Surveillance of mumps in the United States as background for use of vaccine.

MUMPS is a common infectious disease, particularly among children. Although the illness is not usually severe, considerable morbidity and loss of time from school occur because of the large numbers affected. In addition, a number of complications may ensue. Meningeal involvement is the most common complication, but central nervous system disease with residua is rare. However, orchitis, which occurs in approximately 20 percent of postpubertal males with clinical mumps, is a significant complication. The symptomatic ininvolvement of other organs occurs less frequently. The loss of productive time because of uncomplicated mumps as well as the morbidity associated with meningitis and orchitis are reasonable justification for mumps prevention. In the past, the use of hyperimmune globulin and inactivated vaccines has proved to be less than optimal in both effectiveness and duration of protection. A live attenuated mumps virus vaccine, developed recently, appears to be both safe and effective (1-3). No adverse reactions, including fever, have been observed among the more than 6,000 susceptible persons who have received this mumps vaccine. Although antibodies have developed in more than 95 percent of the vaccinees, knowledge regarding the duration of immunity is not yet available. Currently, studies of natural challenge and antibody levels indicate a durable immunity beyond 1 year. The availability of the live attenuated mumps virus vaccine demands a rationale for its use. Since recommendations for the use of a vaccine must relate to the epidemiologic characteristics of the disease, this paper presents a review of the available surveillance data for mumps in the United States.