Mumps

 

Overview

Mumps is an infection caused by the mumps virus. Anyone who is not immune from either previous mumps infection or from vaccination can get mumps. Before the routine vaccination program was introduced in the United States, mumps was a common illness in infants, children and young adults. Because most people have now been vaccinated, mumps is now a rare disease in the United States. Of those people who do get mumps, up to half have very mild, or no symptoms, and therefore do not know they were infected with mumps.

Symptoms

The most common symptoms are fever, headache, muscle aches, tiredness and loss of appetite followed by onset of parotitis (swollen and tender salivary glands under the ears - on one or both sides). Mumps can lead to hearing loss, aseptic meningitis (infection of the covering of the brain and spinal cord) in about 10% of cases, painful, swollen testicles in 20% to 30% of males who have reached puberty (orchitis) but rarely does this lead to fertility problems, and painful swollen breasts in about 30% of women who have reached puberty (mastitis), and in a very few cases, inflammation of the ovaries.

  • Inflammation of the brain and/or tissue covering the brain and spinal cord (encephalitis/meningitis)
  • Inflammation of the testicles (orchitis)
  • Inflammation of the ovaries and/or breasts (oophoritis and mastitis)
  • Spontaneous abortion particularly in early pregnancy (miscarriage)
  • Deafness, usually permanent (usually in children)

Symptoms typically appear 16-18 days after infection, but this period can range from 12-25 after infection.

How mumps is spread

Mumps is spread by mucus or droplets from the nose or throat of an infected person, usually when a person coughs or sneezes. Surfaces of items (e.g. desks) can also spread the virus if someone who is sick touches them without washing their hands, and someone else then touches the same surface and then rubs their eyes, mouth, nose etc. (this is called fomite transmission). Mumps virus has been isolated from respiratory secretions 3 days before the start of symptoms until 9 days after onset.

Treatment and Protection

There is no specific treatment. Supportive care should be given as needed. If someone becomes very ill, they should seek medical attention. If someone seeks medical attention, please contact the EIU Medical Clinic in advance by calling 217.581.2727. Please call in advance and do not walk in unannounced so that you don't have to sit in the waiting room for a long time and possibly infect other patients.

Mumps vaccine (usually MMR), is the best way to prevent mumps. Other things people can do to prevent mumps and other infections is to wash hands well and often with soap,. Eating utensils should not be shared, and surfaces that are frequently touched (toys, doorknobs, tables, counters, etc) should also be regularly cleaned with soap and water, or with cleaning wipes.

Mumps Vaccine

Two doses of mumps-containing vaccine, given as combination measles, mumps, rubella (MMR) vaccine, separated by at least 28 days, are routinely recommended for all children. The first dose is given on or after the first birthday; the second is given at 4 - 6 years of age. MMR is a live, weakened (attenuated) vaccine.

Most adults who have not been vaccinated should also receive 1 dose of MMR vaccine, but adults who work in healthcare, a school/university setting, and persons at high risk of exposure to mumps should get 2 doses. Pregnant women and persons with an impaired immune system should not receive live attenuated vaccines (MMR vaccine).

One dose of mumps vaccine will ‘take' (be effective) in approximately 80% of people vaccinated, but two doses of mumps vaccine will ‘take' in approximately 90% of people. Therefore, two doses are better at preventing mumps than one dose.

Where to get vaccinated

Most family and pediatric doctors keep vaccine in their clinics; and local health departments usually have vaccine. If someone isn't sure where to get vaccine, they can call the local or state health department. For more information, please call EIU Health Service at 217.581.2727. EIU Health Service does have the MMR vaccine. Please, keep in mind that all EIU students taking 6 or more credit hours on campus must have shown proof of two doses of MMR prior to re-enrollment.

The MMR vaccine is safe and there is no increased risk of side effects if a person gets another vaccination.

Exposure

Not everyone who is exposed to someone with mumps will get sick. If a person has been vaccinated with two doses of mumps vaccine, it is very unlikely they will get mumps. However, if a person hasn't been vaccinated, it is possible they could get sick and they should watch for symptoms of mumps. Additionally, if a person hasn't been vaccinated, this is a good time to get another dose of mumps vaccine, and to make sure that everyone else in the house where they live is also vaccinated.

Mumps vaccine has not been shown to be effective in preventing disease after exposure, but vaccination of exposed susceptible persons will reduce the risk of disease from possible future exposures. If symptoms develop (generally 16-18 days after exposure), the person should not go to school or work for at least 9 days and should contact their medical provider.

Information on the Midwest Outbreak

Q: How many cases usually occur in the US each year?

A: In the United States , since 2001, an average of 265 mumps cases (range: 231-293) have been reported each year.

March 30, 2006 [55(13);366-368] )

Q: When did the outbreak in the Midwest start?

A: The first cases of mumps-like illness were reported from Iowa in December 2005. More cases have been occurring since then in Iowa, and in several other states. (See CDC's Report on Recent Mumps Outbreak.)

Q: Where did the outbreak in the Midwest start?

A: The current information indicates that the outbreak may have begun on a college campus. Colleges that have group living, dining, studying, and sports are areas that make disease transmission more likely, and increase the chance of outbreaks. Once started, such outbreaks sometime spread to the community, causing illness in persons who do not attend college. For this reason, CDC recommends that all college students have two doses of measles-mumps-rubella (MMR) vaccine. Currently, it has spread to several states including Illinois. Additionally, some universities have had confirmed cases within Illinois.

Q: Why are people who have been vaccinated getting sick?

A: One dose of mumps vaccine prevents approximately about 80% of mumps and two doses approximately about 90% of cases. Even though the vaccine is effective, if most persons in a population are vaccinated, most cases in an outbreak would also be expected to be vaccinated. However, if the vaccine hadn't been used, the outbreak would have affected everyone, rather than a small percent of the population.

Q: Does the current vaccine work against the mumps virus that is causing the outbreak?

A: Yes. The strain of mumps virus in the Midwest is the same as the one that is found in other countries, and that caused a large ongoing outbreak in the United Kingdom (UK) with more than 60,000 cases. In 2005 a small mumps outbreak occurred in the US after a person visited from the UK and mumps vaccine was effective in preventing this outbreak.

Q: What can be done to stop the spread of mumps?

A: Anyone with mumps should not go back to child care, school or work for 9 days after symptoms begin. People who come in contact with a mumps case should have their immunization status evaluated. Anyone who has not received mumps-containing vaccine (preferably MMR vaccine) should be vaccinated. Persons who may have been in contact with a mumps case should be educated on the signs and symptoms of mumps disease and should seek medical attention if any of these symptoms begin.