditis siguen siendo una enfermedad común en muchas áreas del mundo, su propagación depende de diversos factores asociados, pero controlables. Pese a que existe un programa nacional de inmunizaciones, la vacunación sigue siendo nuestra mejor defensa para la prevención y erradicación de esta patología reemergente. Es importante tener un conocimiento adecuado de esta enfermedad viral, para realizar un abordaje clínico certero, realizando un buen diagnóstico diferencial y brindando un tratamiento adecuado, para evitar las complicaciones, que, aunque sean poco frecuentes, tienen una alta probabilidad de mortalidad...(AU)

Parotiditis en Chile: caracterización clínica y molecular de dos casos en una población altamente inmunizada / Parotiditis in Chile: clinical and molecular characterization of two cases in a highly vaccinated population

Resumen El virus de la parotiditis produce una infección benigna caracterizada por un aumento de volumen parotídeo que, antes de la introducción de la vacuna tres vírica, afectaba principalmente a niños y adolescentes. Luego de que esta vacuna se implementara en el Programa Nacional de Inmunizaciones, se produjo una notable disminución en su incidencia. Además, ocasionó un cambio en la edad y presentación clínica, siendo más frecuente en adultos jóvenes con mayor riesgo de complicaciones. Presentamos dos casos clínicos de parotiditis en adultos jóvenes confirmados por serología y en uno de ellos, por biología molecular. Se caracterizó el virus como del genotipo G, como el descrito en los brotes en E.U.A y Europa, diferente al virus contenido en la vacuna. El virus parotídeo sigue circulando en nuestro país y debemos mantenernos alerta ante eventuales brotes. Se hace relevante optimizar el diagnóstico etiológico por serología o técnicas de biología molecular con fines clínicos y epidemiológicos.

Mumps virus usually produces a benign infection characterized by increased parotid volume which, prior to vaccination, mainly affected children and adolescents. After the introduction of measles, mumps and rubella (MMR) vaccine, mumps incidence decreased dramatically. This intervention also produced a change in its clinical presentation, moving to young adult patients, with an increased risk of complications. We report two clinical mumps cases in young adults with different clinical presentations. In both cases, serologic assays were assessed and, in one case, a polymerase chain reaction (PCR) was performed in order to confirm the diagnosis. The isolated virus was characterized and identifed as G genotype, the same genotype observed during outbreaks in United States and Europe, and different to the vaccinal strain. Mumps virus is currently circulating in Chile and it is important to be aware of possible outbreaks. Viral diagnosis can be difficult, particularly in populations with high vaccination coverage. Therefore, the access to etiologic study through PCR and serology becomes more relevant in order to optimize clinical management and secondary prevention measures.

Static model simulation for routine mumps vaccination in Japan: with a result of mumps-related complications in a Japanese community hospital

PURPOSE: Mumps vaccine has not been included in the routine national immunization program in Japan, leading to low vaccine coverage rates and periodic epidemics approximately every 5 years. Our hospital (a secondary community hospital in Japan) experienced an increased number of mumps-related complications with a nationwide epidemic in 2016. Using previously reported data and mumps-related cases in our hospital, we estimated the cost-effectiveness of routine mumps vaccination in Japan with a static model using current epidemiologic data. MATERIALS AND METHODS: With a decision tree flowchart of mumps infection and adverse events, we estimated the burden of mumps-related complications in our hospital for 5 years, and calculated the current annual national burden. Finally, we compared the current burden and assumptive burden of the stable state after routine vaccination in Japan using a static model. RESULTS: The cost-benefit ratios with sensitivity analysis were 3.69 (1.08-9.52) and 6.84 (1.51-23.73) in independent inoculation and simultaneous inoculation, respectively, from a social perspective in addition to an annual gain of 9,487 (3,227-14,659) quality adjusted life years. CONCLUSION: We contributed additional evidence in terms of cost-effectiveness that routine mumps vaccination should be introduced in Japan with simultaneous inoculation.

Resurgence of Mumps in Korea / 감염과화학요법

Routine vaccination against mumps has markedly reduced its incidence. However, the incidence of mumps continuously has increased since 2007. In 2013, a large mumps epidemic occurred in Korea, and this epidemic is still an ongoing problem. This epidemic occurred primarily in school settings and affected vaccinated adolescents, predominantly male students. The recent resurgence of mumps is caused by multiple factors: suboptimal effectiveness of the current mumps vaccines, use of the Rubini strain vaccine, waning immunity in the absence of natural boosting due to the marked reduction in the mumps incidence, genotype mismatch between the vaccine and circulating mumps virus strains, and environmental conditions that foster intense exposures. Containment of mumps outbreaks is challenging because the sensitivity of diagnostic tests is low among vaccinees and control measures are less efficient because of the inherent nature of the mumps virus. Despite the suboptimal vaccine effectiveness in outbreak settings, maintaining the high vaccine coverage is an important strategy to prevent mumps outbreaks, given that the routine use of mumps vaccines has substantially reduced the incidence of mumps and its complications as compared with that in the pre-vaccine era. In order to control the current mumps epidemic and prevent further outbreaks, we need to better understand the dynamics of mumps among vaccinated populations and the changing epidemiology in Korea. Concerted efforts should be made to systematically monitor the immunization status of the Korean population and to improve diagnosis efficiency. Furthermore, more effective mumps vaccines need to be developed in the future.

Outbreaks of mumps: an observational study over two decades in a single hospital in Korea / 소아과

PURPOSE: The introduction of the mumps vaccine has dramatically reduced the number of mumps cases, but outbreaks have recently occurred among highly vaccinated populations in developed countries. Epidemiological and clinical characteristics of patients with mumps admitted between 1989 and 2012 in a single hospital in Korea are described in the present study. METHODS: We retrospectively evaluated inpatients with mumps between 1989 and 2012 and outpatients and inpatients with mumps in 2011-2012. RESULTS: A total of 152 patients with mumps were admitted between 1989 and 2012, and 163 patients were recorded in 2011-2012. The highest number of admitted cases occurred in 1998 and 2012 (35 and 34 cases, respectively). Among the patients admitted in 2011-2012, the highest frequency was observed among people aged 15-19 years, and low frequency was observed in those aged 20 years, compatible to the city data and national data. In patients admitted to our department in 1998 (35 cases) and in 2010-2012 (27 cases), there were significant differences in the mean age and the rate of secondary measles-mumps-rubella (MMR) vaccination, but had similar clinical features, including complications, except aseptic meningitis. Antimumps immunoglobulin (Ig) G was positive in 83% and 100%, and IgM was positive in 67% and 41%, respectively, in the two periods. CONCLUSION: In Korea, recent mumps outbreaks have occurred mainly among secondary school students who received two doses of the MMR vaccine. The vaccinees might have a modified immune reaction to viral insults, manifesting modified epidemiological and clinical features.

Monitoramento rápido de coberturas vacinais pós-campanhas de vacinação no Brasil: 2008, 2011 e 2012 / Rapid monitoring of vaccination coverage following vaccination campaigns in Brazil: 2008, 2011 and 2012

Objetivo: descrever os resultados do monitoramento rápido de coberturas (MRC) pós-campanha de vacinação com tríplice viral (SRC) (2008 e 2011) e multivacinação com vacinas do calendário da criança (2012). Métodos: estudo descritivo, com dados do Programa Nacional de Imunizações sobre coberturas vacinais (CV) administrativas, MRC e motivos para não vacinação (2011-2012). Resultados: a CV da SRC superou 95 por cento nas campanhas; pelo MRC, a CV com uma dose da SRC foi 92 por cento, em 2008, e 96 por cento, em 2011; em 2011, pelo MRC, foram administradas 41,7 mil doses da SRC, elevando a CV para 99,5 por cento; em 2012, a CV pelo MRC variou entre 97 por cento para poliomielite e hepatite B e 82 por cento para reforço 2 da vacina difteriatétano-coqueluche (DTP); falta de tempo representou o principal motivo para não vacinação (43,6 por cento em 2011 e 32,7 por cento em 2012). Conclusão: o MRC é ferramenta útil para avaliar CV e resgatar não vacinados, fornecendo subsídios para intervenções.

Objective: describe rapid monitoring of vaccination coverage (RMC) following Measles Mumps Rubella (MMR) (2008-2011) and Multivaccination (2012) vaccination campaigns. Methods: descriptive study using National Immunization Program administrative data on vaccine coverage as well as RMC data, in addition to data on the grounds for non-vaccination (2011-2012). Result: MMR vaccine coverage exceeded 95 per cent in the campaigns. RMC data on a single dose of MMR found 92 per cent post-campaign coverage in 2008 and 96 per cent in 2011. In 2011, 41,700 MMR doses were administered post-campaign, raising vaccination coverage to 99.5 per cent in that year. In 2012 post-campaign coverage ranged between 97 per cent (polio and hepatitis B) and 82 per cent (second diphtheria-tetanus-pertussis booster). "Lack of time" was the main motive for non-vaccination (43.6 per cent in 2011 and 32.7 per cent in 2012). Conclusion: RMC is a useful tool for evaluating vaccination coverage and reaching those not vaccinated, in addition to informing interventions.

Comparative analysis on the complete genome sequence of mumps epidemic strain and mumps vaccine strain S79 isolated in Zhejiang province, China between year 2005 and 2010 / 中华预防医学杂志

<p><b>OBJECTIVE</b>To compare the differences in the complete genome sequence between mumps epidemic strain and mumps vaccine strain S79 isolated in Zhejiang province.</p><p><b>METHODS</b>A total of 4 mumps epidemic strains, which were separated from Zhejiang province during 2005 to 2010, named as ZJ05-1, ZJ06-3, ZJ08-1 and ZJ10-1 were selected in the study. The complete genome sequences were amplified using RT-PCR. The genetic differences between vaccine strain S79 and other genotype strains were compared; while the genetic-distance was calculated and the evolution was analyzed.</p><p><b>RESULTS</b>The biggest difference between the 4 epidemic strains and the vaccine strain S79 was found on the membrane associated protein gene; whose average nucleotide differential number was 42.5 +/- 3.0 and the average variant ratio was 13.6%; while the mean amino acid differential number was 12.8 +/- 1.5 and the average variant ratio was 22.4%. The smallest difference among the 4 epidemic strains and the vaccine strain was found in stromatin genes, whose average nucleotide differential number was 73.8 +/- 2.5 and the average variant ratio was 5.9%; while the mean amino acid differential number was 3.0 +/- 0.8 and the average variant ratio was 0.8%. The dn/ds value of the stromatin genes of the 4 epidemic strains reached the highest, as 0.6526; but without any positive pressure (dn/ds < 1, chi2 = 0.87, P > 0.05). There were mutations happened on the known antigen epitope, as 8th amino acid of membrane associated protein genes and on the 336th and 356th amino acid of hemagglutinin/neuraminidase proteins. Compared with the vaccine strain, the glycosylation sites of ZJ05-1, ZJ06-3, ZJ08-1 and ZJ10-1 increased 1, 1, 2 and 2 respectively. The complete amino acid sequence of all strains showed that there were 17 characteristic sites found on the genotype-F mumps strain. Within the complete genome, the genetic-distance between epidemic strains and vaccine strains in Zhejiang province (0.071) was significantly larger than the genetic-distance between strains in Yunnan province (0.013); the difference showing statistical significance (t = 4.14, P < 0.05). Except nucleocapsid protein genes, all the genes shared similar evolution tree.</p><p><b>CONCLUSION</b>There were significant differences found in the genes between mumps epidemic strain and mumps vaccine in Zhejiang province.</p>

Mumps outbreak in Incheon, Korea, 2009 / 소아과

PURPOSE: Recently, we have noticed an increase in the number of patients with mumps in Incheon, Korea. The aim of this study is to estimate the regional trend in mumps incidence and to evaluate the factors related to the recent increase. METHODS: We reviewed the medical records of 66 patients with mumps who had been admitted to Incheon St. Mary's Hospital from July 1999 to June 2009. We compared the differences in records between "outbreak, 2009" and "nonoutbreak, 2000-2008." RESULTS: Of the 66 patients, 35 (53%) were admitted in 2009, and 31 (47%) were admitted between 2000 and 2008. Most of the patients admitted during the outbreak were over 15 years of age (80.0%), were born before 1993 (77.1%), and had received a single dose of mumps vaccine (62.9%). There were no significant differences in contact history, present address, clinical manifestations, and complications, except for orchitis, between the two groups. CONCLUSION: There was a sharp increase in the number of inpatients with mumps who were born before 1993 and who were over 15 years of age. We recommend that a booster vaccination be considered for adolescents and young adults born before 1993 who are susceptible to mumps infection due to their reduced opportunities for receiving two doses of mumps vaccine.

Structure-function analysis of two variants of mumps virus hemagglutinin-neuraminidase protein

A point mutation from guanine (G) to adenine (A) at nucleotide position 1081 in the hemagglutinin-neuraminidase (HN) gene has been associated with neurovirulence of Urabe AM9 mumps virus vaccine. This mutation corresponds to a glutamic acid (E) to lysine (K) change at position 335 in the HN glycoprotein. We have experimentally demonstrated that two variants of Urabe AM9 strain (HN-A1081 and HN-G1081) differ in neurotropism, sialic acidbinding affinity and neuraminidase activity. In the present study, we performed a structure-function analysis of that amino acid substitution; the structures of HN protein of both Urabe AM9 strain variants were predicted. Based on our analysis, the E/K mutation changes the protein surface properties and to a lesser extent their conformations, which in turn reflects in activity changes. Our modeling results suggest that this E/K interchange does not affect the structure of the sialic acid binding motif; however, the electrostatic surface differs drastically due to an exposed short alpha helix. Consequently, this mutation may affect the accessibility of HN to substrates and membrane receptors of the host cells. Our findings appear to explain the observed differences in neurotropism of these vaccine strains.

Seroprevalence of antibodies to measles, mumps, and rubella among Thai population: evaluation of measles/MMR immunization programme.

Stored serum specimens, from four regions of Thailand, of healthy children attending well baby clinics and of healthy people with acute illnesses visiting outpatient clinics were randomly sampled and tested for IgG antibody to measles, mumps, and rubella (MMR). The immunity patterns of rubella and mumps fitted well with the history of rubella and MMR vaccination, seroprotective rates being over 85% among those aged over seven years. A high proportion of younger children acquired the infection before the age of vaccination. MMR vaccination should preferably be given to children at an earlier age. For measles, 73% seroprotective rates among children, aged 8-14 years, who should have received two doses of measles/MMR vaccine, were lower than expected. This finding was consistent with the age-group reported in outbreaks of measles in Thailand. The apparent ineffectiveness (in relation to measles) of MMR immunization of 1st grade students warrants further studies.

Seroprevalence of mumps before inclusion of mumps vaccination in the Iranian Expanded Programme on Immunization

The current target groups for measles, mumps and rubella vaccination in the Islamic Republic of Iran are children at 12 months and 4-6 years. A study of the age-specific seroprevalence of antibodies against mumps in children aged 3-18 years in Shahrekord aimed to establish the need for booster vaccinations to cover non-immune children. Of 338 children, 19.8% were seronegative. Age-specific seronegativity was 33.3%, 20.5% and 4.6% in age groups 7-11, 12-14 and 15-18 years respectively. To obtain herd immunity, we suggest that for the next 5 years children aged 7-11 years entering guidance school are selected as the main group for vaccination

Evaluation of live attenuated S79 mumps vaccine effectiveness in mumps outbreaks: a matched case-control study / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Mumps virus infection is a potentially serious viral infection of childhood and early adulthood. In China, live attenuated S(79) mumps vaccine has been licensed for pediatric use since 1990. The objective of this study was to determine the effectiveness of live attenuated S(79) mumps vaccine against clinical mumps in outbreaks.</p><p><b>METHODS</b>Cases were selected from mumps outbreaks in schools in Guangzhou between 2004 and 2005. Each case was matched by gender, age and classroom. Vaccination information was obtained from Children's EPI Administrative Computerized System. Vaccine effectiveness (VE) was calculated for 1 or 2 doses of S(79) vaccine with 95% confidence intervals (CI).</p><p><b>RESULTS</b>One hundred and ninety-four cases and 194 controls were enrolled into the study. VE of the S(79) mumps vaccine for 1 dose versus 0 confer protection 80.4% (95% CI, 60.0%-90.4%) and VEs against mumps in outbreaks for 1 dose of mumps vaccine are similar among those children aged 4-9 years and aged over 10 years old.</p><p><b>CONCLUSION</b>The live attenuated S(79) mumps vaccine can be effective in preventing clinical mumps outbreaks.</p>

Evaluation of Mumps Vaccine Effectiveness by outbreak investigation in one kindergarten in Ulsan city, 2006 / 한국역학회지

PURPOSE: Despite of the high MMR vaccine coverage, the mumps outbreaks is continued in most developed countries including South Korea. To evaluate the effectiveness of MMR vaccine, we carried out mumps outbreak investigation in one kindergarten. METHODS: In Dec. 2006, a mumps outbreak occurred in a kindergarten. Retrospective study was conducted among 212 respondents (205 children and 7 teachers) in 230 study populations (study participation rate: 92%). To define mumps cases, a questionnaire survey, telephone survey, and mumps antibody test with serum were conducted. MMR vaccination status was verified in 198 children using children's vaccination records, National Immunization Registration System and/or medical records of private clinics or hospitals. RESULTS: Over 90% children had received one dose of MMR vaccination. However, 2nd dose of MMR vaccination rate was 45.1%. Attack rates of mumps were 22.9%(22/96) for one dose MMR vaccinees and 3.3%(3/92) for two doses vaccinees. MMR vaccine effectiveness of two doses over one dose was 86%. Mumps attack rate in one dose MMR vaccinees increased by the duration after MMR vaccination. Among all mumps cases, asymptomatic mumps infection identified by IgM positive or IgG over 10,000mIU/ml was 58% (26/ 45). CONCLUSIONS: MMR one dose coverage rate was high(92.1%), but the second dose vaccination rate was very low (45.1%). Mumps attack rate was increased by the duration after the MMR vaccination, and the maximum effectiveness of one dose MMR vaccination was low (77.1%). Therefore, to prevent mumps outbreaks in the kindergarten, second MMR vaccination should be scheduled in 4 years old age, and the coverage rate should be increased over 90%. Further studies for the effectiveness of MMR two doses after 5 and more years are needed.

Frequency of lymphocytic meningitis associated with mumps before and after a mass campaign for mumps vaccination in children from Salvador, Northeast Brazil

OBJECTIVE: To describe the frequency of lymphocytic meningitis(LM) concomitant with mumps, before and after the mumps mass immunization campaign in 1997. METHOD: Demographic, clinical and cerebrospinal fluid(CSF) information was collected from the chart of all patients aged from 2 to 59 months, whose CSF exam was performed at the CSF Lab/FJS, between 1989 and 2001. LM was defined as pleocytosis composed by lymphomononuclear cells and negative exams for bacterial or mycologic infection. RESULTS: Of 1,519 patients, 894(58.9 percent) had normal exams. LM was present in 301(19.8 percent) patients, out of which 22(7.3 percent) had concomitant mumps. The frequency of LM ranged from 15.8 percent in 1989 to 19.7 percent in 2001 and of LM with concomitant Mumps ranged from 10.5 percent in 1989 to 4.7 percent in 1995, when the last cases were registered. CONCLUSION: It is probable that the mumps vaccine campaign has influenced the absence of LM with concomitant Mumps, from 1996 to 2001

Parotiditis endémica / Endemic parotitis

La parotiditis es una enfermedad que por su magnitud ha sido denominada por la Organización Mundial de la Salud como endémica. Entre los años 2000 y 2001 afectó en México a más de 46,000 personas y en 2002 a 14,738 personas, con tasa de incidencia para este último año de 8.63 casos por cada 100,000 habitantes. La mayor incidencia se presentó en el estado de Guanajuato, con una tasa de 58.51 por cada 100,000 habitantes, seguido por Jalisco (46.12), Nueva León (30.42), Sinaloa (27.08) y Baja California Sur (26.21); en comparación con Michoacán (4.95), Morelos (5.59), Puebla (6.14), México (7.16) y Chiapas (7.72). POr ser uona patología propia del sistema estomatognático, debe ser conocida y manejada por el cirujano dentista en su práctica clínica, para lo cual se exponen los elementos básicos del diagnóstico epidemiológico, clínico y tratamiento en el consultorio dental

Parotiditis y vacuna antiparotídica: perfil de seguridad de las cepas del virus de parotiditis en las vacunas combinadas trivalentes / Parotiditis and mumps vaccine: security profile of the cepas of mumps virus in the vaccines combined

La utilización de vacunas combinadas con cepas de sarampión, parotiditis y rubéola son posibles en varias regiones desarrolladas del mundo, particularmente en países en vías de desarrollo, con dramática reducción en la incidencia de las tres enfermedades. Los datos epidemiológicos venezolanos así lo demuestran. Los componentes de sarampión y rúbeola en la vacuna combinada son de comprobada seguridad y eficacia, sin embargo, las cepas anti-parotidíticas Urabe Am9 y Leningrado-Zagred aunque han demostrado tener alta eficacia, se han asociado en la aparición de meningitis aséptica pos-vacunal. La cepa vacunal de parotiditis Jeryl lynn (Mereck Sharp & Dohme) y la nueva cepa modificada de Jeryl Lynn: RIT-4385 (Glaxo SmithKline Biologicals, Rixensart, Belgica) se relacionan a altos índices de seguridad y eficacia; con incidencia de meningitis aséptica de 0 casos en 600.000 dosis administradas, según estudios publicados. El conocimiento de los efectos adversos asociados a la vacunación pueden tener un significativo impacto sobre la adherencia a los programas de vacunación