Epidemiology and Infection

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Epidemiology and Infection (2010), 138:434-441 Cambridge University Press
Copyright © Cambridge University Press 2009

Original Papers

Childhood infections

A spatial analysis of the spread of mumps: the importance of college students and their spring-break-associated travel

P. M. POLGREENa1a2 c1, L. C. BOHNETTa3, M. YANGa3, M. A. PENTELLAa2a4 and J. E. CAVANAUGHa3

a1 Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, IA, USA
a2 Department of Epidemiology, University of Iowa College of Public Health, Iowa City, IA, USA
a3 Department of Biostatistics, University of Iowa College of Public Health, Iowa City, IA, USA
a4 The University of Iowa State Hygienic Laboratory, Iowa City, IA, USA
Article author query
polgreen pm [PubMed]  [Google Scholar]
bohnett lc [PubMed]  [Google Scholar]
yang m [PubMed]  [Google Scholar]
pentella ma [PubMed]  [Google Scholar]
cavanaugh je [PubMed]  [Google Scholar]


To characterize the association between county-level risk factors and the incidence of mumps in the 2006 Iowa outbreak, we used generalized linear mixed models with the number of mumps cases per county as the dependent variable. To assess the impact of spring-break travel, we tested for differences in the proportions of mumps cases in three different age groups. In the final multivariable model, the proportion of Iowa's college students per county was positively associated (P<0·0001) with mumps cases, but the number of colleges was negatively associated with cases (P=0·0002). Thus, if the college students in a county were spread among more campuses, this was associated with fewer mumps cases. Finally, we found the proportion of mumps cases in both older and younger persons increased after 1 April (P=0·0029), suggesting that spring-break college travel was associated with the spread of mumps to other age groups.

(Accepted August 12 2009)

(Online publication September 09 2009)

Key Words:College students; spatial; travel; mumps; outbreaks


c1 Author for correspondence: P. M. Polgreen, M.D., Assistant Professor, Division of Infectious Diseases, Department of Internal Medicine, University of Iowa, Carver College of Medicine, 200 Hawkins Drive, Iowa City, Iowa 52242, USA. (Email: philip-polgreen@uiowa.edu)