Infectious Diseases- Mumps
Mumps Signs and Symptoms
Appear 2-3 weeks after exposure Most contagious 1-2 days *before* symptoms *Invades parotid gland (attracted to all glands)* *Swollen salivary glands of face or under jaw* Fever, headache, swallowing problems Fever falls 2-3 days Swelling abides 10 days
~95%, 62%
Early trials with the Jeryl Lynn vaccine strain demonstrated an efficacy of ____, but in epidemic conditions, the effectiveness has been as low as _____
Thimerasol
Known mercury in fish caused neurological damage- methylmercury; Body does not metabolize it and accumulates Mercury in ______metabolizes in the body to ethylmercury Not widely studied at the time, FDA has no recommendations for exposure to levels of ethylmercury FDA + American Academy of Pediatrics and other groups, they called for vaccine companies to reduce or eliminate the use of ______in vaccines Institute of Medicine undertook a comprehensive safety review of the issue 2004, reject the hypothesis that mercury in vaccines was associated with neurodevelopmental disorders *Today, ____ is no longer used in childhood vaccines, except influenza vaccine available in multi-dose vials*
Mumps complications
Meningitis 1 in 10 children Encephalitis (usually no permanent brain damage) *Males*- swelling in testes, sterility -Teenagers, adults *Females*- inflammation of ovaries -Older woman Inflammation of heart, pancreas Auditory nerve damage, deafness -5 in 10, 000 patients, usually only 1 ear, permanent
Monovalent
Merck no longer makes _____ vaccines (not available)- only makes MMR vaccine
Efficacy of Mumps Vaccine
*Stephen Krahling & Joan Wlochowski (2 former Merck scientists) file False Claims Act complaint 2010* Merck fabricated study data to promote vaccine effectiveness Ongoing fraud since the late 1990's Merck knowingly f*alsified its mumps vaccine test results to fabricate a 95% efficacy rate* -Spiked blood test with animal antibodies, artificially inflated appearance of immune system antibodies -Achieve more favorable test results, knowing human immune system would never produce such antibodies, and that the antibodies created a laboratory testing scenario that "did not in any way correspond to, correlate with, or represent real life ... virus neutralization in vaccinated people," *Used falsified trial results to swindle the U.S. government out of hundreds of millions of dollars for a vaccine that does not provide adequate immunization, monopolized 95% efficiency* *We still use it today*
Past Mumps Outbreaks
-2016-17: large outbreak in close-knit community in NW Arkansas, resulting in nearly 3,000 children -2015-16: outbreaks reported from several university campuses, including number of smaller outbreaks with limited spread. The 2 largest outbreaks were from Iowa and Illinois, each involving several hundred university students (both held large scale vaccination campaigns)
NHL Mumps Outbreak 2014
-Anaheim Ducks, Minnesota Wild, New Jersey Devils, New York Rangers, Pittsburgh Penguins, St. Louis Blues -20 players -Ex: Sidney Crosby- 2 vaccinations, last one Feb 2014 Sochi Olympics (he even went and saw sick kids) -Players in close contact during play, practice, travel -Players from around the globe, varying levels of immunity -Share water bottles
Mumps Treatment
-No specific treatment -Painkillers, fluids, compresses
Mumps Background
1968: 152,000 US cases (1st vaccine 1967) Everyone got it before vaccine Still prevalent in developing countries 438 confirmed cases U.S. in 2013 1,078 reported in 2014, through Nov. 29 4 outbreaks at universities 2014: Ohio State, Fordham, Wisconsin and Illinois
MMR Vaccine Controversy
1997 Wakefield files for patent for single-antigen measles vaccine 1998 *Wakefield + 12 others publish MMR Vaccine-Autism link paper, promotes getting the single measles vaccine $$$$* Wakefield had been paid by attorneys seeking to file lawsuits against vaccine manufacturers before he conducted the study 12 children, not statistically significant Most of the co-authors of the study retracted the interpretation in the paper 2010, The Lancet formally retracted the paper 2011- journalist reporting on the issue spoke to parents of children in the study, found evidence *Wakefield committed research fraud, falsifying data about children's conditions* Vaccine critics focused on *thimerosal*, (mercury-containing preservative used in some vaccines) *Thimerosal had never been used in MMR, as antimicrobial agents are not used in live vaccines.* *Helped lead to anti-vaxxer movement*
College Mumps Outbreaks
2006 Georgia Tech, Southern Illinois University-Carbondale, University of Virginia, University of Oregon 2008 Middlebury College, University of Toledo, University of Virginia 2009 Northeastern University (Boston) 2011 University of California- Berkeley 2014 Southern Illinois University-Carbondale, Fordham University, Ohio State, University of Wisconsin-Milwaukee 2015 *UT Austin*, Southern Illinois University-Carbondale
College Mumps Outbreaks
2006 Kansas University (2-dose MMR vaccination policy) ~200 cases 135 cases/421 students (complete records 2 MMR shots), 32% *May 2015- 7 cases UT-Austin* August 2015 Outbreak University of Illinois Urbana-Champaign (UIUC) 69 cases *Majority of afflicted students received 2 MMR vaccines *
Orchitis
Mumps can cause ______; painful testicular swelling (~1 week, 50% of patients)
Highly
Mumps is _____ contagious
Epidemic Parotidis
Mumps is caused by?
College
Mumps is common among _____ age people
Before
Mumps is most contagious 1-2 days ____ symptoms
Airborne
Mumps is spread by _____ transmission (droplets) -coughing, sneezing, talking, sharing drinks, silverware, kissing
Ineffective
Mumps vaccination is _____ 78% one shot (protected 10 years) 88% two shots (NOT good, began 1990s) Recommended booster is traveling abroad (over age 1)
1967
Mumps vaccine 1st approved in _____ (single dose)
Epidemic Parotidis (Mumps)
Paramyxovirus ssRNA virus Sensitive to heat and UV light Named for lump and mumble Mild disease, human reservoir
Vaccine Safety (mumps)
Rare- mild, brief fever 1-2 weeks after vaccine Exempt if allergic to eggs, impaired immune system, high fever No evidence of an association between increased exposure to vaccines and autism has appeared
Jernyl Lynn Strain
The MMR vaccine uses which strain (chick embryo fibroblasts)?
Mumps Diagnosis
Usually diagnosed from symptoms Confirmed viral culture (saliva or urine) Antibody titer- IgM vs IgG PCR Skin test no longer used- unreliable *Mumps skin test antigen (MSTA)*- injectable suspension containing inactive mumps virus particles Inactivated mumps virus particles injected into skin, immune system should send antibodies to injection site, form a red bump (positive response) No red bump- negative response
MMR vaccine
You need to wait until the child is 15 months old to receive the?
30+
_____ year olds are less likely to have higher immunity agains Mumps
Aluminum
_______ adjuvant in some vaccines as a potential cause of autism Amounts of ________ used in vaccines are small in comparison to other exposures such as in breast milk and infant formula ______ in vaccines has not been implicated in any infant or childhood health problems.
