Intended for healthcare professionals

Rapid response to:

Clinical Review

Mumps and the UK epidemic 2005

BMJ 2005; 330 doi: https://doi.org/10.1136/bmj.330.7500.1132 (Published 12 May 2005) Cite this as: BMJ 2005;330:1132

Rapid Response:

Re: unusually, an interesting question is posed

My question was simply a question.
And there was no assuming about when mumps was made a notifiable disease,
it was published in the Department of Health book 'Immunisation against
Infectious Disease'- 'Mumps was made a notifiable disease in the UK in
October 1988.'(Page 52, 1990 edition.) As regards to a mumps vaccine being
around since 1948, stated in Dr Midgley's Rapid response. In 'Vaccines' by
Plotkin and Mortimer 1994 edition, it states: An experimental inactivated
vaccine developed in 1946 was tested in humans in 1951.' There appears to
be no further discussion on that particular vaccine, and the text then
leads to 1967 when a live virus mumps vaccine was introduced in the USA.

Interestingly enough it states that following the introduction of this
vaccine that:
'the number of reported mumps cases in the United States decreased
steadily, from 152,000 cases in 1968, to 2982 cases in 1985, a record.
However, this downward trend was reversed in 1986-1987, when a relative
resurgence of mumps occurred in the United States. The resurgence appears
to have been the result of incomplete vaccination coverage of adolescents
and young adults in the years following the introduction of the live virus
vaccine, In 1991, 4264 cases of mumps were reported, a 67% decrease from
1987; this total still EXCEEDS the number of cases reported annually
between 1983 and 1985.' (My emphasis.)

If one looks at all these childhood infectious diseases these declines
were occurring regardless of when vaccination programmes were introduced.
Measles, whooping cough, diphtheria are fine examples of this. Both the
morbidity and mortality were in major decline well BEFORE vaccines were
introduced, and had mumps been notifiable at an earlier time no doubt the
same trend would have followed.

Interestingly, another point to note is that the textbook description of
mumps in the pre-vaccine era was not alarmist, unlike its present day
description. For example in The MacMillan Guide to Family Health, 1982
edition, it simply runs through the general description, with lines such
as 'Mumps is generally a mild disease. The usual outcome is complete
recovery within about 10 days.' Even regarding orchitis, it comments that
this is more common in adults and that invariably the swelling goes down
after a few days leaving no after effects, and that it is excessively rare
for the swelling to cause sterility. And as I remarked in my previous
Rapid Response complications are more likely to occur from the general
healthstyle of the individual or the mismanagement of the illness.

As regards to 'satisfying conspiracists' I always find it puzzling that
when anyone starts asking simple questions or making valid points,
suddenly they become conspiracists. I am not interested in conspiracies, I
prefer to study a subject in depth, which in turn provokes further
questions. And to broaden my knowledge I like to ask questions.
Why?...because it seems sensible, and it is!

Competing interests:
None declared

Competing interests: No competing interests

19 May 2005
MAGDA TAYLOR
Director of The Informed Parent
P O Box 4481, Worthing, West Sussex, BN11 2WH