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    Porter, Aaron T. and Oleson, Jacob J. 2016. A spatial epidemic model for disease spread over a heterogeneous spatial support. Statistics in Medicine, Vol. 35, Issue. 5, p. 721.

    Porter, Aaron T. and Oleson, Jacob J. 2014. A multivariate CAR model for mismatched lattices. Spatial and Spatio-temporal Epidemiology, Vol. 11, p. 79.

    Porter, Aaron T. and Oleson, Jacob J. 2013. A Path-Specific SEIR Model for use with General Latent and Infectious Time Distributions. Biometrics, Vol. 69, Issue. 1, p. 101.

    Heywood, Anita E Zhang, Meng MacIntyre, C Raina and Seale, Holly 2012. Travel risk behaviours and uptake of pre-travel health preventions by university students in Australia. BMC Infectious Diseases, Vol. 12, Issue. 1,


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

  • P. M. POLGREEN (a1) (a2), L. C. BOHNETT (a3), M. YANG (a3), M. A. PENTELLA (a2) (a4) and J. E. CAVANAUGH (a3)
  • DOI:
  • Published online: 09 September 2009

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.

Corresponding author
*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, Iowa52242, USA. (Email:
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6.JP Utz , Clinical and laboratory studies of mumps. I. Laboratory diagnosis by tissue-culture technics. New England Journal of Medicine 1957; 257: 497502.

8.PM Polgreen , The duration of mumps virus shedding after the onset of symptoms. Clinical Infectious Diseases 2008; 46: 14471449.

12.H Peltola , Mumps outbreaks in Canada and the United States: time for new thinking on mumps vaccines. Clinical Infectious Diseases 2007; 45: 459466.

17.C Cohen , Vaccine effectiveness estimates, 2004–2005 mumps outbreak, England. Emerging Infectious Diseases 2007; 13: 1217.

22.I Davidkin , Etiology of mumps-like illnesses in children and adolescents vaccinated for measles, mumps, and rubella. Journal of Infectious Diseases 2005; 191: 719723.

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Epidemiology & Infection
  • ISSN: 0950-2688
  • EISSN: 1469-4409
  • URL: /core/journals/epidemiology-and-infection
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