Mumps outbreaks across Canada, 2016 to 2018.

backgroundAn increase in mumps incidence was observed in late 2016 (365 cases in 2016 compared to 59 cases in 2015). This unusual level of mumps activity prompted the Public Health Network Council and the National Advisory Committee on Immunization to request situation awareness updates from the Centre for Immunization and Respiratory Infectious Diseases (CIRID) at the Public Health Agency of Canada in 2017 and 2018.

methodsA mumps outbreak survey was developed and administered by epidemiologists within CIRID and sent electronically to provincial and territorial public health officials in charge of mumps surveillance. The survey collected information on mumps outbreaks pertaining to demographics, risk factors, laboratory data and public health interventions. The first survey collected data on outbreaks occurring between January 1, 2016 and February 28, 2017, while the second survey contained outbreak data from January 1, 2017 to July 31, 2018. Duplicate outbreaks entries were removed.

resultsThe response rate for the first and second surveys was 61% and 69%, respectively. Twenty-four mumps outbreaks across nine provinces were reported between January 1, 2016 and July 31, 2018, for a cumulative total of 881 mumps cases. Adolescents and adults 15 to 39 years of age accounted for the majority of cases (80.6%). Specifically, adults 20 to 24 years of age represented the largest proportion of cases (24.6%). Community and social gatherings were the most common exposure setting (62.5%). Slightly more than one third of cases were known to have received at least two doses of mumps-containing vaccine (35.6%).

conclusionResults from the surveys indicate that the increase in mumps activity was widespread throughout Canada, affecting multiple jurisdictions. Young adults accounted for the largest proportion of cases. These surveys provided evidence to support recommendations on the use of additional mumps vaccination in outbreak settings.