Mumps! What To Know During An Outbreak

There is a mumps outbreak here in Washington State, as well as various other outbreaks across the nation. The CDC reports that mumps infections are currently at a 10-year high. This post is a quick update on the outbreak and why they occur, an explanation about the mumps virus, the infection and symptoms that are typical, and what parents should know now to avoid mumps.

Mumps Outbreaks In 2016

• Numbers This Year: For the calendar year 2016 through early December, 46 states and the District of Columbia have reported a total of 4,528 mumps infections — well more than double the mumps cases reported in 2015 and creeping up in ways similar to 2006 when we had the last big mumps year. That outbreak was primarily housed in the midwest among college students.
• Mumps In College Students: In general, we often hear more about outbreaks on college campuses in part because of students living in close quarters. Mumps is easily spread when those are in close contact who share cups, talk closely together and share respiratory droplets more readily. The intensity of these environments allows mumps to spread more rapidly and it’s also possible that during college some students have lost immunity from the vaccine they received as a child. In general college students are at higher risk because of how they relate. I love how CDC details the conditions, “certain behaviors that result in exchanging saliva, such as kissing or sharing utensils, cups, lipstick or cigarettes, might increase spread of the virus.”
• Washington State Outbreak: As of 12/23/16 there have been 101 cases in King County (cases updated here by the Public Health Dept). In total, 32 cases are confirmed and 69 probable with additional cases under investigation. The majority of cases are in children under age 18. Some 65% of those cases are in people who are reported as up-to-date on Measles Mumps & Rubella (MMR) vaccine. This occurs in part because although the MMR vaccine works well, it still will leave some vulnerable to an infection if exposed. The MMR vaccine provides protection against mumps to about 88% of us after we get two shots, so it consequently leaves more than 1 in 10 of us vulnerable during outbreaks. We typically don’t know who is in that 12% so during outbreaks we make sure students are up-to-date in immunizations and those with suspicious symptoms are seen, diagnosed, and while infectious, they stay home.
• Schools Send Children Home If No MMR Shots: The outbreak has been of big enough concern that The Auburn School District told more than 200 non-immunized students to stay home so they wouldn’t get the virus and go on to infect others. Public health officials sent letters to the students’ homes saying kids would only be allowed back once they had proof they’ve received the MMR vaccine. Otherwise, the students will be kept from school for at least 25 days after the last mumps case in the Auburn district.

Symptoms of Mumps:

Mumps often presents like other viral infections with overall body symptoms, achiness, and fatigue and soreness in facial glands that often cause puffy cheeks. In general it’s a mild infection but rarely mumps can lead to swelling in the brain, brain infections, deafness or swelling in the testicles or ovaries. Good things to avoid!
Mumps is very contagious and spread easily in groups. Someone who gets mumps is often contagious 2 days before their symptoms of facial swelling start even start so it can spread without clear knowledge.  In addition, mumps can cause unusual pain and discomfort in the glands in your face that make saliva which is atypical for most common cold viruses. Rarely mumps causes severe infections leading to deafness or life-threatening illness. Typical illness with mumps starts a week or more after being exposed and most with mumps are sick for a couple weeks. Mumps symptoms:

• Puffy face. Swollen glands in front of and below the ear or under the jaw (in the glands in the image)
• Pain with opening and closing the jaw
• Fever
• Fatigue and malaise (feeling punky and unwell)
• Headache and earache
• Swelling in scrotum in boys and men (about 10% of the cases)

Reducing Risk During Mumps Outbreaks:

• MMR vaccine works: clearly during outbreaks it is smart to make sure your family is vaccinated with the MMR vaccine. The American Academy of Pediatrics (AAP) recommends the first dose of MMR vaccine between 12 and 15 months of age and the second dose between before kindergarten. After 2 doses nearly 9 out of 10 people are protected during an outbreak.
• Cover your cough or sneeze as is usual, when you’re ill! Wash your hands often with soap and water, or use an alcohol-based hand sanitizer.
• Don’t share food, drinks, cups or utensils with other. Avoid exchanging saliva with others but note that with mumps even conversing in close quarters can spread the disease.
• If any concern you or your child has been exposed or has symptoms of mumps, see your pediatrician, family doc, nurse practitioner or PA. There is no treatment for mumps but by identifying those with mumps we can help protect others and ensure a child is supported and followed during the recovery.

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