Mumps

Unlike measles, mumps is not considered a globally devastating disease. Nevertheless, because of its complications, it was targeted for prevention by use of a vaccine. The complications that prompted this were epididymoorchitis, aseptic meningitis, meningoencephalitis, and deafness (usually, but not exclusively, unilateral) (Coll, 1974).

Before a vaccine was developed, there was no effective means of preventing this disease. Mumps is rare in the first year of life, and its rarity has been attributed to the passive protection rendered by maternal antibodies (Meyer, 1962). Nevertheless, immune globulin injections administered after exposure do not prevent mumps (Reed et al., 1967).

Development of mumps vaccine had two stages. Initially, there was an inactivated vaccine (Enders, 1946). It was not sufficiently effective, in that it offered protection only to some 80 percent of the recipients and the protection lasted for less than 1 year. Therefore, investigators undertook efforts to develop an attenuated strain of mumps virus that could be used as a live vaccine.

The Jeryl Lynn strain, the mumps virus strain used in mumps vaccines in the United States, came about by numerous passages in vitro, first in embryohated ben's eggs and then in chicken embryo cells (Buynak and Hilleman, 1966). The seroconversion rate was nearly 97 percent. Subsequently, two other strains were developed by similar attenuation of a wild-type isolate. They are Leningrad-3-Parkow and Urabe AM9, which were generated in the former Soviet Union and Japan, respectively.

The American Academy of Pediatrics recommends that measles-mumps-rubella vaccine (MMR) be given at age 15 months and at entry into middle or junior high school. The Advisory Committee on Immunization Practices recommends that MMR be administered at 15 months and then again at school entry at age 4 to 6 years. ("MMR" is used in this report to indicate any multivalent vaccine preparation directed against measles, mumps, and rubella. No association with a specific manufacturer is intended or should be inferred.)

BIOLOGIC EVENTS FOLLOWING IMMUNIZATION

Measles

Although the measles vaccine is administered by injection rather than by the natural, respiratory route of infection, the host response is similar to that evoked by the wild-type virus in all but two respects. The immunized subject develops humoral and cellular immune responses some 48 hours earlier than the naturally infected host, and the recipient of the vaccine does



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