Abstract
The aim of the study. Despite of the high vaccination coverage an increased incidence of mumps is observed in the Czech Republic, in both unvaccinated and vaccinated population.
The reason is probably the waning immunity after vaccination in the second year of life. The aim of this prospective study was to evaluate the clinical manifestations of the disease and its potential complications in vaccinated and unvaccinated groups.
We also evaluated the diagnostic benefits of common and less frequently used laboratory methods (viral culture, PCR, IgM, IgA, IgG). Patients and Methods.
In patients with suspicion of mumps the swab of Stenson duct was taken for direct detection of the virus and blood samples for detection of antibodies, blood count, inflammatory markers and pancreatic enzymes. Only laboratory- confirmed cases were included to the study.
Vaccination history and clinical course of the disease were evaluated. Material from the swab was tested in RT-qPCR (Mumps Virus RT-PCR kit, Shanghai ZJ Bio-Tech Co.).
The levels of IgM, IgG and IgA were tested by kits Enzygnost Anti-Mumps / IgM / IgG, Siemens and Mastazyme IgA, Mast Diagnostica. Laboratory-confirmed cases had a) a positive viral culture or PCR from secretions of Stenson duct, b) a positive IgM and / or IgA antibodies in the serum, c) a significant (four-fold) increase in the levels of IgG antibodies in paired sera.
Results. Of the 83 patients included, 41 (49.4 %) were vaccinated, 36 (43.4 %) unvaccinated, in 6 (7.2 %) the vaccination status was unknown.
Severe course of the disease had 21 patients (25.3 %), more in the unvaccinated group (13; 36.1 % vs 8, 19.5 %), though the difference was not statistically significant (p = 0.1993). In vaccinated group only 36.8 % patients had IgM antibodies detected in acute serum, IgA were positive in 57.9 % of patients.