FEAR: Mumps Making Comeback

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Mumps outbreaks are on the rise, according to the Centers for Disease Control and Prevention.

Mumps is a virus that causes swelling of the parotid glands, the salivary glands under the ears, along with some more general symptoms like fever and fatigue, according to the CDC. The symptoms are recognizable; sufferers look like they have swollen “chipmunk cheeks.”

Pediatrician Dr. Janell Routh, a medical officer on the CDC’s mumps team says that more than 6,000 cases of mumps were reported in the United States last year, the highest number in 10 years. Around 2010, the total number of cases was in the hundreds, not thousands.

Lately, mumps has been occurring in outbreaks, such as a large one in Arkansas, rather than sporadic incidences. Most of the outbreaks happen among 18- to 22-year-olds, despite the fact that they might have had the requisite two doses of a mumps vaccine in childhood. “We are seeing it in a young and highly vaccinated population,” Dr. Routh observed.

The mumps vaccine was licensed in 1967, based on the Jeryl Lynn strain of mumps, and developed by Dr. Maurice Hilleman, who cultured the virus from his sick daughter.

Mumps is transmitted by droplets of saliva or mucus. It can be spread by coughing and sneezing, but also by sharing cups and the close contact of living, eating and exercising together. Recent outbreaks frequently occurred in college dorms or among athletic teams, as happened with the Syracuse University men’s and women’s lacrosse teams last month.

“We are seeing it in other close-knit communities that tend to live closely together with strong social or cultural interactions,” including religious groups, Dr. Routh said.

The mumps vaccine is now combined with measles and rubella vaccine in the M.M.R., given at ages 1 and 4. But the immunity wanes over time in some people, and with close contact, there can be sufficient exposure to enough quantities of the virus to overwhelm the vaccines’ protection.

According to a report in The New York Times, “Dr. Patricia Quinlisk, the medical director and state epidemiologist for the Iowa Department of Public Health, dealt with an outbreak at the University of Iowa and surrounding area in 2015 to 2016 of more than 450 cases of mumps. The students involved had all had their childhood M.M.R. shots, she said, as required by the university, and the decision was made to hold a series of clinics offering a third dose of vaccine.”

Dr. Quinlisk and her colleagues found that the third M.M.R. dose was effective. “In our outbreak, it did substantially decrease the risk of other students getting mumps, and was instrumental in stopping the outbreak,” she said.

Other strategies to contain the outbreak included education about cough hygiene and working with student health services to make it possible for infectious students to isolate themselves. Those who had to use communal bathrooms were provided masks.

The current recommendation is that a third dose, while safe, is only warranted for people felt to be at high risk by public health workers.

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