Mumps Outbreak Traced From a Religious School
A one-on-one educational strategy used among Orthodox Jews apparently led to a U.S. outbreak of mumps in 2009 and 2010 even though most of those infected had been properly vaccinated, according to a U.S. study.
The researchers said the outbreak, detailed in the New England Journal of Medicine, signifies how close, repeated contact with an infected person can overwhelm the mumps vaccine.
"The risk of infection with mumps may be higher when the exposure dose of virus is large or intensely transmitted," wrote lead author Albert Barskey, of the U.S. Centers for Disease Control and Prevention's (CDC) National Center for Immunization and Respirators Diseases, and colleagues.
They also added that this may also explain why the mumps vaccine tends to be less effective among household contacts than among school or community contacts.
There are about 3,502 cases of mumps outbreak that were reported over a one-year period beginning in June 2009 in New Jersey, New York City and New York State's Orange and Rockland counties. A camp in the Catskill Mountains was the source.
The researchers, from the involved state health departments and the CDC, studied 1,648 of those cases, nearly all of them Orthodox Jews. The researchers found that 89 percent had received the recommended two doses of mumps vaccine.
Many attended a religious school known as a yeshiva, where boys receive intense training with a study partner known as a chavrusa, who sits across a narrow table. The teaching method often involves animated discussions and the partners are switched several times a day.
The researchers wrote that "chavrusa study, with its prolonged, face-to-face contact," probably resulted in high exposures to the virus, and these "overcame vaccine-induced protection in individual students."