mumps

Mumps can be prevented with routine vaccintions

By: Les Reiss, M.D.

It's been a long time since the mumps were in the news, but recent outbreaks of the disease in Iowa and other parts of the Midwest have people talking – and reporters writing.

The Center for Disease Control reported that as of April 20, over 1,100 cases of mumps had been confirmed with more being expected in the coming weeks. Of the reported cases, most occurred in Iowa, with other cases reported in Minnesota, Nebraska, Kansas, Illinois, Wisconsin, Missouri and Oklahoma. This is the largest outbreak since routine mumps vaccination started in the United States in 1967.

Mumps used to be a common childhood illness in the United States. Since widespread immunization began in 1967, the number of cases dropped dramatically. In 2002, for instance, only 270 cases were reported.

Mumps is a virus
Mumps is a virus that enters through body through the nose and throat. It can be airborne, spreading through respiratory droplets formed during a sneeze or cough. It can also be spread by contact with saliva or contaminated objects such as tissues, hands, or telephones.

The disease typically has an incubation period from two to three weeks. Usually infected people are contagious up to a week before their first symptoms appear, and remain contagious for another week to 10 days.

Some people may have mumps and not even know it because they experience no symptoms. Most people, however, do feel the effects of the mumps virus. Symptoms, which last about 10 days, include swelling and pain in one or both of the parotid glands, which are located between the ear and jaw. One or both cheeks may appear swollen. Although this is considered the classic symptom of mumps, only about 30 to 40 percent of people with the disease experience this swelling. A person with mumps may also have an elevated body temperature (from 101 to 104 degrees F), headache, earache, sore throat, pain when opening the mouth or eating sour foods, tiredness, muscle and joint aches, poor appetite, and vomiting. Men may experience swollen and painful testicles.

Treatment
Mumps is typically treated with rest and care at home. Over-the-counter medication to relieve pain and swelling (such as Acetaminophen) may be given. An ice or heat pack (whichever feels better) can be used on the swollen jaw. It is not necessary to isolate the infected person, because by the time mumps is diagnosed it is likely that all household members have already been exposed. Children and adults should not return to work, school, daycare, or public places until three days after their swelling has gone down.

If you or someone in your household has the mumps, contact your local health department to report the disease. If you visit your doctor, he or she will report it for you. This ensures that accurate records are kept regarding prevalence of the disease.

While most people recover fully from the mumps, complications requiring hospitalization can occur. Rare but serious complications include deafness, sterility, pancreatitis, encephalitis, and miscarriage. Contact your doctor immediately if you have symptoms of a stiff neck or severe headache, painful, tender testicles, or abdominal pain.

Prevention
The best way to prevent mumps is by being vaccinated against the disease. The mumps vaccine is routinely combined with vaccines for measles and rubella, and is commonly referred to as the “MMR.” The Food and Drug Administration recently approved a new vaccine called the ProQuad that contains the original MMR vaccines as well as a vaccine for chickenpox. It is recommended that children receive two injections of either the MMR or ProQuad in order to provide lifelong immunity. The first is given between 12 and 15 months of age; the second is recommended between four and six years of age. Children younger than 12 months do not usually contract the disease, probably because of temporary immunity acquired from their mothers during fetal development.

Adults born before 1957 are considered immune to the mumps. Adults born after 1957 who had the disease during childhood are also immune.

When it comes to the mumps, the best offense is a good defense – in the form of following routine vaccination recommendations. If you or your children need to update your immunizations, or if you have questions about the status of your immunizations, contact your doctor as soon as possible.

Dr. Reiss is a board certified family practice physician at Raiter Clinic.