-
Multiple Sclerosis (Houndmills,... Dec 2023Mumps-Measles-Rubella (MMR) and Varicella zoster vaccines (VAR) are live attenuated vaccines, usually administered in a two-dose scheme at least 4 weeks apart.... (Observational Study)
Observational Study
BACKGROUND
Mumps-Measles-Rubella (MMR) and Varicella zoster vaccines (VAR) are live attenuated vaccines, usually administered in a two-dose scheme at least 4 weeks apart. However, single-dose immunization schemes may also be effective and can reduce delays in immunosuppressive treatment initiation in patients with multiple sclerosis (pwMS) who need to be immunized.
OBJECTIVES
To evaluate the immunogenicity of a single-dose attempt (SDA) versus the standard immunization scheme (SIS) with VAR and/or MMR in pwMS.
METHODS
Retrospective observational study in pwMS vaccinated against VAR and/or MMR. We compared seroprotection rates and antibody geometric mean titers (GMTs) between the two strategies.
RESULTS
Ninety-six patients were included. Thirty-one patients received VAR and 67 MMR. In the SDA group, the seroprotection rate was 66.7% (95% confidence interval (CI): 53.3-78.3) versus 97.2% (95% CI: 85.5-99.9) in the SIS ( < 0.001). For the seroprotected patients, GMTs were similar for both schemes.
CONCLUSION
An SDA of VAR and/or MMR vaccines could be sufficient to protect almost two-thirds of patients. Testing immunogenicity after a single dose of VZ and/or MMR could be included in routine clinical practice to achieve rapid immunization.
Topics: Humans; Infant; Chickenpox Vaccine; Vaccines, Attenuated; Rubella; Multiple Sclerosis; Mumps; Measles; Vaccination; Antibodies, Viral
PubMed: 37728389
DOI: 10.1177/13524585231200303 -
Frontiers in Pediatrics 2022The initial presentations of childhood-onset primary Sjögren's syndrome (C-pSS) vary, making diagnosis challenging. We aimed to improve the diagnosis and evaluation of...
INTRODUCTION
The initial presentations of childhood-onset primary Sjögren's syndrome (C-pSS) vary, making diagnosis challenging. We aimed to improve the diagnosis and evaluation of C-pSS by summarizing its clinical and laboratory features.
METHODS
A total of 49 patients with C-pSS between July 2015 and August 2022 in the Department of Rheumatology and Immunology of Shanghai Children's Medical Centre were enrolled in this study. Their clinical manifestations and laboratory examinations of these patients were compared based on the presence or absence of thrombocytopenia and parotitis and whether the immunological markers, including anti-nuclear antibodies (ANA), rheumatoid factor (RF), anti-Ro52/SSA antibodies (anti-SSA/Ro52), anti-Ro60/SSA antibodies (anti-SSA/Ro60), and anti-Ro/SSB antibodies (anti-SSB), were positive.
RESULTS
The mean age at C-pSS diagnosis was 10.34 ± 3.45 years, and the ratio of boys to girls was 1:6. In the thrombocytopenia group, parotitis (= 0.044), organ involvement except for hematology (= 0.002), positive anti-SSB (= 0.004), and positive RF (= 0.001) were less frequently observed. Complement C4 (= 0.038) and white blood cells (= 0.002) levels decreased and increased significantly, respectively. Anti-SSB (= 0.010) and RF (= 0.004) positivity were independent potential protective factors against thrombocytopenia in patients with C-pSS. In the parotitis group, higher ANA titers (= 0.027), higher focus scores on labial gland biopsy (= 0.024), and positive RF (= 0.001), anti-SSA/Ro60 (= 0.003), and anti-SSB (= 0.001) were observed more frequently. Furthermore, positive anti-SSB (= 0.012) and positive RF (= 0.028) were independent risk factors for parotitis in patients with C-pSS. The hemoglobin level was significantly lower in patients with positive anti-SSA/Ro52 and positive anti-SSA/Ro60 results (= 0.022 and = 0.029, respectively), while immunoglobulin G level was significantly higher in patients in the same group (= 0.048 and = 0.007, respectively).
CONCLUSIONS
Positive anti-SSB and positive RF values may be independent potential protective factors of thrombocytopenia in patients with C-pSS. In contrast, positive anti-SSB and positive RF were independent risk factors of parotitis in patients with C-pSS. More studies are needed to reveal the diagnostic role and pathogenic mechanism of immunological markers in C-pSS.
PubMed: 36683822
DOI: 10.3389/fped.2022.1044812 -
ACG Case Reports Journal Jan 2020End-stage liver disease management requiring orthotopic liver transplantation is being increasingly performed across the United States. However, some of the most common...
End-stage liver disease management requiring orthotopic liver transplantation is being increasingly performed across the United States. However, some of the most common postoperative complications are bile leak and anastomotic stricture formation. These complications are successfully managed in most patients with endoscopic retrograde cholangiopancreatography (ERCP). We hereby report a case of acute parotitis, an extremely uncommon complication after ERCP. The exact etiology of this complication is not known. However, we discuss the treatment and purported mechanistic risk factors of this unusual post-ERCP adverse event.
PubMed: 32309499
DOI: 10.14309/crj.0000000000000305 -
International Journal of Environmental... Feb 2023Respiratory infectious diseases (RIDs) pose threats to people's health, some of which are serious public health problems. The aim of our study was to explore epidemic...
Respiratory infectious diseases (RIDs) pose threats to people's health, some of which are serious public health problems. The aim of our study was to explore epidemic situations regarding notifiable RIDs and the epidemiological characteristics of the six most common RIDs in mainland China. We first collected the surveillance data of all 12 statutory notifiable RIDs for 31 provinces in mainland China that reported between 2010 and 2018, and then the six most prevalent RIDs were selected to analyze their temporal, seasonal, spatiotemporal and population distribution characteristics. From 2010 to 2018, there were 13,985,040 notifiable cases and 25,548 deaths from RIDs in mainland China. The incidence rate of RIDs increased from 109.85/100,000 in 2010 to 140.85/100,000 in 2018. The mortality from RIDs ranged from 0.18/100,000 to 0.24/100,000. The most common RIDs in class B were pulmonary tuberculosis (PTB), pertussis, and measles, while those in class C were seasonal influenza, mumps and rubella. From 2010 to 2018, the incidence rate of PTB and rubella decreased; however, pertussis and seasonal influenza increased, with irregular changes in measles and mumps. The mortality from PTB increased from 2015 to 2018, and the mortality from seasonal influenza changed irregularly. PTB was mainly prevalent among people over 15 years old, while the other five common RIDs mostly occurred among people younger than 15 years old. The incidence of the six common RIDs mostly occurred in winter and spring, and they were spatiotemporally clustered in different areas and periods. In conclusion, PTB, seasonal influenza and mumps remain as public health problems in China, suggesting that continuous government input, more precise interventions, and a high-tech digital/intelligent surveillance and warning system are required to rapidly identify emerging events and timely response.
Topics: Humans; Adolescent; Mumps; Influenza, Human; Whooping Cough; Communicable Diseases; Measles; Tuberculosis, Pulmonary; Rubella; China; Incidence
PubMed: 36900957
DOI: 10.3390/ijerph20053946 -
Cureus Sep 2020Sarcoidosis is a granulomatous disease histologically characterized by non-caseating granulomas. Although it usually affects the lungs, it can affect any organ system...
Sarcoidosis is a granulomatous disease histologically characterized by non-caseating granulomas. Although it usually affects the lungs, it can affect any organ system and present with a wide variety of symptoms. Heerfordt-Waldenström Syndrome, or uveoparotid fever, is a rare form of sarcoidosis that presents with a combination of fever, parotitis, facial paralysis, and uveitis. In this case report, we demonstrate a rare manifestation of sarcoidosis in a patient who presents with both the aforementioned syndrome and cardiac involvement. This case serves to highlight the importance of identifying the various clinical manifestations and management of systemic sarcoidosis.
PubMed: 32983747
DOI: 10.7759/cureus.10619 -
The Canadian Journal of Infectious... 2020We aimed at investigating the prevalence and associated factors of patient delay in hospital visiting and weekend effect of disease surveillance on hand-foot-and-mouth...
BACKGROUND
We aimed at investigating the prevalence and associated factors of patient delay in hospital visiting and weekend effect of disease surveillance on hand-foot-and-mouth disease and epidemic parotitis/mumps.
METHODS
Daily report data on hand-foot-and-mouth disease and epidemic parotitis cases between January 1, 2014, and December 31, 2017, in Hanzhong, Shaanxi, China, were collected. The patient delay in hospital visiting was defined by the date difference between disease onset and patient's visit to hospital. Differences of delayed durations and percentages were compared by using nonparametric or tests across gender, age, occupation, disease classification, epidemic and nonepidemic seasons, and years of disease onset. Additionally, to determine whether there existed a weekend effect of disease surveillance, the mean cases reported on weekdays and weekends were also compared.
RESULTS
A total of 14,814 patients with hand-foot-and-mouth disease and 4013 with epidemic parotitis were recorded, respectively. We found that 43.1% of the hand-foot-and-mouth disease and 36.5% of the epidemic parotitis patients had delayed visiting to hospital. All patients were reported through the online surveillance system on the day of visiting hospital. The percentage of delayed visiting to hospital differed significantly by years and epidemic and nonepidemic seasons and between children in and not in childcare center (all values <0.05). In addition, the reported numbers of both diseases fluctuated on weekdays but obviously decreased on weekends regardless of the epidemic or nonepidemic seasons.
CONCLUSIONS
The reported cases of HFMD and epidemic parotitis had an obvious weekend effect, with an increasing tendency of cases delaying in hospital visiting over the recent years in Hanzhong, China. Parents and caregivers rather than health systems should be primarily targeted for the prevention and control of infectious diseases and their local outbreaks such as community-based education on the second-dose vaccination of mumps and/or hand hygiene.
PubMed: 32454917
DOI: 10.1155/2020/7081219 -
Journal of Primary Care & Community... 2021The purpose of this cohort study was to evaluate measles, mumps, rubella (MMR), and varicella immunity among a population of adult employees receiving primary care in an...
OBJECTIVES
The purpose of this cohort study was to evaluate measles, mumps, rubella (MMR), and varicella immunity among a population of adult employees receiving primary care in an employer-sponsored health center.
METHODS
Participants were eligible for MMR and varicella immunity screening if they were an employee receiving primary care in an employer-sponsored health center between January 1, 2019 and November 1, 2020 who could not provide proof of immunization and 1) had it recommended by their provider, 2) specifically requested immunity testing (often because they had heard of measles outbreaks in their country of origin), or 3) were seen for an immigration physical for their Green Card application.
RESULTS
Overall, 3494 patients were screened for their MMR immunity. Of these, 3057 were also screened for varicella immunity. Among these patients, 13.9% lacked measles immunity, 0.83% lacked immunity to all 3 components of MMR, and 13.2% lacked varicella immunity. Among the 262 patients who presented specifically for immunity screening, the rates of lacking immunity were higher for all conditions: 22.7% lacked measles immunity and 9.2% lacked varicella immunity.
CONCLUSION
Given declines in immunizations during the COVID-19 pandemic, there is reason to be concerned that measles and varicella-associated morbidity and mortality may rise. Employers, especially those with large foreign-born populations or who require international travel may want to educate their populations about common contagious illnesses and offer immunity validation or vaccinations at no or low cost.
Topics: Adult; Antibodies, Viral; COVID-19; California; Chickenpox; Cohort Studies; Disease Outbreaks; Female; Humans; Male; Mass Screening; Measles; Mumps; Occupational Health Services; Pandemics; Primary Health Care; Rubella; SARS-CoV-2; Vaccination; Vaccination Coverage
PubMed: 33813919
DOI: 10.1177/21501327211005902 -
Infectious Diseases & Clinical... Sep 2022Coronavirus disease 2019 (COVID-19) emerged in China at the end of 2019 and spread worldwide. A sixty-three-year-old female patient was admitted to the hospital six days...
Coronavirus disease 2019 (COVID-19) emerged in China at the end of 2019 and spread worldwide. A sixty-three-year-old female patient was admitted to the hospital six days after she tested positive for SARS-CoV-2 with complaints of cough, shortness of breath, and myalgia. After seven days, both parotid gland sites developed swelling, tenderness, and pain. The ultrasonography revealed acute parotitis bilaterally. Viral serological tests were negative. Therefore, COVID-19 infection was considered the cause of acute parotitis. The patient was discharged after recovery. This case report emphasized that acute non-suppurative parotitis may develop due to COVID-19 infection as an atypical manifestation.
PubMed: 38633391
DOI: 10.36519/idcm.2022.127 -
Mumps Outbreaks in Vaccinated Populations-Is It Time to Re-assess the Clinical Efficacy of Vaccines?Frontiers in Immunology 2020History illustrates the remarkable public health impact of mass vaccination, by dramatically improving life expectancy and reducing the burden of infectious diseases and... (Review)
Review
History illustrates the remarkable public health impact of mass vaccination, by dramatically improving life expectancy and reducing the burden of infectious diseases and co-morbidities worldwide. It has been perceived that if an individual adhered to the MMR vaccine schedule that immunity to mumps virus (MuV) would be lifelong. Recent mumps outbreaks in individuals who had received two doses of the Measles Mumps Rubella (MMR) vaccine has challenged the efficacy of the MMR vaccine. However, clinical symptoms, complications, viral shedding and transmission associated with mumps infection has been shown to be reduced in vaccinated individuals, demonstrating a benefit of this vaccine. Therefore, the question of what constitutes a good mumps vaccine and how its impact is assessed in this modern era remains to be addressed. Epidemiology of the individuals most affected by the outbreaks (predominantly young adults) and variance in the circulating MuV genotype have been well-described alluding to a collection of influences such as vaccine hesitancy, heterogeneous vaccine uptake, primary, and/or secondary vaccine failures. This review aims to discuss in detail the interplay of factors thought to be contributing to the current mumps outbreaks seen in highly vaccinated populations. In addition, how mumps diagnoses has progressed and impacted the understanding of mumps infection since a mumps vaccine was first developed, the limitations of current laboratory tests in confirming protection in vaccinated individuals and how vaccine effectiveness is quantified are also considered. By highlighting knowledge gaps within this area, this state-of-the-art review proposes a change of perspective regarding the impact of a vaccine in a highly vaccinated population from a clinical, diagnostic and public perspective, highlighting a need for a paradigm shift on what is considered vaccine immunity.
Topics: Disease Outbreaks; Humans; Measles-Mumps-Rubella Vaccine; Mumps; Vaccination
PubMed: 33072071
DOI: 10.3389/fimmu.2020.02089 -
Frontiers in Public Health 2022Despite the adoption of a new childhood immunization program in China, the incidence of mumps remains high. This study aimed to describe the epidemiological...
OBJECTIVES
Despite the adoption of a new childhood immunization program in China, the incidence of mumps remains high. This study aimed to describe the epidemiological characteristics of mumps in Jilin Province from 2005 to 2019 and to assess the transmissibility of mumps virus among the whole population and different subgroups by regions and age groups.
METHODS
The Non-age-specific and age-specific Susceptible-Exposed-Pre-symptomatic-Infectious-Asymptomatic-Recovered (SEPIAR) models were fitted to actual mumps incidence data. The time-varying reproduction number ( ) was used to evaluate and compare the transmissibility.
RESULTS
From 2005 to 2019, a total of 57,424 cases of mumps were reported in Jilin Province. The incidence of mumps was the highest in people aged 5 to 9 years (77.37 per 100,000). The two SEPIAR models fitted the reported data well ( < 0.01). The median transmissibility ( ) calculated by the two SEPIAR models were 1.096 (range: 1.911 × 10-2.192) and 1.074 (range: 0.033-2.114) respectively. The age-specific SEPIAR model was more representative of the actual epidemic of mumps in Jilin Province from 2005-2019.
CONCLUSIONS
For mumps control, it is recommended that mumps-containing vaccines (MuCV) coverage be increased nationwide in the 5-9 years age group, either by a mumps vaccine alone or by a combination of vaccines such as measles-mumps-rubella (MMR) vaccine. The coverage of vaccines in Jilin Province should be continuously expanded to establish solid immunity in the population. China needs to redefine the optimal time interval for MuCV immunization.
Topics: Humans; Child; Child, Preschool; Mumps; Measles-Mumps-Rubella Vaccine; Immunization Programs; Vaccination; China
PubMed: 36420012
DOI: 10.3389/fpubh.2022.968702