Mumps Outbreak

Fever.  Headache.  Body aches.  Loss of appetite.  Typical viral illness, right?  Then 3-4 days into the illness you start with swelling in front of your left ear.  The swelling quickly worsens until it is pushing your ear up and out and you can’t feel the bone of your lower jaw because of the swelling.

Credit: http://diseasespictures.com

Credit: diseasespictures.com

You’ve got the mumps.

You may not be aware of this, but in the USA we are experiencing a mumps outbreak.  According to the CDC, we have had almost 2900 cases of mumps reported in 45 states and the District of Columbia.  This is the largest number of cases seen in 10 years.  (There may be more cases as mumps is not subject to mandatory reporting.)

Most of the cases have been on college campuses.  Mumps is spread by droplet transmission, in which secretions from an infected person are spread by coughing, sneezing, kissing, or sharing drinks, cigarettes or eating utensils.

Why are we experiencing an outbreak of a disease that is prevented by a vaccine every child is supposed to receive?  Most of the cases are actually occurring in people who HAVE been vaccinated.  It turns out that mumps immunity starts to wear off about 10-15 years after vaccination.

College students, in general, had their last MMR vaccine (measles, mumps and rubella) when they started kindergarten.  There is no current recommendation to give a booster vaccination of MMR prior to college.

Why not?  Turns out even though the vaccine-stimulated immunity isn’t perfect it is still pretty darn good.  Prior to the MMR vaccine being introduced in 1967 about 186,000 cases were reported in the USA per year.  Deaths were very rare but the illness did cause permanent deafness and rare cases of encephalitis and meningitis.  It also inflamed the testicles of boys in up to 10% of cases and could interfere with fertility.

Since the MMR vaccine was introduced, cases of mumps have decreased by 99% and many physicians (myself included) have never seen a case.  It would be difficult to improve much on 99% effectiveness with a third vaccine dose and we very well might hurt more people with an additional vaccine dose than we would help by preventing the few cases of mumps that still develop.  Vaccines are not perfectly safe, and all medical treatments have risks.

However, if an outbreak does occur on an individual college campus or other setting where large numbers of susceptible people are concentrated, offering booster doses of vaccine is standard of care.  In those cases, students and other individuals are at much higher risk of catching the illness.  The balance of chance-to-help vs. chance-to-hurt is much more favorable.

If you or your family member is in college or in a setting where they are exposed to a lot of people on a daily basis and cases of mumps are reported, please consider asking for a booster dose of MMR vaccine.  It is a very contagious disease and getting a booster can decrease the risk of a pretty miserable experience.

QUESTION: Have you or a family member ever had mumps?

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