Prevention Of Mumps

There was once a time that contracting the paramyxovirus also known as mumps was not uncommon. Prior to the production of the vaccine in 1967, reported cases throughout the U.S averaged 186,000 yearly . Since the development of the mumps vaccination program there has been more than a 99% decrease in these cases. However some outbreaks are still occurring, regardless of receiving the vaccine and due to people choosing not to vaccinate.

Mumps is a viral infection that belongs to the genus Rubulavirus in the paramyxoviridae family, so there is no cure but our immune systems will fight it and resolve it over time usually within a 7-10 day period. Even though there is no treatment for mumps we can treat for comfort with ibuprofen and acetaminophen.
Mumps is transmitted through droplets of saliva from coughing, sneezing, sharing drinks, kissing, or handling objects that have been contaminated by these droplets. The virus can be present in these droplets from six days prior to symptoms to nine days after symptoms appear, making the virus a contagious, contact disease. The most common symptoms can range from swelling of the parotid glands and salivary glands along the sides of face and jaw line with swelling and tenderness to difficulty swallowing, fever and headache but many cases can be asymptomatic. There can be serious life threatening or permanent outcomes such as sudden deafness or aseptic meningitis as well but only in rare cases.

The best way to prevent contracting mumps would be by practicing good hygiene in addition to regular hand washing and by getting the MMR vaccine.
The MMR vaccine helps protect from measles, mumps and rubella and is typically given in two doses. The first dose usually after the first year of life and then the second prior to when a child starts school. Due to more current outbreaks of the mumps a third booster has been introduced as a control measure, but only in select cases. According to the (Centers for Disease Control and Prevention) in 2013 there was 584 cases reported, 2014- 1,223, 2015- 1,057 and in 2016 forty-five states have reported cases with five of them having over a hundred cases, all totaling 2,345 as of current date. In my opinion, a significant
increase.

Between 2009–2010, there was a mumps outbreak among a highly vaccinated population in a village in Orange County, NY. “ Of the 2503 students with 2 documented doses of mumps-containing vaccine, 320 (13%) developed mumps. This is the first study to assess the impact of a third MMR vaccine dose for mumps outbreak control. The decline in incidence shortly after the intervention suggests that a third dose of MMR vaccine may help control mumps outbreaks among populations with preexisting high 2-dose vaccine coverage.” (I.Ogbuanu, Pediatrics, December 2012, volume 130/issue)

In 2015-2016 there was another Mumps outbreak at an Illinois University within a highly vaccinated population.” Among the 317 cases identified, at the time of onset, 50 (16%) mumps patients had received 3 doses of MMR vaccine, 232 (73%) had received 2 doses, 12 (4%) had received 1 dose, seven (2%) were unvaccinated, and 16 (5%) had unknown vaccination status.
Forty-five (90%) of the 50 patients with a third dose received it during this outbreak, and five (10%) received it in prior years for reasons unrelated to this outbreak. Some of the 45 persons who received a third dose during this outbreak might have been exposed before vaccine-induced immunity was boosted. Eleven (24%) of the 45 patients had parotitis onset on the same day or within 2 weeks after receiving the third dose, six (13%) within 2–4 weeks, and 27 (60%) >4 weeks after. One (2%) patient received a third dose 3 days after onset.”(Albertson JP, Clegg WJ, Reid HD, et al.2015–2016. MMWR Morb Mortal Wkly Rep
2016;65:731–734.)

Regardless of high vaccination coverage, in recent years the outbreaks have mainly affected schools, colleges, and camps.. The two step vaccination does assist in limiting the size, duration, and spread of these mumps outbreaks but is it time to consider making a third vaccination a regular part of Mumps prevention, a consistent part of protocol when dealing with an outbreak or continue with use in only select cases? People will continue to travel, continue to not vaccinate and will still live and socialize in highly crowded areas, which are all factors for a Mumps outbreak.