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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

  1. Immunization Practices Advisory Committee. Mumps vaccine. MMWR 1982;31:617-20, 625.

  2. CDC. Efficacy of mumps vaccine--Ohio. MMWR 1983;32:391-2, 397-8.

  3. CDC. Mumps outbreak--New Jersey. MMWR 1984;33:421-2, 427-30.

  4. Koplan JP, Preblud SR. A benefit-cost analysis of mumps vaccine. Am J Dis Child 1982;136:362-4.

  5. CDC. Mumps surveillance report, January 1977-December 1982 (in press).

  6. CDC. Mumps--United States, 1980-1983. MMWR 1983;32:545-7.



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