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Environmental factors potentially associated with mumps transmission in Yeshivas during a mumps outbreak among highly vaccinated students

Content Provider	PubMed Central
Author	Fiebelkorn, Amy Parker Rosen, Jennifer B. Brown, Cedric Zimmerman, Christopher M. Hyman, Renshowitz D'andrea, Christopher Gallagher, Kathleen M. Harpaz, Rafael Zucker, Jane R.
Copyright Year	2013
Abstract	During 2009–2010, a large US mumps outbreak occurred affecting two-dose vaccinated 9th–12th grade Orthodox Jewish boys attending all-male yeshivas (private, traditional Jewish schools). Our objective was to understand mumps transmission dynamics in this well-vaccinated population. We surveyed 9th-12th grade male yeshivas in Brooklyn, NY with reported mumps case-students between 9/1/2009 and 3/30/2010. We assessed vaccination coverage, yeshiva environmental factors (duration of school day, density, mixing, duration of contact), and whether environmental factors were associated with increased mumps attack rates. Ten yeshivas comprising 1769 9th–12th grade students and 264 self-reported mumps cases were included. The average yeshiva attack rate was 14.5% (median: 13.5%, range: 1–31%), despite two-dose measles-mumps-rubella vaccine coverage between 90–100%. School duration was 9–15.5 h/day; students averaged 7 h face-to-face/day with 1–4 study partners. Average daily mean density was 6.6 students per 100 square feet. The number of hours spent face-to-face with a study partner and the number of partners per day showed significant positive associations (p < 0.05) with classroom mumps attack rates in univariate analysis, but these associations did not persist in multivariate analysis. This outbreak was characterized by environmental factors unique to the yeshiva setting (e.g., densely populated environment, prolonged face-to-face contact, mixing among infected students). However, these features were present in all included yeshivas, limiting our ability to discriminate differences. Nonetheless, mumps transmission requires close contact, and these environmental factors may have overwhelmed vaccine-mediated protection increasing the likelihood of vaccine failure among yeshiva students.
Related Links	http://dx.doi.org/10.4161/hv.22415
Ending Page	194
Page Count	6
Starting Page	189
File Format	PDF
ISSN	21645515
e-ISSN	2164554X
Journal	Human Vaccines & Immunotherapeutics
Issue Number	1
Volume Number	9
Language	English
Publisher	Landes Bioscience
Publisher Date	2013-01-01
Access Restriction	Open
Rights Holder	Landes Bioscience
Subject Keyword	Research in Higher Education
Content Type	Text
Resource Type	Article
Subject	Immunology and Allergy Immunology Pharmacology

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