Whooping cough, I haven't been following closely but I think they're finding the same in the UK

[saintlyjimjams]

Can't say I'm particularly surprised

www.reuters.com/article/2012/04/03/us-whoopingcough-idUSBRE8320TM20120403

Saintly, very interesting re Mumps. Are there any indications that these side effects were in kids, or were they all in adults where Mumps is worse?

I have a little boy and I am hoping he acquires Mumps naturally while he is little. It bothers me that so many people recieve temp immunity through the MMR when it is uneccessary and reduces the chances my little man can catch it while it is safe and natural.

Considering the scientific and medical community know this, my question is WHY?

Yes I've been asking why for a long time.

Certainly the 7 cases of hearing loss in Japan recorded in the poster were in children, but I have no idea how the incidence breaks down across age groups. I'm fairly certain from previous reading that the chance of an asymptomatic dose decreases with increasing age which might have an effect. Of course the biggest change is he potential to affect fertility post puberty, although I think that long term effects are fairly rare, even though orchitis isn't that uncommon.

I did find a figure of hearing loss in 1 in 6 million cases of vaccine. That seemed a fairly accepted figure.

Saintly: www.ncbi.nlm.nih.gov/pubmed/19209100
www.ncbi.nlm.nih.gov/pubmed/15917168

Ok so the first one is the paper version of the poster - which I personally think had major issues with identifying mumps cases which could skew the 1 in 15,000 to 1 in 20, 000 figure that seems to be more common, and the second one is a survey so not going to be hugely reliable (and I would be interested to see how numbers of mumps cases was calculated as well, given so many cases of mumps infection are mild/asymptomatic).

how are you getting from the 1 in 1000 measured in a prospective study to 1 in 15000?

Because all the other literature quotes 1 in 15,000 to 1 in 20, 000 - that seems from a brief browse to be the most accepted figure. The group you have linked to have 1 in 1000 but imo they haven't identified mumps rates correctly. They do give that criticism themselves on the poster.

but the Japanese are the only ones who have enough mumps cases to be making a good estimate on mumps sequalae. In the older paper, their estimate was even higher (about 1 in 650 in the epidemic year).

Er but they still have to identify all the cases to get an accurate result. If they only identify a third of the cases then their rate is going to be overstated.

The authors themselves in their poster say that ascertaining mumps cases is difficult. They give a figure of 30-40% of cases being asymptomatic, with further cases being so mild people don't consult a doctor. But they make no adjustment for that in their calculations.

If you take into account the above then it isn't impossible that they're only seeing about a third, or just over a third of cases - which then brings you back to the original 1 in 20,000 ish

the math does not pan out. The study sees 7400 cases of which 7 end up with hearing loss. That makes an observed rate of 1 in 1060 (give or take a couple). Now if 30% of kids are non symptomatic, you ad those to the risk (1060/70% symptomatic kids x 100) = risk for hearing loss 1 in 1514 (assuming that the non-symptomatic children do not suffer hearing loss, we don't know that). That is no where near 1 in 20000.

You think everyone with mumps goes to the doctor? I am reckoning they are seeing a third of cases, half maybe. They have said in the poster they won't have got all mumps cases they (giving a figure of 30-40% as asymptomatic and mentioning that others won't have gone to the doctor) then calculated the rate as if they did get all the cases. 1 in 1000 cases of mumps bad enough to warrant a trip to the doctor is very different from 1 in 1000 cases of mumps.

I didn't make up the 1 in 15,000 to 1 in 20, 000 figure from that paper. It seems the most widely accepted figure. The only ones quoting anything different is this study, which calculates the rate using figures that is going to hugely underestimate the number of mumps infections so skew the rate.

This is interesting: ecdc.europa.eu/en/ESCAIDE/Materials/Posters%202009/ESCAIDE2009_Poster_session_B6_Dittrich.pdf although I'm a little bit at "mumps infections in vaccinated persons are not uncommon"

when dd2 had mumps recently I only took her to the doctor so that I could notify her school (if necessary - which it was, as it turned out), and more importantly, dd1's school (and keep dd1 off whilst potentially contagious etc).

otherwise I would not have bothered - there was nothing the doctor could do for her that I couldn't (and hadn't).

so I htink docs see a minority of mumps cases. once dd2 was back at school, I had several other mums tell me their children had had a 'nasty virus' recently, and now they thought about it it could have been mumps etc. a tiny percentage had been to the docs with their children, yet half the year were off school over a short period of time...

silverfrog - I have no problem believing that for the UK - DS has had a fever for a week and it took a lot of calls to the GP/NHS24 to finally get them to start searching for specific bugs today. I think DH and I talked to 6 doctors in all

I don't know much about the Japanese health system, but presumably, if those clinics participated in a study, they'd be more interested in verifying mumps infections and following up?

but they can only verify those cases brought to them in the first place.

yes, even when I was at the doctor's, I had trouble convincing them to verify mumps. but out of the rest of dd2's year (32 children in total), at least 20 of them were ill at one point or other, and only 3 (that I know of, I have not exhaustively interviewed each parent ) went to the doctor's with it.

I lived in Japan. You go to a hospital for every illness, so there isn't a GP service as such. It was very much like a quicker version of the NHS, the hospitals I saw were the same sort of standard luxury wise (ie not american hotel like!). You were always given some sort of medication but often it was chinese medicine rather than western, and the Japanese were happy to interchange the two. I went with tonsillitis as I thought I might need antibs and came out with packages of stuff including a bunch of green herbs (which is fine by me, I prefer that to pharma pills - prefer to take them only when absolutely necessary). I vaguely remember docs are paid per prescription so routinely over-prescribe anti-bs as well. Am more than happy to be corrected on that, it's a recollection.

Not sure that I'd bother going with kids in tow though, waiting rooms were full of people with drips in their arms.

I'm sure those particular dx were reasonably accurate, but they've made no account of the missing mumps infections - although they identify that they exist. So their rate is 1 in 1000 mumps infections that are bad enough to make you go to the doctor. So excludes asymptomatic infections and mild infections.

My Mum btw os deaf in one ear from measles. She still says 'don't you go giving those children MMR, especially him ' (not that I would anyway)