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Canadian Journal of Public Health

, Volume 102, Issue 1, pp 47–50 | Cite as

Mumps Virus Detection During an Outbreak in a Highly Unvaccinated Population in British Columbia

  • Kennard E. TanEmail author
  • Maureen Anderson
  • Mel Krajden
  • Martin Petric
  • Annie Mak
  • Monika Naus
Quantitative Research
  • 1 Downloads

Abstract

Objectives

Control measures of mumps involve isolation of those symptomatic or potentially exposed. Recent guidelines have recommended shortening the isolation period from 9 days to 5 days after the onset of parotitis, despite using mainly historical evidence. In British Columbia, mumps circulated in a predominantly unvaccinated population in 2008. We compared laboratory findings between the different vaccination groups and assessed the period of mumps viral detection after onset of parotitis.

Methods

Demographic and clinical data were collected according to guidelines during the course of the outbreak. Clinical specimens, including buccal swabs, urine, CSF and sera, were collected on a single visit upon presentation for diagnosis. Laboratory diagnosis of mumps was confirmed by either virus detection by PCR and/or isolation in cell culture from clinical specimens, or by serology.

Results

Laboratory testing confirmed mumps on 85 (74%) of 115 cases by virus detection and/or serology. Thirty-nine (78%) of 50 cases had virus detected within the first 5 days after onset of parotitis, with the rate highest in specimens collected early. However, virus could be detected in 5 (56%) of 9 cases after day 5 and up to day 9.

Conclusion

Our study questions whether a 5-day isolation period is sufficient to prevent mumps transmission in a susceptible population. Our observations are based on single specimen submission, whereas an optimal study design would entail serial collection after presentation of parotitis, as this reflects true viral shedding. Further investigations are warranted to validate patient isolation guidelines.

Key words

Mumps polymerase chain reaction virus shedding patient isolation 

Résumé

Objectifs

La lutte contre les oreillons consiste à isoler les personnes symptomatiques ou potentiellement exposées. Des lignes directrices récentes recommandent de réduire la période d’isolement de 9 à 5 jours après l’apparition d’une parotidite, mais les preuves à l’appui sont principalement de nature historique. En Colombie-Britannique, les oreillons ont circulé en 2008 dans une population majoritairement non vaccinée. Nous avons comparé les résultats de laboratoire des deux groupes (vaccinés et non vaccinés) et déterminé le délai de détection virale des oreillons après l’apparition de la parotidite.

Méthode

Nos données démographiques et cliniques ont été recueillies selon les lignes directrices, durant l’éclosion. Des prélèvements cliniques (buccaux, urinaires, de liquide céphalorachidien et de sérum) ont été obtenus au cours d’une même visite de diagnostic. Le diagnostic d’oreillons obtenu en laboratoire a été confirmé soit au moyen d’une détection virale par RPC et/ou par isolement en culture cellulaire à partir des prélèvements cliniques, soit par sérologie.

Résultats

Les épreuves de laboratoire ont confirmé les oreillons dans 85 des 115 cas (74 %), par détection virale et/ou par sérologie. Dans 39 cas sur 50 (78 %) le virus a été détecté dans un délai de 5 jours après l’apparition de la parotidite, le taux le plus élevé ayant été observé dans les échantillons prélevés tôt. Cependant, on pouvait encore détecter le virus dans 5 cas sur 9 (56 %) après le jour 5 et jusqu’au jour 9.

Conclusion

On peut se demander si une période d’isolement de 5 jours est suffisante pour prévenir la transmission des oreillons dans une population réceptive. Nos observations reposent sur une seule séance de prélèvement, tandis qu’un protocole d’étude optimal impliquerait une série de prélèvements après l’apparition de la parotidite, pour tenir compte de l’excrétion réelle du virus. Il faudrait pousser la recherche pour valider les lignes directrices sur l’isolement des patients.

Mots clés

oreillons réaction de polymérisation en chaîne excrétion virale isolement du patient 

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Copyright information

© The Canadian Public Health Association 2011

Authors and Affiliations

  • Kennard E. Tan
    • 1
    Email author
  • Maureen Anderson
    • 2
  • Mel Krajden
    • 3
  • Martin Petric
    • 3
  • Annie Mak
    • 3
  • Monika Naus
    • 2
  1. 1.Department of Pathology and Laboratory Medicine, UBC, Rm 1501Vancouver General HospitalVancouverCanada
  2. 2.Epidemiology ServicesBritish Columbia Centre for Disease ControlVancouverCanada
  3. 3.Laboratory ServicesBritish Columbia Centre for Disease ControlVancouverCanada

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