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Mumps -- United States, 1983-1984
During the first 37 weeks of 1984, a provisional total of 2,112
mumps cases was reported to CDC; this is a 13.5% decline from the
2,443 cases reported during the same period in 1983. To date, two
states and the District of Columbia have reported no mumps cases.
In 1983, a total of 3,355 mumps cases was reported to CDC, for
a
reported incidence rate of 1.4 cases per 100,000 population (Table
1). This is 36% lower than the 1982 total of 5,270 cases and is
the
lowest reported incidence rate since mumps became a nationally
notifiable disease in 1968 (Figure 1). It represents a 98%
decrease
from 1968, the year after mumps vaccine licensure. In 1983, one
state
reported no mumps; in four other states, mumps is not a reportable
disease.
Age-specific data are available for 2,074 (61.8%) of the cases
reported for 1983 (Table 1). As in 1981 and 1982, approximately
three-fourths of mumps cases for which ages were known occurred
among
individuals under 15 years of age. During the past 3 years, the
reported incidence decreased for all age groups. While the
reported
incidence among children under 5 years old increased by 6.5% from
1982
to 1983, the rates in the other age groups declined by 17%-57%. In
1983, a 55% decline occurred among persons 10-19 years of age, the
age
group responsible for the overall increased occurrence of mumps
observed from 1981 to 1982. During 1982, the highest age-specific
incidence shifted for the first time from the 5- to 9-year age
group
to the 10- to 14-year age group. However, in 1983, 5- to
9-year-olds
again had the highest incidence; children 10-14 years of age had
the
next highest risk of acquiring disease.
Reported by Div of Immunization, Center for Prevention Svcs, CDC. Editorial Note
Editorial Note: Mumps vaccine has consistently been shown to be
safe,
effective, and cost-beneficial (1-4). The distribution of over 65
million doses of mumps-containing vaccine in the United States over
the past 17 years has been associated with a 90% or greater decline
in
the reported occurrence of mumps in all age groups (Figure 2). As
in
the prevaccine era, persons under 15 years of age continue to have
the
highest incidence rate (5.0 cases/100,000 population); this rate is
over 10 times that for persons 15 years of age or older
(0.4/100,000). In a 1982-1983 nationwide survey, 95% of persons
entering school were found to be immunized against mumps; however,
the
school-aged population continues to be the group at highest risk
for
disease. Unvaccinated cohorts exist in many areas (5,6).
A school immunization law that includes mumps may be effective
in
controlling mumps infection, since this would ensure high
immunization
levels. Based on 1982 data, the reported mumps incidence rate for
states that required proof of mumps immunity for school entry was
one-half that for the 19 states without such a law (2). Twenty
states
currently do not require proof of mumps immunity for school entry,
and
15 states have laws that affect only first entry to school. Based
on
1983 data, there was a 20% lower mumps incidence rate between
states
with laws and those with no law. In a recent mumps outbreak among
schoolchildren in New Jersey, children covered by the state's
school
entry law had only one-fifth the risk for mumps as children not
affected by the law (3). These observations indicate that further
declines in the reported mumps incidence rate can be expected as
more
children entering school are required to provide proof of mumps
immunity for school attendance.
References
Immunization Practices Advisory Committee. Mumps vaccine.
MMWR
1982;31:617-20, 625.
CDC. Efficacy of mumps vaccine--Ohio. MMWR 1983;32:391-2,
397-8.
CDC. Mumps outbreak--New Jersey. MMWR 1984;33:421-2, 427-30.
Koplan JP, Preblud SR. A benefit-cost analysis of mumps
vaccine.
Am J Dis Child 1982;136:362-4.
CDC. Mumps surveillance report, January 1977-December 1982 (in
press).
CDC. Mumps--United States, 1980-1983. MMWR 1983;32:545-7.
Disclaimer
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