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Resurgence of Mumps in Korea

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대한감염학회 (The Korean Society Of Infectious Diseases)|2015.03|Infection and Chemotherapy|제47권 제1호|pp. 1-11

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키워드

AdolescentsRepublic of KoreaIncidenceMaleMumpsDisease outbreaksGenotypeMumps vaccine
주제분류내과학

초록

Routine vaccination against mumps has markedly reduced its incidence. However, the incidence of mumps continuously hasincreased since 2007. In 2013, a large mumps epidemic occurred in Korea, and this epidemic is still an ongoing problem. Thisepidemic occurred primarily in school settings and affected vaccinated adolescents, predominantly male students. The recentresurgence of mumps is caused by multiple factors: suboptimal effectiveness of the current mumps vaccines, use of the Rubinistrain 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 intenseexposures. Containment of mumps outbreaks is challenging because the sensitivity of diagnostic tests is low among vaccineesand control measures are less efficient because of the inherent nature of the mumps virus. Despite the suboptimal vaccine effectivenessin 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 comparedwith that in the pre-vaccine era. In order to control the current mumps epidemic and prevent further outbreaks, we needto better understand the dynamics of mumps among vaccinated populations and the changing epidemiology in Korea. Concertedefforts should be made to systematically monitor the immunization status of the Korean population and to improve diagnosisefficiency. Furthermore, more effective mumps vaccines need to be developed in the future.

Abstract

Routine vaccination against mumps has markedly reduced its incidence. However, the incidence of mumps continuously hasincreased since 2007. In 2013, a large mumps epidemic occurred in Korea, and this epidemic is still an ongoing problem. Thisepidemic occurred primarily in school settings and affected vaccinated adolescents, predominantly male students. The recentresurgence of mumps is caused by multiple factors: suboptimal effectiveness of the current mumps vaccines, use of the Rubinistrain 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 intenseexposures. Containment of mumps outbreaks is challenging because the sensitivity of diagnostic tests is low among vaccineesand control measures are less efficient because of the inherent nature of the mumps virus. Despite the suboptimal vaccine effectivenessin 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 comparedwith that in the pre-vaccine era. In order to control the current mumps epidemic and prevent further outbreaks, we needto better understand the dynamics of mumps among vaccinated populations and the changing epidemiology in Korea. Concertedefforts should be made to systematically monitor the immunization status of the Korean population and to improve diagnosisefficiency. Furthermore, more effective mumps vaccines need to be developed in the future.

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