Iowa is experiencing the largest outbreak of mumps in 20 years. This outbreak began in December 2005. In mid April, 2006 over 800 suspect, probable and confirmed cases have been reported to the Iowa Department of Public Health. Eight neighboring states with mumps cases are now also under investigation. The source of the outbreak is unknown; however the mumps strain has been identified as genotype G, the same genotype circulating in the United Kingdom. The outbreak in the UK has been ongoing for 2 years and has involved over 70,000 cases.
Mumps is an acute viral infection. The most common symptoms are fever, headache, and swollen salivary glands under the jaw. Respiratory symptoms are common. Complications of mumps can include deafness, orchitis, (inflammation of the testicles), oophoritis (inflammation of the ovaries), or mastitis (inflammation of the breasts). Other complications can be pancreatitis, meningitis/encephalitis, and spontaneous abortion. With the exception of deafness, these complications are more common among adults than children.
Transmission of the mumps virus occurs by direct contact with respiratory droplets with sneezing and coughing, or saliva contact. The incubation period is generally 16-18 days with a range of 12-25 days from exposure to onset of symptoms. This virus can be spread from an infected person for about five days after onset of symptoms. You are most infectious three days before onset of symptoms and four days after onset.
The best strategy to prevent the mumps is to maintain high immunization levels. Preschool children between 12 -15 months receive the first dose of MMR vaccine and then the second dose is given between the ages of 4-5 years, before they enter kindergarten. Two doses of MMR vaccination are more effective than a single dose. The vaccine is not 100 percent effective. Effectiveness of the mumps vaccine with two doses is 95 percent. An example is: In a community of 100 people, 100 percent have been vaccinated. Everyone is exposed to the mumps. What happens is 95 people (95 percent) in the community are protected by the vaccine and do not get mumps. Five people (5 percent) in the community become ill with mumps because the vaccine did not "take". Of the five people who get mumps, all (100 percent) have been vaccinated. This does not mean that the vaccine is not working; in fact the mumps vaccine is working as expected.
The majority of the cases in Iowa are young adults, with the median age at 21. State health officials are initiating a plan for mass vaccination in phases. Focus will be on college students (18 through 22 years of age) because they as a group are most likely to spread or transmit the virus to others. Thirty-five counties have been identified that have post secondary educational institutions. These will be the focus of phase 1.
This will take place from April 26th, 27th, and 28th. Parents should check their college student's records to see if they have had two MMRs, and if not they should strongly encourage the student to attend one of clinics that will be set up near their college.
The next phase will take place from May 2nd to the 4th . This will involve Cherokee County. Focus will continue on the 18 through 22 years olds. Watch your local newspapers and listen the local radio and TV stations for times and places of these vaccination clinics.
Other preventions methods include covering your mouth and nose when coughing and sneezing, staying home from work or school when sick, and not sharing eating and drinking utensils. It is important for the focus group to receive their 1st and 2nd MMR vaccination, but also for other age groups. The mumps vaccination was not routinely used until 1977. If you were born before 1957 you are likely to have natural immunity because of exposure, but in a case of an outbreak as we are experiencing an MMR vaccination should be considered for protection. If you have documentation of two doses of MMR or a confirmed case of the Mumps, there is no reason to have another MMR. Infection with the mumps occurs only once.
Cherokee County Community Health has the vaccine for childrens program. The next clinic is April 26th from 3 to 6 p.m. This is for children from birth to 18 years of age. We also have a supply of MMR vaccine for adults. Call our office at 225-6718 to set up an appointment for adults. It is especially important for health care workers, child care providers, teachers, and anyone that has not been previously vaccinated with two MMRs to strongly consider vaccination.
Public Health's daily job is to investigate normal or unusual cases of illness. We have established procedures and processes that we are following to inform and educate the public. If anyone has any questions concerning this matter please call.