Epidemiology and the economic assessment of a mumps outbreak in a highly vaccinated population, Orange County, New York, 2009–2010

Figures & data

Figure 1. Epidemiological curve of the mumps outbreak in Orange County village by Sex, New York, 2009–2010 (n = 790) .

Table 1. Characteristics of reported mumps cases, Orange County, New York, 2009–2010 (n = 790)

Characteristics	n (%)
Age (y)
<1	6 (0.8)
1–5	60 (7.6)
6–10	186 (23.5)
11–17	338 (42.8)
18–24	117 (14.8)
25–34	55 (7.0)
≥35	28 (3.5)
Sex
Female	282 (35.7)
Male	508 (64.3)
Documented Vaccine History (n = 658)
0 dose	44 (6.7)
1 dose	64 (9.7)
2 doses	550 (83.6)
Clinical Presentation and Complications
Parotitis	790 (100)
Orchitis* (n = 312)	20 (6.4)
Meningititis	2 (0.3)**
Hospitalization	1
Orchitis* and vaccination status
0 dose (n = 5)	1 (20)
1 dose (n = 12)	0
2 doses (n = 228)	14 (6.1)
Unknown vaccination status (n = 67)	5 (7.5)
Time from vaccination for those who received only 1 dose of MMR vaccine (n = 65)
Median (Range)	5.5 y (3 mo–34.3 y)
<1 y	4 (6.2)
1–4 y	27 (41.5)
5–9 y	20 (30.8)
≥10 y	14 (21.5)
Time from last vaccination for those who received 2 doses of MMR vaccine (n = 532)
Median (Range)	8.7 y (3 mo–19.7 y).
<1 y	9
1–4 y	97 (18.2)
5–9 y	221 (41.5) ^±
10–14 y	168 (31.6)
15–19 y	37 (7.0)
Reported Source of transmission (n = 599)
School	430 (71.8)
Household/Family	135 (22.5)
Religious gathering	12 (2)
Workplace	11 (1.8)
Community	5 (0.8)
Unknown	3 (0.5)
Outside the community	2 (0.3)
Medical	1 (0.2)
Laboratory: Serology
IgM Positive (n = 39) Mumps Vaccination status
0 dose	7 (18.0)
1 dose	2 (5.1)
2 doses	27 (69.2)
Unknown	3 (7.7)

*In males ≥12 y of age. **One case-patient had 2 documented doses of MMR vaccine; the other had unknown vaccination status. ^±Majority of mumps cases were 11–17 y of age.

Table 2. Resource Utilization and direct costs of containing Mumps, Orange County, New York, 2009–2010

	Orange County Health Department*	New York State Health Department*	Overall
Resource utilization
Number of responders	20	22	42
Hours per activity†
Planning and coordination	429	687	1116
Case confirmation & isolation	1206	74	1280
Contact identification	549	-	549
School based vaccination	476	482	958
Specimen collection and lab testing	-	920	920
Database analysis and report	1419	410	1829
Public and media communication	1	206	207
Other ‡	-	877	877
Total personnel hours	4080	3656	7736
Vehicle Miles	1759	6975	8734
Lodging (days)	-	49	49
MMR Vaccine (doses)^§	-	1812	1812
IFA test kits^¶	-	120	120
Costs (US $)
Personnel
Salary and wages	111 537	122 017	233 554
Fringe benefits	34 063	49 874	83 937
Overhead	59 802	35 054	94 856
Miles^║	862	3418	4280
Lodging	-	7194	7194
MMR Vaccine^§lll	-	34 392	34 392
IFA test kits and laboratory costs	-	4166	4166
Other costs**	-	825	825
Total Cost	$206 264	256 938	463 202

*Dashes indicate “not applicable.” †Activities included case-finding and interviewing case-patients and tracing contacts planning and coordinating responses, vaccinating contacts, collecting specimens, encourage isolation and quarantines, developing and reports, answering public inquiries, and working with the media, analyzing databases, developing information for the public and preparing reports. ^‡Other activities included data entry, immunization program (maintaining mumps surveillance and assessment of vaccine adverse events). ^§MMR vaccine intervention and associated cost. ^¶Specimen collection includes blood-collection kits, swabs, urine tests, and serologic tests for mumps IgM and IgG antibodies. ^║Unitary mileage costs are at US $0.49 per mile. ^lllUnitary costs are from public sector prices of MMR vaccine at US$18.98 per dose (as September 2011) http://www.cdc.gov/vaccine/program/vfc/cdc-vac-price-list.htm. **Other costs include tolls, meals.