Alarming rise in mumps cases in the UK

Main Category: Public Health
Article Date: 03 May 2004 - 0:00 PDT

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Malcom Chisholm, Health Minister for Scotland, says he is concerned about the rise in mumps cases. He stressed that people must embrace the MMR vaccine if rises in diseases like mumps and measles are to be stopped.

Just during the first quarter of this year there were a total of 370 cases of mumps in Scotland. This is four times as many cases as in the whole of 2003. Most of the cases involved young people in their early twenties or late teens.

An outbreak of mumps appeared in Stirling University, Scotland. Everyone there, students and staff, were offered the MMR injection. In England so far this year there have been six mumps outbreaks.

England totals during the first quarter of this year are the same as for the whole of 2002 - 450 cases.

The Health Protection Agency, UK, says this rise has nothing to do with the recent fall in the number of babies having the MMR as most of the patients are young adults or people in their late teens. They are too old to have had the injection when it first came out.

Health authorities are urging young adults and people in their late teens to have the injection.

Mumps can be a disease with serious complications - it can lead to male infertility, the brain can experience serious inflammation. In some cases mumps can be fatal.

The British Medical Association said a mass immunisation campaign is needed. Their spokesman said, "If you have got a group that misses out then I am afraid that outbreaks will sometimes happen. If the uptake of the MMR vaccine continues to fall then further outbreaks will occur," she added.

WHAT IS MUMPS?

Mumps is a generalized acute viral disease caused by the mumps virus. This virus multiplies in the nose, throat, and lymph nodes; salivary glands are most often directly affected. More rarely, the pancreas, reproductive organs, and the brain can be affected.

WHO GETS MUMPS?

Anyone not previously vaccinated with at least one dose of a mumps containing vaccine on or after the first birthday or who has not developed mumps previously is susceptible. Mumps outbreaks have occurred in settings where large numbers of children or young adults congregate in close contact such as schools, child care centers, military services, colleges, and other institutions.

HOW IS MUMPS SPREAD?

A susceptible person becomes infected with mumps after being exposed to an infected person's respiratory droplets or saliva.

WHAT ARE THE SYMPTOMS OF MUMPS?

One third of persons have inapparent or no symptoms. For those persons exhibiting symptoms, they may include non-specific signs such as malaise, headache, appetite loss, or low grade fever. More specific symptoms may last about one week and include swelling of the salivary glands, tenderness in the jaw, and earache.

HOW SOON DO SYMPTOMS OCCUR?

Symptoms of mumps usually occur 14-25 days following exposure to another infected persons or their soiled and contaminated articles such as tissues or handkerchiefs.

HOW IS MUMPS DIAGNOSED?

Mumps is often diagnosed by a physician based on the clinical presentation of symptoms such as salivary gland swelling and/or ongoing mumps activity in the community. Laboratory diagnostic serologic tests to confirm the diagnosis are usually recommended since mumps is becoming less common and other conditions can cause similar symptoms; viral testing is performed less commonly.

WHAT IS THE TREATMENT FOR MUMPS?

There is not treatment for this viral disease. The entire disease course from incubation to recovery may last for up to one month.

HOW LONG IS AN INFECTED PERSON INFECTIOUS TO OTHERS?

An infected person can be infectious to others about 6 days before and 9 days after the onset of salivary gland swelling. Inapparent cases can also transmit the virus to others.

SHOULD AN INFECTED PERSON BE EXCLUDED FROM WORK OR SCHOOL?

Persons with mumps should generally be excluded from school or the workplace until at least 9 days after swelling onset if other susceptible persons are present in the setting.

HOW CAN MUMPS BE PREVENTED?

A mumps live virus vaccine given by injection has been available since 1967.

Mumps can be prevented by receiving at least one dose of a mumps containing vaccine, preferably the combined measles, mumps, and rubella (MMR) vaccine on or after the first birthday. This one dose is 95 percent effective at preventing disease.

Mumps can also be prevented by avoidance of sharing drinking or eating utensils with others and by avoiding contact with soiled and contaminated tissues and similar articles of nose and throat secretions from infected individuals.

ARE THERE ANY SIDE EFFECTS TO THE MUMPS VACCINE?

Mumps vaccine is one of the safest viral vaccines. Rarely rash, swollen salivary glands and fever have been reported. Persons with severe allergies to eggs and neomycin should only be vaccinated with caution in an appropriate medical setting. Persons with certain impaired immune system conditions should not be vaccinated without first consulting a physician. Pregnant women should not be vaccinated based on theoretical concerns.

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