Estimation of the infection attack rate of mumps in an outbreak among college students using paired serology

Abstract

AbstractMumps virus is a highly transmissible pathogen that is effectively controlled in countries with high vaccination coverage. Nevertheless, outbreaks have occurred worldwide over the past decades in vaccinated populations. Here we analyse serological data from outbreaks of mumps virus genotype G among college students in the Netherlands over the period 2009-2012. To identify infections in the presence of preexisting antibodies we compared mumps specific serum IgG concentrations in two consecutive samples (n= 746), whereby the first sample was taken when students started their study prior to the outbreaks, and the second sample was taken 2-5 years later. We fit a binary mixture model to the data. The two mixing distributions represent uninfected and infected classes. Throughout we assume that the infection probability increases with the ratio of antibody concentrations of the second to first sample. The estimated infection attack rate is higher than reported earlier (0.095 versus 0.042). The analyses yield probabilistic classifications of participants, which are mostly quite precise owing to the high intraclass correlation in uninfected participants (0.85, 95%CrI: 0.82 − 0.87). The estimated probability of infection increases with decreasing antibody concentration in the pre-outbreak sample, such that the probability of infection is 0.12 (95%CrI: 0.10 − 0.13) for the lowest quartile of the pre-outbreak samples and 0.056 (95%CrI: 0.044 − 0.068) for the highest quartile. We discuss the implications of these insights for the design of booster vaccination strategies.HighlightsWe use paired pre- and post-outbreak serological data to estimate mumps infection rates in college students.We use a two-component mixture model to provide individual estimates of infection for each participant.The estimated population infection attack rate is higher than reported earlier (9.5% vs 4.2%).The estimated individual probability of infection increases with decreasing pre-outbreak antibody concentrations, from 12% in the lowest to 5.6% in the highest quartile.