Mumps Advisory for Health Care Providers

Background
Two cases of mumps were reported to CDHD this week. These cases were connected to an ongoing mumps outbreak at the University of Idaho. Both of these cases were among college-aged individuals who received 2 doses of MMR vaccine.

Symptoms and Transmission
The classical symptom of unilateral or bilateral parotitis is seen in 30%-40% of mumps cases but non specific symptoms such as myalgia, anorexia, malaise, headache and low-grade fever may precede the parotitis by several days. Up to 20% of cases may be asymptomatic and nearly 50% of cases are associated with non-specific respiratory symptoms with or without parotitis.

Mumps cases can still occur among vaccinated individuals. A single dose of MMR vaccine is about 80% effective in preventing mumps disease and two doses are about 90% effective.

Mumps is spread through contact with infected respiratory droplets and direct contact with infected saliva. The incubation period for mumps infection ranges from 12 to 25 days but is usually 16 to 18 days. Persons with mumps are considered to be most infectious 1 to 2 days before and until 5 days after the onset of parotitis. Peak infectiousness is generally 2 to 4 days after the onset of symptoms. Suspect cases should stay home 5 days after the onset of parotitis.

Laboratory Specimens and Testing
Laboratory testing is important for case confirmation. The preferred specimens are:

• A buccal or oral swab in Viral Transport Medium for viral PCR testing AND
• Serum for IgM antibody testing

Both specimens should be collected at the time that mumps is first suspected but ideally within 1 to 3 days after onset of symptoms. Please call the Office of Communicable Disease Control at (208) 327 8625 to coordinate testing through the Idaho Bureau of Laboratories.

Treatment and Prevention
There is no antiviral medication approved for mumps infection.

Post-exposure vaccination may not prevent disease among susceptible contacts but will confer protection against infection from subsequent exposures.

Routine vaccination with two doses of MMR vaccine is recommended for children.
Adults born in 1957 or later should receive at least one dose of MMR vaccine and two lifetime doses of vaccine are recommended for students attending colleges or other post-high school educational institutions, healthcare personnel and international travelers.

For additional information about MMR vaccine see http://www.cdc.gov/mmwr/preview/mmwrhtml/rr6204a1.htm .

To report suspected or confirmed cases please call the Office of Communicable Disease Control at (208) 327-8625.

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