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Journal of Education & Teaching in... Apr 2023A 36-year-old immunocompetent female presented to the emergency department (ED) with five days of headache and left-sided facial pain. Physical exam showed conjunctival...
UNLABELLED
A 36-year-old immunocompetent female presented to the emergency department (ED) with five days of headache and left-sided facial pain. Physical exam showed conjunctival injection of the left eye with multiple vesicular lesions distributed along the V1 dermatome. Labs were remarkable for mild elevation in erythrocyte sedimentation rate (ESR) and c-reactive protein (CRP) with no elevation in white blood cell (WBC) count. Computed tomography (CT) with contrast of the neck revealed soft tissue stranding around the parotid gland. The patient was diagnosed with herpes zoster ophthalmicus (HZO) with concurrent ipsilateral parotitis and subsequently treated with valacyclovir, ofloxacin eye drops, topical erythromycin ointment and amoxicillin/clavulanic acid. Upon follow-up ten days after discharge, the patient noted marked improvement in her symptoms and reduction in pain. To our knowledge, this is the first case described in medical literature of a female patient with HZO and ipsilateral parotitis.
TOPICS
Herpes zoster opthalmicus, varicella-zoster virus, parotitis.
PubMed: 37465656
DOI: 10.21980/J8R93N -
Investigative and Clinical Urology Jul 2023To analyze the presentation of mumps and mumps orchitis using the National Health Insurance Service Database (NHISD).
PURPOSE
To analyze the presentation of mumps and mumps orchitis using the National Health Insurance Service Database (NHISD).
MATERIALS AND METHODS
Using information from the NHISD representing all cases of mumps in Korea, data regarding mumps orchitis were analyzed. The International Classification of Diseases, Tenth Revision, and Clinical Modification codes were used for diagnosis. The incidence estimates of the number of mumps cases were analyzed using the Statistical Analysis System (SAS) software.
RESULTS
Based on the NHISD, 199,186 people were diagnosed with mumps, and males accounted for 62.3% cases. Teen males accounted for 69,870 cases, the largest number of patients diagnosed with mumps. The annual incidence of mumps increased every year (poisson regression, hazard ratio [HR] 1.026, 95% confidence interval [CI] 1.024-1.027; p<0.025). The risk of mumps was lower in females than that in males (poisson regression, HR 0.594, 95% CI 0.589-0.599; p<0.001). Of the 199,186 patients diagnosed with mumps, 3,872 patients (1.9%) had related complications. Among the mumps complications, the most diagnosed complication was mumps orchitis, which was seen in 41.8% of the males. Mumps orchitis cases accounted for less than 1.5% of the patients with mumps in minors under the age of 20 years and was somewhat higher in 2009 and 2013-2015.
CONCLUSIONS
Among the complications related to mumps, meningitis was most common in females, while orchitis was dominant in males. Mumps orchitis also shows periodic outbreaks but is particularly prevalent in adults, which suggests the potential need for additional vaccination against mumps.
Topics: Male; Adult; Adolescent; Female; Humans; Young Adult; Mumps; Orchitis; Incidence; National Health Programs; Republic of Korea
PubMed: 37417567
DOI: 10.4111/icu.20230064 -
Epidemics Sep 2023Mumps is a vaccine-preventable, reemerging, and highly transmissible infectious disease. Widespread vaccination dramatically reduced cases; however, case counts have...
Mumps is a vaccine-preventable, reemerging, and highly transmissible infectious disease. Widespread vaccination dramatically reduced cases; however, case counts have been increasing over the past 20 years. To provide a quantitative overview of historical mumps dynamics that can act as baseline information to help identify causes of mumps reemergence, we analyzed timeseries of cases reported from 1923 to 1932 in the United States. During that time, 239,230 mumps cases were reported in 70 cities. Larger cities reported annual epidemics and smaller cities reported intermittent, sporadic outbreaks. The critical community size above which transmission continuously occurred was likely between 365,583 and 781,188 individuals but could range as high as 3,376,438 individuals. Mumps cases increased as city size increased, suggesting density-dependent transmission. Using a density-dependent SEIR model, we calculated a mean effective reproductive number (R) of 1.2. R varied by city and over time, with periodic high values that could characterize short periods of very high transmission known as superspreading events. Case counts most often peaked in March, with higher-than-average transmission from December through April and showed a correlation with weekly births. While certain city pairs in Midwestern states had synchronous outbreaks, most outbreaks were less synchronous and not driven by distance between cities. This work demonstrates the importance of long-term infectious disease surveillance data and will inform future studies on mumps reemergence and control.
Topics: Humans; United States; Mumps; Epidemics; Vaccination; Disease Outbreaks; Basic Reproduction Number
PubMed: 37379775
DOI: 10.1016/j.epidem.2023.100700 -
PloS One 2023Measles is a vaccine-preventable disease whose vaccine was introduced in England in 1988, however, Measles outbreaks have still been occurring in the country....
Measles is a vaccine-preventable disease whose vaccine was introduced in England in 1988, however, Measles outbreaks have still been occurring in the country. Consequently, the World Health Organization (WHO) removed the elimination status of Measles in 2019 from England and the whole United Kingdom. Noticeably, MMR vaccination coverage in England is below the recommended threshold with geographical variations across local authorities (LA). The research into the effect of income disparities on MMR vaccine coverage was insufficiently examined. Therefore, an ecological study will be conducted aiming at determining whether there is a relationship between income deprivation measures and MMR vaccine coverage in upper-tier local authorities in England. This study will be using 2019 publicly available vaccination data for children who were eligible for the MMR vaccine by their second and fifth birthday in 2018/2019. The effect of spatial clustering of income level on vaccination coverage will also be assessed. Vaccination coverage data will be obtained from "Cover of Vaccination Evaluated Rapidly (COVER)". Income deprivation score, Deprivation gap, and Income Deprivation Affecting Children Index will be obtained from Office for National Statistics and Moran's Index will be generated using RStudio. Rural/urban LA classification and mothers' education will be included as possible confounding factors. Additionally, the live births rate per mothers' age group will be included as a proxy for the mothers' age variation in different LA. Multiple linear regression will be used after testing the relevant assumptions, using SPSS software. Moran's I together with income deprivation score will be analysed through regression and mediation analysis. This study will help in determining whether income level is a determinant of MMR vaccination uptake and coverage in LA in England which would help policymakers in designing targeted campaigns, thus preventing measles outbreaks in the future.
Topics: Child; Female; Humans; Infant; Measles-Mumps-Rubella Vaccine; Mumps; Measles; England; Vaccination; Rubella
PubMed: 37379282
DOI: 10.1371/journal.pone.0280008 -
Revista Brasileira de Epidemiologia =... 2023To analyze the spatial behavior of hepatitis A, measles, mumps, and rubella (MMR), and varicella vaccination coverage in children and its relationship with socioeconomic...
OBJECTIVE
To analyze the spatial behavior of hepatitis A, measles, mumps, and rubella (MMR), and varicella vaccination coverage in children and its relationship with socioeconomic determinants in the state of Minas Gerais.
METHODS
This ecological study investigated records of doses administered to children, extracted from the Immunization Information System of 853 municipalities in Minas Gerais, in 2020. We analyzed the vaccination coverage and socioeconomic factors. Spatial scan statistics were used to identify spatial clusters and measure the relative risk based on the vaccination coverage indicator and the Bivariate Moran Index, and thus detect socioeconomic factors correlated with the spatial distribution of vaccination. We used the cartographic base of the state and its municipalities and the ArcGIS and SPSS software programs.
RESULTS
Hepatitis A (89.0%), MMR (75.7%), and varicella (89.0%) showed low vaccination coverage. All vaccines analyzed had significant clusters. The clusters most likely to vaccinate their population were mainly located in the Central, Midwest, South Central, and Northwest regions, while the least likely were in the North, Northeast, and Triângulo do Sul regions. The municipal human development index, urbanization rate, and gross domestic product were spatially dependent on vaccination coverage.
CONCLUSIONS
The spatial behavior of hepatitis A, MMR, and varicella vaccination coverage is heterogeneous and associated with socioeconomic factors. We emphasize that vaccination records require attention and should be continuously monitored to improve the quality of information used in services and research.
Topics: Child; Humans; Infant; Brazil; Chickenpox; Chickenpox Vaccine; Hepatitis A; Measles-Mumps-Rubella Vaccine; Mumps; Rubella; Spatial Behavior; Vaccination; Vaccination Coverage
PubMed: 37377251
DOI: 10.1590/1980-549720230030 -
Archivum Immunologiae Et Therapiae... Jun 2023Many factors have been implicated in the pathogenesis and severity of COVID-19 pandemic. A wide variation in the susceptibility for SARS-CoV-2 infection among different...
Many factors have been implicated in the pathogenesis and severity of COVID-19 pandemic. A wide variation in the susceptibility for SARS-CoV-2 infection among different population, gender and age has been observed. Multiple studies investigated the relationship between the antibody's titre of previously vaccinated individuals and the susceptibility of coronavirus infection, to find a rapid effective therapy for this pandemic. This study focused on the association between measles-mumps-rubella (MMR) antibodies titre and the severity of COVID-19 infection. We aimed to investigate the correlation between the antibody's titre of MMR and the SARS-CoV-2 infection susceptibility and disease severity, in a cohort of COVID-19 Egyptian patients, compared to a control group. MMR antibody titre was measured using enzyme Linked Immune Sorbent Assay; (ELISA) for 136 COVID-19 patients and 44 healthy individuals, as control group. There were high levels of measles and mumps antibodies titer in the deteriorating cases, which could not protect from SARS-CoV-2 infection. However, the rubella antibodies might protect from SARS-CoV-2 infection, but once the infection occurs, it may aggravate the risk of case deterioration. MMR antibodies could be used as a guideline for COVID-19 symptom-severity and, in turn, may be considered as an economic prognostic marker used for early protection from multiple autoimmune organ failure.
Topics: Humans; Rubella; Mumps; Pandemics; COVID-19; SARS-CoV-2; Measles; Measles-Mumps-Rubella Vaccine
PubMed: 37341786
DOI: 10.1007/s00005-023-00680-1 -
BMJ (Clinical Research Ed.) Jun 2023To test for potential non-specific effects of an additional, early measles, mumps, and rubella (MMR) vaccine at age 5-7 months on risk of infection related... (Randomized Controlled Trial)
Randomized Controlled Trial
OBJECTIVE
To test for potential non-specific effects of an additional, early measles, mumps, and rubella (MMR) vaccine at age 5-7 months on risk of infection related hospitalisation before age 12 months.
DESIGN
Randomised, double blinded, placebo controlled trial.
SETTING
Denmark, a high income setting with low exposure to MMR.
PARTICIPANTS
6540 Danish infants aged 5 to 7 months.
INTERVENTIONS
Infants were randomly allocated 1:1 to intramuscular injection with standard titre MMR vaccine (M-M-R VaxPro) or placebo (solvent only).
MAIN OUTCOME MEASURES
Hospitalisations for infection, defined as all hospital contacts of infants referred from primary care for hospital evaluation and with an infection diagnosed, analysed as recurrent events, from randomisation to 12 months of age. In secondary analyses implications of censoring for date of subsequent diphtheria, tetanus, pertussis, polio, type B, and immunisation with pneumococci conjugate vaccine (DTaP-IPV-Hib+PCV), potential effect modification by sex, prematurity (<37 weeks' gestation), season, and age at randomisation were tested, and the secondary outcomes of hospitalisations ≥12 hours and antibiotic use were evaluated.
RESULTS
6536 infants were included in the intention-to-treat analysis. 3264 infants randomised to MMR vaccine experienced 786 hospitalisations for infection before age 12 months compared with 762 for the 3272 infants randomised to placebo. In the intention-to-treat analysis the rate of hospitalisations for infection did not differ between the MMR vaccine and placebo groups (hazard ratio 1.03, 95% confidence interval 0.91 to 1.18). For infants randomised to MMR vaccine compared with those randomised to placebo, the hazard ratio of hospitalisations for infection with a duration of at least 12 hours was 1.25 (0.88 to 1.77), and for prescriptions of antibiotics was 1.04 (0.88 to 1.23). No significant effect modifications were found by sex, prematurity, age at randomisation, or season. The estimate did not change when censoring at the date infants received DTaP-IPV-Hib+PCV after randomisation (1.02, 0.90 to 1.16).
CONCLUSION
Findings of this trial conducted in Denmark, a high income setting, do not support the hypothesis that live attenuated MMR vaccine administered early to infants aged 5-7 months decreases the rate of hospitalisations for non-targeted infection before age 12 months.
TRIAL REGISTRATION
EU Clinical Trials Registry EudraCT 2016-001901-18 and ClinicalTrials.gov NCT03780179.
Topics: Infant; Humans; Measles-Mumps-Rubella Vaccine; Mumps; Diphtheria-Tetanus-Pertussis Vaccine; Poliovirus Vaccine, Inactivated; Measles; Immunization; Hospitalization; Haemophilus Vaccines
PubMed: 37286215
DOI: 10.1136/bmj-2022-072724 -
The Indian Journal of Medical Research Apr 2023
Topics: Humans; Infant; Measles Vaccine; Rubella Vaccine; Rubella; Measles; Immunization Schedule; Measles-Mumps-Rubella Vaccine; Mumps; Vaccination; Antibodies, Viral
PubMed: 37282389
DOI: 10.4103/ijmr.ijmr_79_23 -
Indian Journal of Otolaryngology and... Apr 2023To analyse the aetiology and outcomes of all patients attending otorhinolaryngology department for Lower Motor Neuron type facial palsy over one year. STUDY...
To analyse the aetiology and outcomes of all patients attending otorhinolaryngology department for Lower Motor Neuron type facial palsy over one year. STUDY DESIGN-Retrospective study. SETTING-SRM medical college hospital and research institute, Chennai from Jan 2021 to December 2021. SUBJECTS-23 patients with LMN facial palsy in the ENT department were analysed. METHOD-Details about the onset of facial palsy, history of trauma, surgeries were collected. Facial palsy grading according to House Brackmann was done. Relevant investigations, neurological assessments, appropriate treatment, facial physiotherapy, eye protection and relevant surgical management were carried out.Outcomes were assessed by HB grading. Among 23 patients, mean age of presentation of LMN palsy is 40.39 ± 15.0 years. According to House Brackmann staging 21.73% had grade 5 facial palsy, 43.47% had grade 4,30.43% of patients had grade 3 and 4.34% had grade 2 facial palsy. 9 patients (39.13%) had facial palsy due to idiopathic cause, 6 (26.08%) had facial palsy due to otologic cause, 3(13.04%) due to Ramsay hunt syndrome and post traumatic in 8.69% of patients. Parotitis in 4.3% of patients and iatrogenic in 8.69% of patients. 18(78.26%) patients were treated medically alone and 5 (21.73%) patients required surgery.Mean duration of recovery is 28.52 ± 12.6 days. In follow up, 21.73% of patient had grade 2 facial palsy and 76 .26% of patients had recovered completely. Facial palsy in our study had very good recovery due to early diagnosis and early start of appropriate treatment.
PubMed: 37206849
DOI: 10.1007/s12070-022-03314-8