Mumps Control
The largest epidemic of mumps in the US since 1988 is being investigated by the CDC. The first cases were reported on a college campus in Iowa, and, as of April 19, the state reported 975 confirmed, probable or suspected cases. While one-fourth of the state’s cases are college students, 147 are children ages 5 through 17 years. Laboratory testing identified the strain as genotype G. Ongoing studies address vaccine coverage on college campuses, means of virus transmission, and the effectiveness of one or two doses of MMR vaccine.
The source of the Iowa epidemic is undetermined. The United Kingdom [UK] recorded a mumps epidemic that peaked during 2005 with a high rate of cases among young adults. The strain was also genotype G, and the UK epidemic was linked to an outbreak in the US.
Mumps is an acute viral infection typically characterized by fever, sore throat and swelling of the salivary glands, but up to 30% are asymptomatic. Complications include inflammation of the testicles or ovaries, meningitis/encephalitis, and hearing loss. Before vaccine was available, most US residents had mumps infection, generally before age 15 years.
Since 1991, Iowa schools require two doses of MMR vaccine, and for 2004-05, documented compliance was 97%. Epidemic mumps control measures include: requesting at least 5 days isolation of cases, ensuring that students and staff on all college campuses have had 2 doses of MMR or are immune (positive mumps IgG), and checking the vaccination status of all health-care professionals and offering vaccination as needed.
A subsequent report indicated that some air travel passengers were in close proximity to two Iowa cases who were potentially infectious with mumps. This investigation used new software, eManifest, developed by the CDC to securely import, sort, and assign passenger-locating information to help with timely identification of exposed persons. These data are securely transmitted to state/territorial health officials via the Epidemic Information Exchange (Epi-X) Forum for notification of potentially exposed passengers.
(MMWR 2006;55(13):366-368; MMWR 2006;55(14):401-2; and http://www.idph.state.ia.us/adper/common/pdf/mumps/mumps_update_042006.pdf accessed April 22, 2006)
Comment: The new software obviously has application to any infectious disease exposure. The Iowa Department of Health has detailed mumps information for health care providers including a brief model school letter at http://www.idph.state.ia.us/adper/mumps.asp. --J.O.
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