Spread of the Disease
Symptoms typically appear
16-18 days after infection, but this period can range from 12-25 after
infection. 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. toys) 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
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, they should
call their doctor in advance so that they don't have to sit in the waiting room
for a long time and possibly infect other patients.
Prevention
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, and to teach
children to wash their hands too. 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.
Vaccination
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. 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.
If you don't know if you've been vaccinated, get vaccinated. The MMR vaccine is safe and there
is no increased risk of side effects if a person gets another vaccination.
Most people who had mumps will be protected
(immune) from getting mumps again. There is a small percent of people though,
who could get reinfected with mumps and have a milder illness. If mumps was not
diagnosed by a physician, then that person is not considered immune and
vaccination is recommended.
What if I'm Exposed to Mumps
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.
Current Outbreak
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. In the United States , since 2001, an average of
265 mumps cases have been reported each year.
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. Studies have suggested that strict
enforcement of these recommendations is important for preventing and stopping
outbreaks.
Why are People Who Have Been Vaccinated Getting
SIck?
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.
Does the current vaccine work against the
outbreak?
The current vaccine does work against the mumps
virus that is causing the outbreak. 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 controlling this outbreak.
Other Outbreaks
There has been an ongoing mumps outbreak in
the United Kingdom (UK). This outbreak was mostly among unvaccinated young
adults, 3.3% of them had 2 doses of mumps vaccine, and 30.1% had one dose of
mumps vaccine.
There was a mumps outbreak in a camp in New York
in 2005 that was believed to have begun after a camp counselor from the UK
developed mumps.
Schools
Many different things affect whether or not an
outbreak of mumps might begin in a school, but outbreaks can only begin when
there are enough people in an area (school or community) who are not immune from
the disease. The best way to prevent a mumps outbreak in a school is to make
sure that everyone in that school has had two doses of mumps vaccine (MMR).
Stopping the spread
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. The local health department or a physician can help determine if a
person needs one or two doses of MMR vaccine. 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.
