Mumps antibodies in the cord blood: Association with maternal recall of mumps. Possible consequences for vaccination strategies.

The present study aims to contribute to the evaluation of the serological impact of vaccination against mumps in Portugal, measuring anti-mumps IgG (MuIgG) levels in cord sera and the corresponding proportions of seropositive newborns, and their association with potential predictive variables. The data from this study came from 198 umbilical cord sera. Detailed vaccination records were available for all mothers. MuIgG were measured in the sera, using a commercial immunoassay. The geometric mean concentration (GMC) of MuIgG was 31.7 RU/ml. Seropositive/immune sera (concentration ≥16 RU/ml) were 75.3%. While 49 mothers were "unsure" about ever having had mumps, 46 said they had had the disease and 103 said they had not had it. Eighty eight women did not receive a single dose of MMR while the other received 1 or 2 doses, with different combinations of vaccine strains. This study found that recalling mumps was predictive of higher MuIgG GMC and seropositivity. Maternal age and vaccination status were not associated with GMC or seropositivity. Nevertheless, in the small subset of newborns from vaccinated mothers not recalling mumps, receiving two doses was predictive of higher GMC than just receiving one. Maternal recall of mumps is highly predictive of seropositivity while not recalling the disease results in numerous false-negatives. This is consistent with other studies and with the fact that infection with mumps virus can result in a wide range of clinical manifestations. We agree on the need for further research to support a recommendation of a three (or more)-dose MMR strategy but we also believe that evidence is fast accumulating in favour of a higher dose strategy. The issue of waning immunity due to vaccines when vaccination succeeds in controlling (and nationally eliminating) target diseases like measles and mumps must be urgently taken into account.

The response of a local health authority to reported cases of salmonellosis in a Portuguese municipality, 2007 to 2011.

BACKGROUND: Human salmonelloses are statutorily reportable infectious diseases (SRID) in Portugal. Data derived from SRID surveillance systems have been used in international comparisons as well as in studies assessing the sources and modes of transmission of Salmonella infections in humans. METHODS: We evaluated a salmonellosis (statutorily reportable) surveillance system in a Portuguese local health authority, consulting routine data available. The main objectives were describing procedures used to investigate and respond to reported cases, and identifying the sources of infection and modes of transmission. RESULTS: In the five year period from 2007 to 2011, medical doctors reported 58 cases of non-typhoidal salmonellosis to the local health authority. Fifty four reported cases were in hospitalized children (age range 1-19 years) and 44 were associated with drinking water from private wells or eating raw egg products, which is consistent with other studies. CONCLUSIONS: This local surveillance system was useful for detecting both isolated cases and outbreaks of salmonellosis and for identifying modes of transmission and sources of infection. It stimulated community health educational activities to prevent future cases. However, further evaluation including economic analysis and an impact assessment is required at both local and national levels.

Prevention of perinatal transmission of hepatitis B to babies at high risk: an evaluation.

We aimed to determine factors associated with successful vaccination coverage and development of infection in high-risk infants born to hepatitis B infected women. Immunisation of 860/932 (92%) of babies was started within 48 h of birth and three doses of vaccination completed for 794/921 (86%). Only 543 (58%) infants were tested and 26 (4.9%) were found to have evidence of current infection. Delayed start of immunisation was significantly associated with unbooked pregnancy, maternal hepatitis B e-markers and year. Current infection in the baby was strongly associated with maternal hepatitis B e-status, ethnicity and year of vaccination. The proportion of infants developing infection declined after 1998, coinciding with the publication of national recommendations and the wider use of the accelerated schedule.