In a letter sent home from schools, community physicians warn of a Mumps outbreak in our community. The note said that “although at this time seems concentrated amongst adolescent boys; we expect will spread further throughout the community.” The note goes on to explain what the symptoms are and how to go about treating it.
An Urgent Message from the Healthcare Providers of Our Community Concerning the Recent Outbreak of Mumps
There has recently been an outbreak of mumps that although at this time seems concentrated amongst adolescent boys; we expect will spread further throughout the community.
What is mumps?
Mumps is a highly contagious viral illness spread by droplets (i.e. the tiny droplets of saliva and other respiratory secretions that are exchanged when people are close to one another).
What is the incubation period for mumps?
The incubation period of mumps is a long one, extending from 2-3 weeks. That means that a person exposed to mumps will not present with the illness until 2-3 weeks later.
The infectious period of mumps begins 2-3 days prior to the onset of symptoms and extends for at least 5 days after the onset of symptoms.
What are the symptoms of mumps?
Most eases begin with mild non-specific symptoms such as headache and fatigue, during which time the infected individual is contagious. They might then progress to the clinical illness of mumps which is often mild involving swelling of the salivary glands (the glands that make saliva) located in front of and below the ear.
Other salivary glands under the jaw may also be involved. The swelling may be on one or both sides and is commonly associated with pain during eating, particularly food stuffs that stimulate the flow of saliva such as citrus. The illness usually lasts up to a week and gets better spontaneously.
Are there complications from mumps?
About 10-15% of all those infected with mumps may, G-d forbid, develop complications such as: severe headache, inflammation of the gonads (testicles or ovaries) and less frequently damage to the hearing apparatus and inflammation of the pancreas. Although most of the complications do resolve without consequence, rarely there is long-lasting damage to the affected organ(s).
Is there antiviral treatment for mumps?
At this time there is no antiviral medication for mumps that is known to work.
What is the treatment for affected individuals?
Treatment of affected individuals consists of:
1) Isolation: that means stay home
2) Rest and fluids until completely better
3) Analgesia (relief of pain and discomfort) with Tylenol and/or Motrin as needed
What should I do to help prevent infection’?
Universal hygiene precautions should always be in place. These are:
I) Frequent hand washing
2) Covering one’s mouth and nose when sneezing or coughing. Don’t sneeze into your hand but rather into a tissue or the crook of the arm,
3) If your children are not well, keep them home until it becomes clear what they have.
What about vaccination for mumps?
This is an unfolding situation and a rather novel one. Therefore, there remain some unanswered questions regarding the current outbreak as to the effectiveness of vaccination.
The MMR vaccine is usually given at one year and a booster dose at 4 years of age.
The recommendation has always been, and continues to be, that all children receive 2 shots of MMR (measles, mumps, and rubella) in order to be maximally protected. There is no single component vaccine available. When all the individuals in a group are vaccinated, there exists “herd immunity”. Unvaccinated individuals allow the virus to take hold, gather velocity and spread throughout the group.
Many of the cases in the current outbreak have occurred in children who had previously received 2 doses of the vaccine. This obviously raises questions about the effectiveness of the mumps vaccine currently in use against the strain currently circulating. Nevertheless, the CDC together with the NYC Health Department are still strongly advising, that although not perfect, the best protection remains giving all children 2 doses of vaccine.
Anyone who has been exposed (and by this time having just finished Tishrei, the assumption is that most people have been exposed) will probably not benefit from post-exposure vaccination. This means that if one’s sibling or classmate has mumps, there is little likelihood that unvaccinated individuals who receive vaccine at this time will be protected in the current outbreak.
There does not appear to be any added benefit to receiving a third booster vaccination in those that have had 2 vaccinations already.
Do I need to see a doctor?
In the usual situation, the answer is no. In the event that you feel that your child is particularly ill, please make an appointment to see your doctor. Make sure to inform the secretary that you or your child has mumps so appropriate isolation precautions can be taken.
We hope that these recommendations are clear and will be followed, particularly those concerning isolation of affected individuals.
Eli Rosen, MD
Avraham Gottesman, MD
Howard Levine, MD
Allan Plaut, MD
Robert Feldman, MD
David Hurwitz, MD
Thomas Rehm, MD